MANAGING FLARE UPS FOR CHRONIC PAIN

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For those of us who have experienced chronic pain we know it can be a long and often confusing journey as we try to find that perfect state of balance, where we are living life to the fullest without causing flare ups in our problem areas.

Sometimes you might feel like you’re winning, and you almost cross your fingers or touch wood as you realise you’ve had a great period where your routine has been working for you.

Almost inevitably, however, it seems as though that fragile balance can be far too easy to disrupt. Whether it be a holiday away or more stress at work that ends up disrupting your routine, you are faced once again with a painful flare up and it feels like you’ve taken two steps backwards.

What is important at these times is to understand the body processes driving these presentations. Chronic pain in the absence of disease (think auto immune/inflammatory conditions) is almost always caused by a historical traumatic event that has left its mark both physically and mentally. This becomes a real focus point for the body from then on, long after the incidence of continuing tissue damage. Consequently, as a protective mechanism, when stressed the body may perceive such stress as a risk to this ‘weak’ area and will respond accordingly with an inflammatory response – pain, swelling, stiffness and a heightened sense of dysfunction. A flare up.

Now the stressors that cause these flare ups to occur can vary. Sometimes the cause is black and white, such as a huge spike in activity that in hindsight was probably above your current level of capability. Other times the trigger is not so clear, and it takes a more detailed look back into the past month of activity to determine what parts of your lifestyle were contributing factors. It helps to think of the area as an empty glass. Many things can fill up this glass such as poor sleep, stress, diet, mood, beliefs and physical markers to name a few. When the glass overflows, a response is generated and we find ourselves dealing with a flare up.

The important thing to acknowledge here is that while there is pain, it does not necessarily indicate that more damage has occurred to that area. Often the physical outcome is insignificant, hence why imaging can be so inconclusive and provide no further explanation in times like these. It also explains how flare ups can occur in the absence of a significant change in physical load.

If you have successfully managed to not panic and go visit your surgeon, the next step is simple. Reflect. Look back on your lifestyle over the last month and try and determine what may have contributed. Maybe your diet was worse, or a stressful month at work saw you also getting less quality sleep. Maybe you started walking with friends but hadn’t done any strength training to prepare and help yourself recover. Whatever it is, by addressing multiple factors, we give ourselves a far better chance of reducing how many things are filling up our glass and causing it to overflow. It’s what holistic care describes so well, that many things can be contributing to a certain outcome, and the most effective way to manage the situation is by attacking it from all angles.

So if you take away anything from this blog, remember that for chronic conditions, pain doesn’t always equal damage, and the most effective way to get better is to reflect on what you could be controlling better, managing your body in multiple ways to get the best outcome!

Dan Ryles

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