Managing your flare-up

A flare-up is when the symptoms increase for a period of time. Sometimes it is clear why this happens such as after new activities or exercise, an increase in activity levels, when you are unwell, stressed or fatigued. In other cases there is no obvious reason as the routine has not changed and you cannot think of a reason why the pain has worsened.

Your brain will know why as it is responding to a potential threat. The brain is constantly monitoring the body and the environment through the senses and other body systems (e.g. endocrine, immune) and responds accordingly. Visual input has a significant effect and when we see others moving in a particular way or doing certain tasks, a threat value can be determined even though it is not ourselves doing it! For example, observing someone bend over and pick up a heavy box can evoke pain in our backs. The message is that our pain and perception of our body can change in response to things that we see.

So what do you do?

To manage a flare-up actively means that you can ride the storm more effectively and also learn about the process for greater effect if there is a further flare later on. In essence it is trying to remain active but tolerably.

1. Continue to break up sustained activities into chunks (pacing) as instructed by your therapist in terms of the timing. I would suggest as a ball park figure that 50% of the time it takes for the pain to enforce a change or cessation of activities should be a start point.
2. ‘Little & often’: change position, move affected body part (avoid the area stiffening and provoking a worry about then moving) and other areas.
3. Use your prescribed exercises but in a calm way, i.e. Relaxed or meditative breathing before to ‘calm the seas’, think positively rather than dwelling on negative thoughts that can evoke other brain responses. Be flexible in the repetitions, for example, split the sets into shorter bouts but spread out over the day.
4. Before moving the affected area or undertaking the exercises, move regions that are remote or on the other side first. For example, if it is a foot problem, move the other knee and foot first, or the hip and knee on that side initially.
5. Pain relief as prescribed
6. If you are feeling unwell with a flare-up, manage as if you are sick. Your body is in a restorative mode and you must treat it as such, including rest periods.
7. Remember that this flare-up will pass.

Take the advice of your health professional in terms of the timings, repetitions and exercises. All activities should not be causing further increases in symptoms. It should be tolerable.

Little and often
Motion is lotion
Be consistent with your activities

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