How to create a pain flare plan that works for you

Chronic Conditions
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What are flares?

A flare is a period of intense pain or increase in symptoms which is more severe than day-to-day chronic pain. Flares can last hours or days and often, there’s no set pattern. They can come on quickly, without warning, and it can be difficult to pinpoint why. 

Flares are one of the biggest challenges with living with chronic illness.

They upregulate the nervous system and put the body into ‘fight-or-flight’ mode, making it harder to make smart decisions to manage and ease the flare. For that reason, it’s really critical to have a plan in place before a flare hits.

What is a flare plan?

A flare plan is a tool that helps you deal with flares when they happen.

When you write your flare plan you have anticipated what will happen with a flare, thought about how to best reduce the impact and have a clear checklist to follow. So, when you’re in a flare and you can’t concentrate, you know exactly what you can do to ease the pain.

Every person’s flare plan is unique because everyone’s experiences, triggers and management techniques are unique.

Your plan will get you thinking about what is most effective for you.

Creating a fare plan

Creating a flare plan gives you a good reason to step back and take a look at your condition. 

What are the self-care things that are most helpful? These are the things you can do to help reverse a flare, but also what you can be doing consistently to prevent one in the future.

Who are the medical practitioners who give you the most help? Who do you feel the best after seeing? Is there a part of your medical team that you’re missing? Having your team in place prior to a flare makes it easier to know who to call when you feel it coming on.

What are the foods that you really enjoy, that you know are safe, and that are easy to make?  Maybe you always have the ingredients on hand, or make something you enjoy and freeze it for future use. You want to be confident in what you’re putting into your body during a flare.

Below are some flare busting examples across different categories for you to think about including in your plan, but you know your body best – it’s important that you consider your own needs and circumstances to come up with your unique flare busting plan that will work for you.

Personal flare busters

Start by writing down your top three personal flare busters. Use the examples below or come up with your own.

Personal flare busters are things that you know bring benefit to your body and are entirely in your control. They are things that you can do yourself and can make a significant difference in symptoms. 

These are your first line of defense. If you feel a flare coming on, or are in the midst of one, start with these to minimize the impact.

Examples:

  • Deep breathing
  • Warm bath
  • Meditation
  • Yoga
  • Skin rolling
  • Trigger point release
  • Pelvic floor stretches
  • Support group meeting
  • Pain medication

Medical interventions

Next, let’s look at what medical interventions provide the most relief for you. This is where you want to think about what interventions provide you with the most relief. 

When you feel the flare coming on, book an appointment for one of your interventions as soon as possible. Get on a waitlist, or (politely) continue to call to see if they can squeeze you in. The earlier you can catch a flare the less time it has to build. This is the time to use the experience of your medical team!

Patients often feel like they shouldn’t attend a regular appointment because they’re in a flare but it can be the most important time to get help. Not only can your medical team begin to reduce your symptoms and break the feedback loop of the flare, but it also gives them more insight into what is going on. They want to be able to see you and help you when your symptoms are at their worst.

Examples:

  • Physical therapy
  • Acupuncture
  • Breakthrough pain medication
  • Bladder instillations
  • Massage

Safe foods

Next, make a list of foods that you know are ‘safe’ foods for you. These are your ‘go-to’ foods that are healthy, easy to prepare, and that you are confident won’t further flare your symptoms. This can be especially important if your condition is sensitive to diet. You don’t want any additional fear or anxiety around what you’re eating and drinking during a flare.

You need these to be easy to make because when you’re in a flare you probably aren’t feeling like going to the grocery store to grab 14 ingredients or spending the whole day in the kitchen!

The aim is to eliminate food/drink triggers that are a contributing factor so we can get to the root cause of the flare.

After the flare

Sometimes it’s really clear what has caused a flare. Maybe it’s eating a trigger food, or a new stressor in life, having to get on a long flight or stopping your physical therapy home program.

Often it’s a combination of several different things that combine to cause the issue. Other times, it seems to come out of the blue. You may not have eaten anything unusual or remember changing any of your habits.

Understanding the flare gives you power over it, and can help prevent future issues.

Your physiotherapist or physical therapist should work with you to help understand the cause.  They’ll talk to you about the details of what you’ve done and consumed up to several days prior to the flare to help you identify contributing factors like stress, a new exercise, a long drive, a specific food/drink, etc.

You want to have that same mindset when trying to understand the cause of your flare for yourself. For some flares, you may never know, but it’s important to be thinking about why it came on.

From pain research, we know that when pain is caused by something we don’t understand, we actually feel worse than if we have an explanation. When we understand the reason behind a flare we take back control of our health. It also helps us prevent future flares.

Keeping a symptom log can give you a more accurate picture of your symptoms and can be beneficial for your healthcare provider to see when your symptoms actually started to flare, how much of an increase you’ve noticed, and which symptoms are flaring. Sometimes it can provide an important clue to what treatment will be most effective in reversing the flare.

Remember, a flare is – by definition – temporary

It’s really hard to remember when you’re in the midst of one, but a flare is a transitory event. It doesn’t mean you’re ‘back to square one’ and that all the progress you’ve made is undone. This isn’t the new normal.

When you’re in a flare, the goal is to reverse the flare and get your body back to its new, healthier normal point. A flare is frustrating, but it doesn’t wipe out the progress you’ve made.

Having a plan in place before a flare is essential in managing it and minimizing the impact. You can download a copy of the free Personal Flare Busting Plan.

You can also check out our recent live interview where we discuss pain flares and how to manage them in even more detail.