Managing flare ups

While I have been self managing my chronic back pain now for over 6 years, I still get flare ups. I was never under the disillusion that my pain would go away. So now when pain looms, I use my flare up management strategies. I know just what to do.

Even though it can be worthwhile to reflect on the reason (i.e. Did I over do it? Have I been neglecting my daily stretches? Did I stand or sit for too long without moving?) I am less focused on trying to figure out the cause of increased pain. I find it’s more important to launch into action.

So here is my step by step approach to managing a flare up:

Accept. Often my flare ups are still caused by overdoing it! Yes, I know all about pacing, taking breaks and have a good understanding of my own limitations but sometimes I still push through and over do it. But rather than beat myself up with guilt and blame and anger…I just stop, nourish, repair, move on. I also am much more willing to accept and just acknowledge that sometimes it is OK to have a bad day (I give myself a free pass - more on this soon). Also by simply accepting the pain, I am less likely to buy into negative, unhelpful thoughts which could develop into a snowball.

Plan. I need to make sure I communicate and get help if I need it. I know my bad flare ups last maximum of a day or two. I can deal with that. Two days is not a lifetime.While this may cause a problem if I have commitments/events, I just accept that my plans may need to be re-scheduled, re-organised or prioritised.   I will work simply from a daily plan worksheet, breaking my day into small manageable chunks with lots of breaks and only the necessary jobs (of which, walking, stretches and exercises get top billing!).

Act.  I have a list of activities I can do that I know will turn down my pain dial. I choose one of these and act. I don’t rest anymore or ruminate or wallow in my pain (that gets you nowhere or backwards - fast!). Your loved ones will soon recognize flare ups coming on too and if you share your flare up action plan with them, they can help. My daughter has told me I needed to do some stretches when I told her my back was sore. My husband often tells me it’s time to go out for a walk or he sends me to my room some meditation time. So I will go sit, stretch, breathe, relax. Remove some of the mental clutter. I need to do activities that turn the dial down. Here are some examples of things that work well for me:

Helpful thoughts

Relaxation/meditation

Stretching

Going for a walk

Listening to a motivating podcast/music or reading book

Awareness (posture, thoughts, activities)

Pacing (take breaks)

Carefully preparing a nourishing meal/snack

Be: I re-connect with the present moment, I cannot change the way things are right now so if I practice mindfulness and be aware of what I am doing, I can resume my normal day to day  activities much more refreshed and ready to cope with the current situation.

What do you do? A flare up action plan might be a good starting point. Take note of helpful thoughts or activities that you know turn down your pain dial and be aware of pacing cues, timing and taking breaks.