A quick word on…the flare up

When pain flares up we need ways of dealing with the increase in symptoms, the distress that this can cause and the impact upon day to day living. If we could look inside our brains when a flare up is in full swing we would see a storm of activity in many areas, especially the sensory and emotional regions. These parts of the brain let us know where the pain is in our body and try to make sense of the situation – the meaning of the pain.


To deal with a flare up takes knowledge and understanding of pain so that best choices can be made. Undoubtedly a flare up can be influenced heavily by worry and anxiety that is often underpinned by a fear of what the pain means. In the early stages of a treatment programme, pain and its influences must be explained and be understood, creating fertile ground and context for exercise and other strategies to be employed most effectively.

Flare-ups are common and not to be feared but to be dealt with. Anyone who has increased their exercising or re-started a gym programme is familiar with the feeling of increased pain and stiffness subsequently. This is a normal body response to a physical demand. A flare up can be an amplified version of this response to a new activity, an increase in activity, to a stressor, change in health, fatigue or sometimes it is not obvious.

Nothing happens in isolation, inlcuding flare-ups or sharp, sudden pains – there is a build-up with the moment of awareness being the point when the threshold of sensitivity is reached. The questions to ask are what have I been doing and how have I been feeling?

How can we calm the storm? Remembering that there are many parts of the brain involved in the pain state, including the sensory regions, emotional centres, areas that play a role in homeostasis and the motor centres, we can seek to change the activity with a range of strategies. This can include activity modification (e.g. changing the training parameters, altering the time of day, even the room and other contexts), active rest periods (breaking up activities into sections including having rest breaks), relaxation (e.g./ breathing, music, gentle stretches), mindfulness based stress reduction and distraction*. Clearly each individual will find that a different blend of the techniques that work for them at different times. Some flare-ups last for a day or two and sometimes longer with a more aggressive response to what may seem to have been an innocuous activity. This can of course be frustrating and indeed worrying but it is important to remember that flare-ups do come to an end (even if you have to keep reminding yourself) and that more angst often triggers further physical responses and pain.

If you are unsure about your flare-up or symptoms, contact us here or speak with your GP.

* Examples of strategies that we teach on the treatment programmes – learn more here


The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about pain should consult with a qualified healthcare professional

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