Management of flare-ups in chronic pain

Management of flare-ups in chronic pain


A flare-up is basically defined as an episode of intense pain, in which the chronic pain abruptly increases for a brief duration. In this section, we have discussed some of the most important steps that can be taken for the management of flare-ups of chronic pain.

Distraction – Concept and Techniques

Distraction refers to the process of diverting one’s mind to any other object, activity or event in order to shift the awareness of the pain to something else. Instead of allowing the pain to dominate the mind, it is important that the awareness and focus of mental attention be shifted elsewhere.

Either the process of distraction can involve doing some different activity, also known as action strategy or it can also be purely mental and psychological. These generally involve imagining activities of the following types:

  • Relaxing and enjoyable activity, such as fishing, swimming etc.
  • Stimulating activity, such as meeting a new romantic partner
  • Realistic activities, such as preparing a shopping list
  • Fanciful ideas, such as imagining that you’ve won a lottery and planning what you’ll do with the money

In addition, some people will even like to design, assemble or construct some ideas in their minds, e.g. designing the floor plan for a dream house or a new workplace.

Intense Pain and Distraction

Since the pain can become very intense in some cases, the technique of distraction has to modified from the above explained method.

The approach of mindful awareness and constructive response strategy has to be adopted in such situations. Mindful awareness basically implies that the sufferer acknowledges pain, identifies where it hurts and how it feels like. However, he/she does it in such a positive and constructive manner that such acceptance does not contribute to further suffering. In this section, we have listed some of the most useful Mindful Awareness and Constructive Response strategies for the purpose:

  1. Encouraging self-reminders
  2. Prayer and spiritual approaches
  3. Modify the meaning of chronic pain flare-up
  4. Pain modification imagery
  5. Detached pain awareness
  6. Radical acceptance

Activity Level

A chronic pain flare-up has a strong impact on the entire body. In addition, the sufferer’s mind and overall sense of well-being comes under a cloud. For effective management of such chronic pain flare-ups, it is important that the whole pattern of the daily routine be altered and the management of pain be made the first priority.

Towards this end, it is extremely crucial to modify the activity levels pursued by the individual concerned. Experts suggest that if you are suffering from a flare-up of chronic pain, you must cut down on your daily activity by at least 25% of the normal activity level.

Further, the activity level must be designed and reduced according to the specific disease associated with the chronic pain. For instance, if the pain stems from the left arm, the load can be reduced on it and the right arm can be used more. However, if the pain is associated with the leg, the overall activity has to be reduced to a greater level.

Stay Positive

To be in the right position to handle a chronic pain flare-up, it is important that you always try to steer away from negative thoughts. Research shows individuals who make a conscious attempt to avoid negative and self-defeating feelings are able to handle the flare-ups much better.

It is crucial that you learn to catch any stem of a negative thought the moment you realize it creeping into your mind. Here we list a few pointers for you to watch out for. Such thoughts are extremely negative, self-defeating and debilitating and should be nipped in the beginning itself.

  1. I am to blame for my pain.
  2. I am creating a problem for my family/friends.
  3. Life is extremely unfair.
  4. I don’t deserve this.
  5. My pain is imaginary.
  6. My doctors are ignoring me intentionally.

Soothing and Relaxation

Attitude and the state of mind go a long way in helping the sufferer handle a chronic pain flare-up. It is important for an individual experiencing a flare-up to be able to sooth himself.

Music is the most effective way to soothe the nervous mind and irate senses. Besides, when undergoing a pain flare-up, try to focus your mind on something that will have an immediate calming effect. This can include visualizing a beautiful countryside, thinking of happy memories, planning for a cherished holiday and many more.

Relaxation is also equally significant for those suffering from chronic pain flare-ups. The best way to relax in a chronic pain flare-up is to practice deep diaphragmatic breathing that helps you stay calm and also focus on the management of your pain.


The pattern of medication has to be changed at times in accordance with the pain flare-up. It is important that you make a note of important details like the medicine name, dosage, frequency and alternations required beforehand. Such details should be based on previous experiences and adequate consultation must be done with your healthcare provider for the purpose.