Flare-ups are distressing and not always avoidable. Planning to get through them can give you some control and lessen their impact.
What is a flare-up?
Fibromyalgia flare-ups are periods of increased symptoms in the form of more pain, more fatigue or other common symptoms that can last from hours to weeks.
Most often these flare-ups are not because of new damage or disease in your body. Rather, they arise from an increased level of sensitization of your central nervous system and/or other systems of your body and brain that are already responsible for your Fibromyalgia symptoms.
Read more on the free “Understanding Fibromyalgia” resource.
Why are you having a flare-up?
Sometimes you can identify obvious triggers for your flare-up – perhaps a stressful event, an infection, extreme changes in the weather – that you can intentionally avoid or manage in future. Sometimes you can’t.
Flare-ups may also start for one of these reasons but continue for others, like:
- the stress of the increased pain
- the negative impact of being less physically active
- the uncertainty about when the flare may ease
- the anxious pursuit of relief (with a new exhausting round of healthcare appointments, investigations and interventions!)
With intentional and consistent self-management of your Fibromyalgia it is possible to reduce the frequency, duration and intensity of flare-ups and their impact on your daily functioning. Nevertheless, flare-ups may reoccur after years of living relatively symptom-free or coping well.
So, what can you do when you are having a flare-up of your Fibromyalgia?
FLARE-UP steps to take
F – Forgive yourself for not “getting it right”. When that flare-up comes, you may be tempted to mentally list all the things you should or shouldn’t have done preceding it. This can get you stuck in self-blame. Flare-ups are not about past failures. Focus instead on what you can do now to move forward through it.
L – Let go of some tasks. Moving through a flare may require lightening your load for a while. Identify the work tasks, domestic chores and other responsibilities you could delegate out to others over this time. Negotiate reasonable work accommodations with your employer ahead of time to minimise conflict or confusion when you least need it.
A – Accept your current experience. Acknowledge your current experience and adopt a willingness to respond, rather than react, to it. This means taking considered action instead of either giving up in hopelessness or fighting it in frustration (both of which can prolong flares). Choose to follow your sense of purpose and a plan (see below), not the pain.
R – Rest more – but not too much! It may be necessary to slow life down but don’t stop altogether. Too much passive rest (e.g. bedrest) quickly results in deconditioning of your muscles, joints and bodily systems and interrupts the circulation of your internal pain-relieving chemicals.
E – Exercise at an adjusted level. Reduce your physical activity levels somewhat in intensity or duration but continue doing daily movement. This can be any fun, physical activity that fits with your lifestyle and routine. Regular movement breaks throughout the day are also important.
U – Upgrade your use of comforting and calming strategies, like heat and other sensory techniques, deep breathing, meditation, somatic practices and distracting activities. Use medication sensibly over this time by taking these as prescribed but checking with your prescriber about using additional over-the-counter drugs.
P – Plan ahead by creating your personal flare-up plan. This is helpful to follow when pain becomes all-consuming and fibrofog interferes with your problem-solving and decision-making. Your plan can include notes on activities, strategies and medications to reduce or increase during a flare. Also note the contact information of the trusted team of practitioners and other people you could call on for extra support.
Once your flare-up eases, gradually return to your previous level of physical activity and resume the activities and roles you had delegated.
Feel free to get in touch if you need guidance on creating your Flare-up plan.
Source: Your Pain Playbook – Helen Roome, 2023.