Pain Flair Tool Kit – How to Manage Your Most Painful Moments

      When a person with chronic pain experiences a “pain flair” - a period where the pain is more severe than usual - the capacity to function is significantly decreased is and can feel very demoralizing.  When you are so sick and unable to think clearly, it is easy to be ruminating in a downward spiral and become stuck in that hopeless state of mind, making your pain worse than it already is.  It’s important to create a pain flair plan to remind yourself of what you can actually do to alleviate any amount of pain and help your emotional state. 

       In the beginning of the year, I decided to go back to the Lifestyle Redesign Pain Management program at USC Occupational Therapy because my pain flairs were increasing.  When I experience pain flairs, I could be in bed till 3 pm – 5 pm experiencing imbalance, migraines, difficulty breathing, and muscle spasms from my head all the way down to my foot without eating or drinking anything.  Learning how to plan for my pain flairs made me feel more in control and hopeful during the most difficult moments.  My pain therapist taught me to prioritize 3 things in my pain flair planning, which are SELF-CARE, STRESS MANAGEMENT, and LEISURE. 

My pain flair self-care box next to my bed

Self-care:  Food & Hydration 

Consider keeping a stock of bottled water and nutrition bars near your bed.  If you don’t eat anything, your blood sugar will drop and your muscles will become dehydrated, which causes the body to ache and will increase your pain.  Your pain is already severe, so by having easy access to food and water, you’re preventing it from getting worse.  If chewing is painful, you might want to check in with your doctor if it’s safe to drink Ensure with your medical condition and medication.  Although drinking Ensure shouldn’t be a permanent meal replacement, it might be better to drink it than to not eat at all.  I will typically have bottled water, Vitamin Water, Kind Bars, medication, and supplements in a box near my bed for easy access. 

Stress Management

Create a queue - a list of things in a certain order that you may be able to do depending on the day.  It’s a reminder that these things might be possible on a bad day.  Think about what has made you feel better in the past. 

Is there anyone that can help you or hang out with? 

I hang out at my partner’s house because he can adjust my body by trying to copy osteopathic manipulation techniques to relieve my pain.  It’s a comforting feeling to feel supported at his house and lay in bed with my dog, which automatically brightens my mood.  If I have the capacity, sometimes I’ll call a friend if they want to watch Netflix or just take a light walk. 

Are there any medications you can take or treatments you can do? 

      Taking medical cannabis is very helpful when the pain is unbearable, but it makes me fall asleep, and most of the time, I’d rather be awake than asleep.  Sometimes heat or cold therapy will work for people with chronic pain, but depending on the degree of the pain flair, access to getting heat or cold therapy may not be possible.  

What activities can you can do to relieve your pain and stress?  Each activity should be purposeful.  

      There is a high chance my pain will decrease if I force myself to get out of bed and shower.  Getting out of bed with time, can increase my circulation, decrease headaches, and realign my body that was pushed into a misaligned position for many hours of sleeping in bed.  Getting out of bed can distract the mind from focusing on the intensity of the pain.  I can spend up to 2-3 hours trying to talk myself to get out of bed.   From my observation of chronic pain forums, mornings are the hardest and taking a couple hours to get out of bed is very normal.

     Try to be purposeful with your activities.   If getting out of bed and walking around the house for circulation is a goal to decrease pain, think about where to walk in the house.  Maybe walk to a bright area with natural light to lift up the mood.  Sometimes I’ll force myself to walk around the garden to look at plants, breathe in fresh air, and feel the sun shine on my skin just for 5 minutes.  

Relaxation Apps

If getting out of bed is not a possibility that day, consider downloading relaxation apps such as “Headspace” or “Calm.”   These apps can lower your stress and anxiety by guiding you through meditation and relaxation when sometimes it’s hard to do yourself. 

Videos

Although it’s not encouraged to binge watch shows during pain flairs, sometimes I do, and I have no regrets.  When you feel betrayed by your body no matter how hard you try to get better and external stressors pile on, you deserve a big break!  I can temporarily ease and distract my pain by watching Netflix series, dance videos, or funny animal videos.  And I hope the next day can be better. 

Leisure

Depending on your level of pain, you might want to do something of leisure to help your emotional state.  If you like reading but are unable to because of the pain, you can listen to audio books or podcasts.  If art is therapeutic and you can’t sit upright or look down to color or paint, there are painting apps or ways to accommodate your position in bed.  Lately, I’ve been finding satisfaction putting together video clips on the movie making app and slowly getting into podcasts. 

Unfortunately, learning to manage pain is not a prioritized discussion with health-care providers.  Doctors prescribe more pain medication, blame stress and diet, and your time is done.  You are expected to just go home and figure out how to deal with these major life changes.  There aren’t many accessible therapists that specialize in pain management.  The specialty of teaching chronic pain patients how to adapt to daily life tasks is fairly new.  But I’m so grateful I have access to the top university that is doing the research for pain management and can share to you what has been useful for improving my quality of life.  I hope this post is beneficial to you or your loved ones to have hope in the possibilities to manage the most difficult and painful moments of your lives and to have empathy for the misunderstood challenges of invisible chronic pain.