It can happen in an instant. You are going about your life, maybe you are at the gym, maybe you are sitting on the couch, maybe you are on the floor with your kids. Bam! Your pain decided to rear its ugly head again.

This can leave you frustrated or even anxious. You may be wondering if your injury is getting worse or maybe an old injury has come back. You may be shouting profanities!

We’ve all been there. The good news is that flare-ups of pain are common and completely normal. A flare-up doesn’t mean that you are getting worse or that you will never get rid of your problem.

Why do pain flare-ups occur?

A lot of times, the reason we experience a flare-up is the same reason we were injured initially. If you have worked with us, then we have likely figured out the root cause of your issue. If not, this cause may be less known to you. The factors at play are usually faulty movement patterns, poor sleep hygiene, improper nutrition, high levels of stress, and lack of recovery.

Even if the flare-up seems to happen out of nowhere while you are sitting on the couch, try to think about how the past few days and nights have gone. If you are pushing your body too hard and not giving it proper recovery and fuel, then you are at a high risk of a flare-up. Maybe you are under increased stress from work.

Flare-ups can happen even if you are diligent about your movement form, sleep, nutrition, and stress. This is especially true for chronic pain issues. People with chronic pain are likely to experience a phenomenon called central sensitization, which is a change in our brain’s perception of pain and how it responds. You may experience pain from a non-painful stimulus. You may experience excessive pain that is greater than what is expected from a painful stimulus. These changes can be out of your control.

How to manage pain flare-ups:

1. Gentle movement

One of the worst things you can do while injured or experiencing a flare-up is to completely rest. Rather, you should practice relative rest. You shouldn’t overstress the painful area, but you should remain active. A small amount of pain or discomfort is typically fine. You should stretch, focus on form, move with intention, and get your heart rate up as much as possible. Our joints rely on movement for nourishment. Our muscles and tendons need blood flow to heal.

2. Slowly increase load tolerance

Reduce the load/resistance that you are using. For example, if your shoulder is hurting with overhead pressing then you shouldn’t press heavy weights overhead when in a painful state. Depending on your specific situation, you may either need to start with lighter weights (to tolerance) or modify the types of exercises you are performing for a short while. As your tolerance improves, you should increase your load by 5-10% per week as long as you are not experiencing an increase in symptoms. Muscles and tendons need to be loaded to get stronger and protect you from further injury.

3. Get adequate sleep

You should be getting a minimum of 7 hours of sleep per night. That being said, you should strive for 9 hours each night. Get into the habit of a nightly routine to eliminate the use of electronics, get to bed at the same time each night, and wake up at the same time each morning.

4. Focus on an anti-inflammatory diet

Avoid processed foods for a while. Processed foods and foods high in sugar are likely to spike your inflammation. Focus on produce and lean meats. Some good choices include dark leafy greens, blueberries, foods high in omega-3, turmeric, and ginger. I usually tell my clients to start their day with an anti-inflammatory smoothie for breakfast to get each day started well.

5. Reduce stressors

If you are able to get rid of certain stressors, then do so. Most likely, you will have to work on better stress management skills as stressors don’t typically go away. This might include meditation, breathing exercises, or taking a nap during the day. When your body and mind are overwhelmed with stress, it has negative consequences on all of the systems in your body.

6. Seek help

If your flare-up is particularly bad or is lasting longer than a week, you should get some professional advice. Reach out to your physical therapist, primary care physician, or someone who knows your specific issue well so that you can get specific guidance on the best path forward. If you have never received professional help for your issue, then now is the time to get it checked out. Doing nothing will not get you results. You need to get out of pain and have the root cause of your problem addressed.

If this sounds like you, we would be happy to help you out. Call us at (410) 357-1529 to find out how we can help you.

Corey Hall, PT, DPT