When you live with chronic pain, it becomes part of your life. Every day, it’s there, and you deal with it. That’s the nature of the beast. However, when the beast becomes unruly, and you experience a flare-up of your condition, managing that intense spike in pain can be challenging. A lot of times, pain sufferers turn to the ER to control their pain.
The ER focuses on life-threatening and acute injuries and illnesses. Any leftover resources are devoted to managing non-life threatening issues. Many times, there are no leftover resources, and non-life threatening issues, like a chronic pain flare-up, must wait… and wait… and wait.
Once they do get seen, they don’t always find relief. First, they battle the stigma of drug-seeking and chronic pain complaints. Long time abuse of the system has left many caregivers jaded, and they struggle to see past their preconceived notions. Once that battle is won, then comes the treatment itself.
Chronic pain flares are notoriously hard to conquer. It can take several different therapies and/or medications before any progress is made. In the meantime, the patient continues to hurt. In short, the ER is the last place you want to go to manage your chronic pain.
Flare-ups will happen. The key to managing them and avoiding the ER lies in day-to-day management of chronic pain.
- Know your triggers: We’ve all heard the joke about the guy that goes to the doctor and says, “Doc, it hurts when I move my arm like this.” The doctor says, “I’ve got the cure! Don’t move your arm like that!” While this might be oversimplifying things, it is crucial to understand what triggers your pain. One of the best ways to identify triggers is to keep a pain journal.
It’s very difficult to look back over weeks of ups and downs with your pain without having reliable documentation of what the journey was like. Our memories easily get confused as time passes. With a journal, you’ll be able to clearly correlate your symptoms with causes and look for patterns within your pain. This can be powerful information and a huge step in being able to avoid flare-ups.
- Follow your treatment plans: When you establish a treatment plan with your healthcare provider, it’s paramount that you follow it. Take medications as prescribed and alter behaviors as necessary. Without following the provider’s advice and engaging in your treatment plan, flare-ups will be more frequent.
- Don’t wait: Sometimes, flare-ups come on quickly and turn bad even faster. However, a lot of them start gradually, and people can feel them coming on. Try to get in front of the flare-up by paying attention to the signals of an impending episode and taking action early. Once the pain gets past a certain point, it can be very difficult to control.
- Don’t overreact: Flare-ups can be frightening. People worry that something has changed in their condition. Sometimes people are concerned that the pain won’t go away. Flare-ups cause increased depression and anxiety, which only add fuel to the fire. Flare-ups are rarely a result of some significant degeneration in a patient’s condition or herald impending doom. They’re simply part of the chronic pain journey. It’s essential to maintain perspective.
Unfortunately, you can’t just think your pain away with positive vibes. However, you don’t have to let a flare-up pull you down. I always tell my patients they have to play head games with themselves. Everyone has something that makes them feel better. For some, it’s music. For others, it’s scripture or a photo of their grandchild. Identify one thing that can always make you smile and focus your energy on that instead of catastrophizing your flare-up.
- Moderation: Chronic pain flare-ups often result after a marked increase or decrease in activity. Some days you just don’t feel like getting up, and some days life demands more than you ought to give. It’s just the nature of living. However, there will be a price to pay on the other side. Instead of going all out on either side of the spectrum, pace yourself and aim for the middle.
On the days you don’t feel like getting up, do ½ your normal activity rather than none. Know when to ask for help if your burden is getting more than you can bear. Your body will tell you when you’re asking more than it can give. It’s ok to say no, and it’s ok to ask for help. If you know you’ve pushed the envelope too far, be sure to be aggressive with your flare-up plan. The earlier you initiate it, the shorter the flare-up should be.
- Have a plan: I suggest working with your healthcare provider to establish a plan for flare-ups. Identify the things that improve your pain. If your plan includes pain medication, take it early in the process. Oral pain relievers are not particularly effective with pain that has gone past a certain point. You want to take them before that point. Also, consider ice and/or heat. Topical pain relief can help certain situations, and a bland diet or herbal tea might be called for in gastrointestinal issues. Rest, meditation, music, and distractions are also excellent tools to use in dealing with flare-ups. Make your plan ahead of time and employ it at the first sign of a flare-up.
- Know when to go: If a flare-up is accompanied by new symptoms or brought on by a significant event, like a fall or car accident, then it would be wise to seek medical advice. It’s always best to contact your primary healthcare provider first. However, if they are unavailable or if your symptoms are very concerning, then you might have to go to the ER or an urgent care clinic. You must be very clear about what is new or different about your pain. Be detailed and share your medical history and medications with the ER staff. Also, share everything that you’ve done to control the situation before going to the ER, including attempting to reach your primary care provider.
Flare-ups come to everyone with chronic pain. The Pathways app (download links below) has several tools, including a pain journal, exercises, and distraction techniques, that can help you through your flare-ups. Remember, there is always a backside to the flare-ups. It will end, and you will find relief.
Please note: This article is made available for educational purposes only, not to provide personal medical advice.