Flare Ups: Make a Plan

Flare Ups: Don’t Panic, Make a Plan

Medical advice these days for back pain flare ups is to ‘keep active’. Much better than what they used to advise, which was bed rest – that’s a recipe for going downhill.
However. if you are really suffering, this sounds like you are being told to soldier on without making allowances for the pain. The general principle is sound – try and minimise the impact pain has on your life and activity levels and you will recover quicker. That’s true (lots of science behind this) BUT you are allowed to acknowledge you are in a lot of pain and adjust accordingly.

My advice: Make a Plan for Flare Ups

Ideally think about this in advance, if you are prone to episodes of back pain, or you have chronic (persistent or ongoing) pain that goes up and down.

Firstly: Don’t Panic!

Flare ups get better, it is likely this will settle down in a few days to weeks. Often after a couple of weeks it can seem like it will never get better and this is what you are going to have to live with forever. Do your best to calm this way of thinking, as worrying will ramp up your experience of pain.
It may take longer than you would like, maybe 4-8 weeks sometimes, but it will pass (or settle down to what is ‘normal’ for you).
If you are still struggling after that time or you just can’t get the worry out of your head, go and see your G.P.*

What should my Flare Ups Plan include?

It’s good to think about a plan on two levels : crisis – the absolute worst days, and recovery – how to manage for maybe 2-6 weeks to help everything to settle down.

Firstly give yourself a break. What you can ditch for a while when it’s all too much?
Keeping active doesn’t mean powering through and doing lots of stuff that aggravates your pain!
It does mean you still need to move even if it is painful, but you are allowed to reduce the amount and intensity of movement for a while IF it is making your pain worse
Try and reduce anything that is making pain worse – if that is sitting, then standing while on the phone, or balancing the laptop on a shelf. If lifting things gives you a sharp twinge everytime, avoid it for a couple of weeks, and gradually introduce.
If this all sounds obvious: well it is. But we often have pressures put on us, or we put on ourselves to carry on despite lots of pain. Or conversely, if we tell people we have pain they won’t let us lift anything ever again! Learning to trust your own experience – to keep going, and build back up again, but within the limits of what you can tolerate, can take a bit of thought and practice.

Rest and Comfort

Having pain is unpleasant so give yourself some comfort and recovery time. Pain is produced by the body and mind together (for more on this see here), so treating yourself gently actually really helps you recover. Hugs from humans and animals are a great resource to tap into : a good cuddle gives you a hit of the hormone oxytocin, which is calming and comforting. If there are no handy humans, a phone call with someone who really cares about you will do the same job.

Example Flare Up Plan

Note these are JUST examples, you have to think what is appropriate for you, and adjust according to how bad the flare up is. What is stressful or pain provoking in one person, may not be for another. What you can actually change will depend on your commitments and support.So your plan is going to be very personal to you.
Notice the doing less column is the longest one! However, avoid dropping those things that are good for you for any longer than a couple of days – self care isn’t about eating chocolate and having scented candles round the bath  (though that can be a bit of comfort short term), eating well and being active are big parts of looking after yourself. Not all the things that you might want to skip will be physically difficult either: think of things that are draining or stressful: are there any that can be avoided or shared with someone else for a bit?

 Crisis: a few daysRecovery : a few weeks
Doing LessNo cooking (healthy freezer meals ready? Someone else can cook? Or just beans on toast )Absolute minimum cleaningSkip meeting (or leave early – too much sitting)Ask my brother to check in on  DadHoover the house one room at a time, do it less oftenNo heavy work in the gardenNo long drivesNo commitments at all at least one day each weekendAsk someone else to take Dad to his weekly club for a few weeks.
ComfortHot baths
Extra hugs on demand
Stick on heat pad (have some ready)
Time alone with a good book
Hot water bottles
Phone friends, meet for a cup of tea or a pint (they can come to me for a couple of weeks, tell them it will have to be a short  meet up as I can’t sit for too long )
Nice scents at home
Wedge cushion on seat at work so can vary seating position.
Potter in the garden because I enjoy it, but make sure don’t do anything for too long (put timer on my phone to make sure I don’t over do it!)
Semi supine 3 times a day. x 10 minutes.
(In the office at lunchtime, when get in from work, and after dinner.)Lie on floor to watch TV or listen to an audiobook rather than sit on the sofa using my laptop.
Semi supine at least once a day, twice when I can.Make sure I get plenty of sleep, have a regular bedtime.
ExerciseNo Yoga – short walks insteadGet up more often at work so not sitting for too long.Avoid aggravating movements in Yoga Class (speak to teacher).
If that isn’t possible go swimming instead (play this by ear, keep up activity, but change to something more gentle if needed)Keep up regular movement breaks at work.Partner to take dog out in the evening on lead because he pulls sometimes and that sets pain off again – I’ll just do offlead walks for a few weeks.

Hopefully having a plan will help you feel more in control and help the pain pass more quickly. When you are ready you can have a bit of think about what might have caused the flare up and therefore how to avoid them in future (see here). Sometimes they are mysterious or unavoidable unfortunately, but there are lots of things you can do to help yourself be more resilient.

If you want to work on your resilience to avoid pain flare ups, or want help with managing a pain flare up: get in touch

*This blog is not medical advice. If you have had an injury, or are concerned with new or increasing pain, please see your G.P.

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