How not to be scared of a chronic pain flare

So often clients come into the clinic with a ton of pain that started over the holidays or a new life change. 

This can be due to trying to clean up the house to the point that it looks like nobody lives there, trying to cook so much food you could feed an entire army, fact that you have to spend time around family members that challenge your boundaries, or figuring out the logistics of how to function with this new life change. 

These flares can knock you down for a little while and the tendency is always there to try to figure out what you did, mistakenly thinking it was a singular event, when in actuality, it was likely a combination of things.   

What might be causing my pain flare?

Pain flares are a result of the body and the nervous system doing the best they can to attempt to protect you.  Unfortunately, this interaction can sometimes result in a scenario similar to that of a toddler trying to “help” you bake cookies in the kitchen.  

While it is so sweet and kind that your toddler would try to help you, really they are just making a bigger mess with every move they make. 

The same thing happens when the nervous system and body attempt to manage a chronic pain flare.  

Your body perceives a threat and sends a signal to the brain. The brain interprets that threat and sends a signal throughout the body to protect you.  You muscles tighten up to guard against said threat in order to protect your body, ready to fight off whatever the threat may be. If you’re someone experiencing chronic pain vs acute pain, these signals can get all out of whack due to your pain tolerance and pain threshold.

The really hard part about all of this is that the brain responds to both perceived threats and actual threats in the exact same way and when you experience chronic pain, these lines can get even more blurred! 

The threat could be that your toddler headbutted you in the stomach or it could be that your mother-in-law is on her way to your house.  One is an actual physical threat with an actual physical blow to the abdomen. The other is a perceived threat. While the words your mother-in-law says to you may feel like a blow to the gut, she is not actually physically placing her hands on your body. So how might you feel actual pain in response to her pending arrival? 

It’s because your nervous system doesn't know the difference. And what does it do? It responds in kind to both stimuli.  Your body clenches to guard itself, your adrenaline courses through you and you go into protection mode. 

How long your body has been in protection mode can impact how significant and prolonged your symptoms are.  Some people are in protection mode for a few moments while others stay in protection mode for years! 

How to manage a pain flare

Recognizing what your triggers may be and developing an Emergency Action Plan (EAP) prior to going into a pain flare can be incredibly beneficial in helping you manage the pain before it becomes too intense!

An EAP is something used in hospitals, schools and businesses to respond to an emergency or threat. You can use the same system to help manage the threat in your own internal environment. It is a list of the things you know help you reduce your pain during a flare. 

To develop your EAP:

1. Pick the top 3-5 things that help when you’re in pain. This can be medication, stretches, relaxation, etc. Anything! 

2. Be specific when you list them, including how much time it takes to fully accomplish the task (ex: if a 30 min warm bath helps, include the time it takes to draw the bath, take the bath and get dressed after the bath. Having a 30 min bath on your list may actually take 45 min to accomplish) 

3. Share this list with your support person. This person is going to be the one who will take over the other things that are happening in life in order to give you the time that you need to follow your plan. This can be a partner/family member/neighbor/friend, anyone who will be willing to watch the kids, make sure the dinner doesn’t burn or take the dog for a walk, whatever may be keeping you from doing your plan. 

Your EAP may be 15 min, it may be 2.5 hrs. It’s completely individual. The goal is that the time you spend on your EAP drastically outweighs how much time you spend in the fetal position, missing out on life due to the flare. 

If you feel like you need guidance on understanding your body better and setting up your own individualized EAP, reach out to a pelvic health rehab specialist in your area to assist you in discovering what your body needs during a flare. If you’re in the Columbus, Ohio area and want guidance and assistance with this, contact us and we will help you get moving in the direction of no longer fearing the flare!