Fibromyalgia is a chronic syndrome defined by widespread muscle pain, fatigue, sleep dysfunction and cognitive dysfunction. Fibromyalgia pain dysfunction involves an increased sensitivity to pain known as hyperalgesia. People with Fibromyalgia can experience what is referred to as ‘flares’ where their symptoms get more severe.
A survey in Pain Medicine recently looked into the nature of flares to ask people with Fibromyalgia the nature of these flares. They asked open-ended questions to determine how they perceived the fibromyalgia flares, the triggers of them and possible alleviating factors for them. They were asked how these flare-ups are different from their baseline symptoms and how they cope with them. There were 44 participants in the survey.
Primary causes of flares:
• overdoing it
• poor sleep
• weather changes
Primary symptoms of a flare included:
• flu-like body aches with exhaustion
Primary treatments were:
• medical treatments (medications)
• activity and stress avoidance
• waiting it out
The study concluded that the periods of “symptom exacerbation (i.e., flares) are commonly experienced by patients with fibromyalgia and symptoms of flares can be differentiated from every day or typical symptoms of fibromyalgia. Our study is the first of its kind to qualitatively explore characteristics, causes, and management strategies of fibromyalgia flares. Future studies are needed to quantitatively characterize fibromyalgia flares and evaluate mechanisms of flares.”
It would indeed be interesting to see further analysis of the flare phenomena in the future. Particularly the mechanism of it. What is going on such that these flares are so suddenly and abruptly different than the baseline experience? Clearly, it is an event that is triggered. However, discovering what is going on what a flare could perhaps further what is going on with the entire fibromyalgia syndrome itself.
When flare-ups occur consider these:
• Taking a break- flares tend to occur at times of high stress when it is not exactly good timing for a break. However, no matter what is going on if we push through the pain like we are inclined to do often, we will pay for it. Instead, we should try to ask help from others, ask for extended deadlines, reschedule things if possible and take care of the flare first. Try and reduce what is causing you stress and get that as low as possible. Also, take breaks during the day to help.
• The say ‘No’ tip- is very valid again. At this time of a flare, it is even more important to protect your time and reserves. No, you can’t take on extra work. No, you can’t do that favor for a friend or your kid’s school. No, you can’t babysit for a friend. You don’t have to have an excuse, just a polite refusal. You just cannot take on extra things at this time.
• Sleep- Sleep is always a factor in Fibromyalgia symptoms. This means that adequate quality sleep is even more important during a flare-up. Getting eight or more hours of sleep is important. Keep to a regular sleep schedule. Don’t nap too much during the day such that it disrupts your sleep at night, but you can have a short nap during the day.
• Relaxation- Doing biofeedback, deep breathing, meditation and self-hypnosis can help take your mind off the pain. As well as distraction methods you may already use, like soothing music or a good book.
• Pacing- We can keep doing activities, at a slower pace, which has been found to be better than not doing activities at all. However, we need to know our limits. Slow and steady. We can incorporate some gentle exercise such as gentle stretching, walking, and some light yoga. However, if you have an exercise routine consider decreasing intensity.
• Pain management- Use your medications following the schedule you use to manage the pain. If they are not sufficient ask your doctor about them. Use any alternative treatments you might find effective. Acupuncture, chiropractic care, massage therapy, biofeedback and other therapies may be beneficial for your pain management
• Support- It can be difficult to deal with so sometimes talking about it can help. So utilize the support group you have. Either an online support group, real-life one, or the people in your support system like family and friend
• Baths- some people find it relaxing to take baths in Epsom salts.
Source: Pain Medicine, January 13, 2015. By A. Vincent, M.O. Whipple and L.M. Rhudy. Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota.