Tips On Managing A Flare-Up.

Flare-ups are inevitable with Fibromyalgia and other chronic pain conditions. A flare-up is when symptoms temporarily increase in intensity or the number of symptoms experienced. I've had flares that lasted a day or two after strenuous activity to as much as numerous weeks for seemingly no good reason. I used to fear causing a flare by doing too much. I also used to fear flares themselves and the anticipation made the experience worse! I was living in trepidation of when the next flare would hit all while ruminating about its possible severity and duration.

When I attended the Chronic Pain Self Management Program at Constance Lethbridge we talked a lot about pacing ourselves, prioritizing tasks and then when a flare-up did come on despite our best efforts; we would put our flare-up self management plan into effect. A plan that involves both trial and error. Experimenting with different techniques to find what works best for you. My set of strategies can look very different from yours but below I'll show you an example of the things that work best for me.

1. Heat (as opposed to ice which makes me tense up for the most part)

2. Walking (I walk every day but I cut back on the steps that I do normally which is between 10,000-12,000 and just focus on moving my body)

3. Watching tv/movies that make me laugh (I love watching stand-up comedy with my husband)

4. Prioritizing what is actually important in the here and now (I delegate or delete things that aren't)

5. Deep breathing (stopping regularly throughout my day to take three or so deep and slow breaths)

6. Prioritizing rest (as someone that hates sitting around I make sure to stop and do just that as I need it)

Your list of strategies can include any of these or so many more, the sky really is the limit! Here are some more ideas on how to self manage a flare-up and make your own plan:

- Applying ice/heat (magic bags, rice bags, ice cubes in a plastic bag, a bag of frozen vegetables, a heat pad, etc.)

- Using gentle movement/exercise (walking, stretching, swimming, biking or a gentle strengthening program designed for someone with chronic pain in mind, etc.)

- Breathing exercises (deep breathing or diaphragmatic breathing, 4-7-8 breathing, box breathing, equal breathing, etc.)

* I will link websites with specific instructions below.

Deep Breathing - https://www.uofmhealth.org/conditions-treatments/digestive-and-liver-health/diaphragmatic-breathing-gi-patients

4-7-8 Breathing - https://www.medicalnewstoday.com/articles/324417

Box Breathing - https://acclaimhealth.ca/four-square-breathing-technique/

Equal Breathing - https://www.healthline.com/health/breathing-exercises-for- anxiety#equal-breath

- Relaxation Techniques (progressive muscle relaxation, mindfulness meditation, guided imagery, etc.)

* I will link some tutorial on how to complete the relaxation techniques mentioned above but there are so many videos out there too, feel free to check out YouTube for more inspiration.

Progressive Muscle Relaxation - https://www.healthline.com/health/progressive-muscle-

relaxation#beginner-tips

Mindfulness Meditation - https://www.mindful.org/meditation/mindfulness-getting-started/

Guided Imagery - https://www.medicalnewstoday.com/articles/guided-imagery#step-by-step-guide

- Listen to music (the world is your oyster, from hip hop to classical and everything in between)

- Watch movies or tv shows (this may include any movie or show that you love but I'm a fan of anything that makes me laugh because it keeps my mind off of the pain)

- Keep a balanced schedule by prioritizing the things that are important or need to be done and delegating or deleting the others. Read more about that here.

- Do something enjoyable (call your mom, write in a journal, paint a picture, send a snail mail letter to cheer someone up, etc.)

- Positive affirmations (using statements that challenge unhelpful thoughts or using positive phrases about yourself, for example: "this pain is temporary and I will soon feel better" or, "I am strong!"

- Rest (there's nothing wrong with a little rest or a short nap when you need it)

- Medications (check with your doctor)

Even though flare-ups are unavoidable that doesn't have to make them all consuming. Start to take notice of the tell tale signs of a flare-up. These signs can manifest as gradual increases in physical pain, tension, feeling irritable or depressed and not wanting to engage in social activities like you normally do. You can also start to identify your triggers or the events or situations that lead to a flare-up. Also knowing that you are not in any immediate danger helps quell the fear that the pain is threatening or harmful. Know that this is temporary, this is key.

When the flare-up hits make sure to use all of your pain self management strategies to help you get through it. Think of it as a tool box of helpful aids. Reach for it when you need it and don't hesitate to share with family and friends so they know what to do to support you. This too shall pass.