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Pain Flares

stockbrokersstockbroker Posts: 464
edited 06/11/2012 - 8:27 AM in Chronic Pain
PAIN FLARES, the bane of my(our?)existance. Why do they occur? What can we do to deal with them? I hope this isn't a topic thatr has been done to death but I had a flare last year that lasted 32 days. I didn't think I could make it through. Its more typical to have a flare that lasts 7 to 10 days. The year before last I hads one that lasted 20+ days. If I had just my normal pain to deal with, my life would be easy. I wouldn't complain (well maybe/ I would but not about my pain). If I could tame the pain flares, I could handle everything. What do you all think? Susan.


  • LizLiz Posts: 7,832
    Hi Susan
    I am 6 weeks into a flare up, so I know how hard they are, for 6 weeks I have not been able to lie in bed, but try and prop myself up on the sofa each night. I don't think there is any easy way of getting through them, apart from trying to do gentle exercise everyday, and not to sit for too long without a little walk however hard. I use ice packs when back spasm is at it's worse. I know it makes us feel like we will never get through it.
    I hope you find a way of coping, as it seems to be part of our lives.
    Take care

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • That is a good question. Pain flares come around to smack us around now and then when we're already down. It happens when we get brave enough to tackle chores that we get sick of neglecting, when we venture out after being homebound for so long, when bitter cold arctic fronts blow in causing us pain, or it can be for no reason at all. All I know is that when I get hit with pain flares, my regular meds seem to not work at all and I grit my teeth watching the clock for the next scheduled dose. Of course I employ ice, heat, and alternative means to combat this, but I always keep in mind that pain flares are like storms we have to ride out. Eventually it should subside.
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    Hi Susan, Liz, meyday,
    I refer to the situation as a roller coaster ride. I,m much like all of you. I simply can't stand it. I was on a roll, about 5 weeks of only mild to moderate pain.
    And wham! the ride reached the top and hold on because the pain is intolerable. And the depression that goes with it. I went down hill as fast as the roller coaster could take me!
    I once again, thought I had "turned a corner" and was finally getting better. NOT!... This has happend time and time again. And I should Have learned by now, this is just a cruel trick being played on me.
    I give good advice to others, but can't follow it myself.Acceptance,Acceptance, Acceptance! But I'm just a hypocrite.
    Because I can't accept Having no life. It's a catch 22. With the drugs that only work minimally, with bad side effects, I'm drugged and therefor can't have a life. Or with the minimum amount of drugs that I can semi function with, but won't control the pain at all, I have no life. because I'm in too much pain to do, or even want to do anything that remotely resembles having a life.
    So one way or the other I'm just not going to have a life.
    Sometimes the flare may last only 2 or 3 days. Sometimes 4,5,6,7 days. But I'm going on 30 this time! And I've been doing this way to long. Well, that's enough whining for me!
    I have a ticket to ride, but not one to get off!
    Live for the good ones, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • I thought I was the only one who had a 30+ day pain flare, meaning I thought that was very unusual. Meydey, you're right about the meds. During a flare, they don't even make a dent. The only thing that helps me is to take some Lyrica since it will put me do sleep. What happens in our bodies to make the pain so bad? J. Howie, you know that this too shall pass but I'm so sorry you have to go through it. Susan
  • dilaurodilauro ConnecticutPosts: 9,863
    is hard to figure out.

    Its one thing that when you get a flare up because of some physical activity you did that shouldn't have be done. Thats when you can get into trouble, and those flare ups can last for months and sometimes result in additional surgery.

    The hardest thing to figure is when you get flare ups that you really cant put a cause to. Over the 30+ years in dealing with chronic pain, I have dealt with both of them.
    Some of my note adhering to restrictions not only cause a flare up that last over 90 days, it finally resulted in another spinal surgery.

    I have not had any spinal surgery since 2000. I have herniated 4 thoracic discs since then. Those herinations were due basically to over doing what I should have, plus the fact that the thoracic area was taking the beating, since it was sandwiched in between my cervical and lumbar surgeries. When I had flare ups, most of the time some muscle relaxings , pain medication and a couple of weeks of Physical Therapy corrected that.

    Right now, I am in a flare up that has been going on since about Thanksgiving. My daily dosage of pain medications has increased and my pain management doctor believes that she may want to put back on an Extended Release pain medication.

    I would try contacting your doctor and discussing this with them to see if something is wrong that requires some different type of attention.

    The unfortunate thing for spinal patients is that many of us have been or will be sentenced to a life of flare ups.
    So, knowing what caused them to start with is important, but knowing how to deal with them

    Good luck

    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    The worst thing for me right now is not knowing what I did to cause this flair up. If it was a case of having a pain flair up due to something I knew better than to do, then OK it's my own stupidity and I have no one to blame but myself. But not knowing what caused it. That's just cruel. I know that if I get busy and do lightweight activities it would get my mind off of it. But when I'm like this I just can't find the ambition. I have the mental tools to deal with this, but just can't summon them.
    Susan thanks for the concern.
    Good luck Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • I had successfully stayed at work a full two weeks and then had an epidural injection. Went back to work the next day and the following day made the fatal mistake of taking a site walk (I work on a 1400 room hotel project) because my big boss was in town). I took it really easy but by the end of the day knew I was in trouble. Spent the next 3 or 4 days on heavy meds hoping for relief. Went back to work on Monday of this week, only to spend the next three days at home, then back to work on Friday. This weekend has been the best I've felt by far. I haven't had surgery -- just dealing with mean, nasty, sciatica in my left leg and foot. I put a thera care patch around the pad of my foot and that seems to help ease the pain in my foot when I walk. After I shower, I use icy-hot on the back of my knee and thigh. That's my new perfume when I go to work -- la Mentholade! I've been getting better and then having pain flare ups since mid October afer foot surgery. I'm holding on to my job by a thread (thankfully they are wonderful people) and my husband just lost his job two weeks ago -- no stress! I had a crying breakdown on my primary care physician this week and, of course, he gave me some antidepressants to help me get through the psychological part of the pain events. Anyway, I am SO, SO thankful for all of you on this website -- friends seem to shy away from coming by or calling -- I think they are afraid they'll catch it (LOL) -- yours in pain, take care.
  • JHowie, please don't be hard on yourself. You're just trying to do what you can to have some resemblance of a normal life. Pain flares are cruel and they rob us of our mental fortitude and inner peace. While it's going on, all we can think is that the world is crashing down upon us and all hope is lost. Everything comes to a halt, and our loved ones have to nurse us through it. After it's over with, we have to brace ourselves for the next one. But always remember we're not alone in this. Help is just one keystroke away here at SH.
    Jkerner, I understand the struggle you deal with everyday. When I read that someone is working with this type of pain, I am in awe of that person because I couldn't do it. How long has this been going on?
    Hi ROn, I finally got to reading your life story and I was shocked at all you had to endure. It makes so much sense that when one segment goes bad, the others go down like dominoes. I hope that you won't have to need any more surgeries again.
  • In, my opinion, there is no cause to these events. Since my surgery, I have gone downhill skiing (for the first time in my life). I fell so much I had bruises head to toe. The next day, I went x-country skiing and got lost. We were out there for four hours. I got back to the lodge, exhausted and sore, but in a good way, but no increase at all in pain. Those epis can do it, that's for sure and, I believe Meydey is right about cold fronts (or is it a drop in barometric pressure) but I think humidity might set something off. So activity may or may not contribute as was previously pointed out. Dilauro, I'm happy to report that I am not, at this time, having a flare up. Has anyone had any success with visualization or meditation? I can see this helping with mild pain but not a flare. Susan.
  • i like the description of the roller coaster, it is so true. you know when you are reaching the top of the hill, and it is so scary, my ride is stuck at the top, and won't come down. it is never ending for me dealing with RSD, also known as (chronic pain syndrome). the burning pain won't subside, and has worsened. i feel for you Howie, for those that do not know what causes flare-ups, for me it is getting out of bed in the morn. or sleeping at nite, i can only lay on my back, (back of head and neck for so long,) i cannot win for losing, i think that alot of us feel that way. heat bothers me, ice is terrible and can cause RSD to progress and spread. i cannot wait to see p.m. soon starting after i have surgery on my shoulder (MUA) on feb. 10th. we will see what he can do with me. in the mean time we all have each other to talk to, and relate one way or another. take care everyone LEO :T ~X(
  • Yes, I have had success with visualization and meditation, but only in aborting the pain flare as it starts. When I feel this beginning to happen, if I act quickly enough I can lesson it or stop it enough to fall asleep and let it ease.

    If I can't get it when it is starting, then the visualization and meditation don't work.

  • Hello Everyone,

    Do your flare ups just include your back for pain or does it include your leg as well?

    I'm in this boat right now. I had a micrdisc and laminonomy in Sept. I live by myself and had a tuff time recovering. My scare tissue on the outside is almost nonexistant and an mri confirmed a small amount anterior to my the spinal chord. I misstepped at 7 weeks and stamped my foot to prevent falling. I paid for that. Last week, I decided to shovel some snow (3months out)and it started to burn in my back them travel down my legs. Ouch

    I also drive for a living, Backman38
  • How can you tell when a flare is starting (as opposed to just a bad day)? Curious, Susan
  • stockbroker said:
    PAIN FLARES, the bane of my(our?)existance. Why do they occur?
    I can honestly say that every single one of my pain flares has started with a poor decision that was usually accompanied by the phrase "I can" when I could, but shouldn't. #o
  • It's a certain type of pain that is usually accompanied by the inner feeling (intuition) of "oh sh_t". Kind of like the signs of when a migraine is starting. Someone who suffers migraines long enough will know when one is starting.

    Hope that makes sense.

  • Haven't you also "overdone it" and NOT suffered a flare up as a result? Also, do you still get flares with your stimulator? Apparently so. Are they as bad? Are they different? Do you remember what it was like without the stimulator? (By the way, my new osteopathic neurosurgeon is having me try a tens unit as he claims if it helps me, that would be an indicator that the SCS would work for me--sorry off topic)

    Backman: Don't shovel snow! And yes. All of my pain is in my legs and when it flares, distraction (like going to work if I can) is the best way of dealing with it. If its so bad I can't sleep all night I usually just lie on my bed in the fetal position and cry. Clearly, I need to come up with something more "proactive"? "effective" "less babyish"?
  • I found that using a TENS unit on my neck and shoulders was excruciating, however my SCS is the most comfortable thing in the world. The TENS unit exacerbated the muscle spasms so bad, I couldn't stand to use it. If I were to have gone on the theory that your doc is using, I would never have tried an SCS trial.

  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    Hi all,
    I believe I'm at the end of this pain flair, finally! Yesterday was good and today is better. That lasted well over 30 days. Now it will be a couple of days of being scared to touch it off again. Believe me I'll be taking things slow and cautious. But I know I have to get acctive again. I started walking again. And keeping it to 1 or 2 mi max. and doing very lightweight projects around the house.
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • I'm glad your flare is winding down. 1 to 2 miles a day? For real? Wow. I'm in awe of you! I live in the south and it's considered "cold" if it's in the 50's. I just can't seem to find the time or the energy to walk like I used to. I only walked a mile a day - my house is on a highway, no where really to walk, except for this dirt road next to my house that's about a quarter mile one way. I'd walk in the morning and in the afternoon. But that was before my back surgery, and when I was suffering with excruciating leg pain. I guess if I put my mind to it, I could walk a mile or 2. Then turn around to go home and realize I'm so tired, don't think I'll make it home! :)

    Seriously, thank you for keeping us posted; I am glad you're feeling better again!

  • Is there a public gym or fitness center where you can go and walk inside on a treadmill, or a shopping mall where you can go inside and walk? Many shopping malls open their doors early to allow "walkers" inside.

  • I haven't had a flare since I got my permanent SCS 3 weeks ago, but used to get them like you describe. It was either a car trip, sitting in church, or doing something I shouldn't have done (typically mild housecleaning because I did very little in general) that triggered them and the longest mine lasted was 2 weeks. Usually just a week or so. It was so depressing!!

    Also, on the SCS and TENS unit, the TENS unit KILLED me. Horrible pain. I laid there for 20 minutes and held my breath, trying to relax until the PT came back in the room. (I can't believe how similar my story is to "C"'s story!) It caused my muscles to spasm which I'm assuming then triggered nerve pain. The SCS feels nothing like the TENS unit, in my experience.

    Take care,


  • We have several Malls here (I'm thinking about 5 or 6 within a 5 mile radius - PLUS a YMCA right across the street!). I know these are all God's way of providing me what I need, but I am not motivated enough at this point, I guess. My only excuse for not doing it is that I'm too busy at this point in my life.

    Basically, as someone else said, and excuse is just an excuse. Truer words were never spoken!

    I am thinking once I get "Honorable Son #2" his driver's license, I may have a bit of free time on my hands. He is high maintenance with all his music (school band, honor bands, piano lessons, playing piano in church, etc), and my Son #3 just turned 12 and he is also very busy in his activities. Where's my husband in all this you ask? Well, he's off doing his own thing of course! Asking him for assistance is like asking for a kidney sometimes.

    My interest lies in water aerobics. Although, me - in a swimsuit? OY! I'd have to work out to feel comfortable enough to put one on to look in the mirror, let alone appear in public!

    It's like that time my husband tried to be nice and hired someone to come clean my house for me twice a month. I'd clean the whole house the night before so she couldn't see what slobs we are! 8}

    I know, I'm a complicated multi-celled organism.

    I actually started walking the campus here at work back in April 2008 - twice around the parking lot is a mile. But after I'd gotten into the routine, my Mom was diagnosed with Lung Cancer (aggressive, inoperable small cell carcinoma), I got caught up in all of that drama, and then just never went back. I believe if I wanted it bad enough though, I'd figure out a way.

    I work with a "southern gentleman" who gets up at the crack of dawn and runs 5 - 7 miles a day (even though he was attacked by a pit bull back in October) and he's almost 65!

    Fact is I am just tired these days - taking care of my family, my parents, my job...

    It was very nice of you to ask, though.
    Thanks again for asking.

  • Who here is getting slammed by this arctic front? I couldn't sleep at all and had to take meds b/c of all the pain. When will this misery end? :<
  • Meydey,

    I don't like this cold weather either. The cold combined with rain which turned into an ice storm by this morning made me miserable.

  • Well, no. I've never overdone it and not had a flare as a result, but that's probably because that's part of my definition of overdoing it. If I do a lot and at the end of the day I'm tired and/or sore, then I'm tired and/or sore; if I do a lot and throw myself into a full blown pain flare, then I've overdone it.

    I do still have pain flares with my SCS. The SCS gives me better pain control when I'm having a flare, but since it's not a cure and just covers up pain, it doesn't prevent or stop a pain flare. It's like turning up the radio in the car so that you don't hear that rattle coming from the engine - the problem is still there and it's still rattling, you just can't hear it as well. ;))

    As far as the TENS being a predictor of the SCS success goes, my SCS is an absolutely success and there's not enough money in the world to make me go near a TENS unit ever again. All I got from TENS was muscle spasms and the kind of insanely itchy skin that makes you want to scratch your back with a wire brush!

    I firmly believe the only true predictor of success with the SCS is the SCS trial, but that's just my opinion.
  • Stockbroker,
    Flare up are never easy and the only criteria is that it will happen again, an amalgam of situations and as Howie said, wrong decision making increases the occurrence or propensity for this to happen and we need to be brutally honest with ourselves when we have exceeded our capacity with knowledge or default. Having said that, you can do everything beneficial and still these occur and in the knowing what increases the pain for us individually and specifically can we hope to manage it all more effectively.

    Our invisible threshold changes ever day and the notion of repeating activity that historically we may have been able to perform, has no bearing on doing it again today.

    That roller coaster analogy is a good one and at times we have to sit and ride out its duration until the pain subsides and even in immobility an improving plan is always helpful. I have finite capacity and mornings for me are usually better, I begin to flag around noon and its downhill all the way till 8/9pm, when rest is mandatory. My to do list is based on this capacity and I have responsibility to all those people and areas, I have no reset button and once my energy has gone, that’s me. I am still learning to say no and prioritise, doing what is expected of me rather than catering to my own requirements it is a balance every day and I can anticipated that look of disappointment,

    Our PM attempted to help us developed better management of these flare ups and how to deal physically and emotionally when they happen with varying intensity. Flare ups are an integral part of chronic pain and we all hope we can endure the next occurrence and get through, the whole thing is never easy and we are to be proud of achieving what and how we do things even while in pain, that effort may go unnoticed or expected by some and we know what tenacity all of this takes and is a measure of the strength we have within.

  • Hi all -

    I'm new to the boards and have been bouncing around to topics that struck a nerve - Ha! I made a bad pun! So sorry! ( actually I'm doggone proud of it.)

    Anyway, I sometimes think the chronic flares and the inability to predict from day to day how things are going to be have had a much worse toll on me overall than the acute phases. There's nothing like the acute type of pain that comes along with back pain (and I've had a kidney stone - No contest!) But the damage the chronic phase has done psychologically to me is devastating.

    I never worried about pain BBP (Before Back Pain). I think I was even a little proud (make that a lot proud) of being able to tolerate pain. I enjoyed working in the yard, moving stones to build a wall, wrestling horses at home and work, riding till my legs were ready to fall off and hiking till I was ready to fall over or going in a pen of rhinos at the zoo. None of it really scared me. Now, one of the most dreaded sights for me is that horrid pain scale chart! I always felt that if I didn't focus on pain that I'd be able to handle it better. Now, it seems like everywhere I go, I have to tell someone if I'm a 2 or a 5 or a 9! I just hate that!

    I also hate the fact that I'm never sure what's waiting around the corner. It's like my entire world is now paved with eggshells. Last winter some friends wanted to head off for a few days to try snowshoeing. I love the snow and would adore trying something like that but was afraid to go with them - not only because I wasn't sure if I'd screw up my back but because I knew if I did I'd put a damper on things for the rest of the group.

    I hate asking for help at work but am afraid that if I don't I might endanger someone else or put a patient in harm's way. ( I work with a number of large animals in a university veterinary clinic).

    I hate that I never took naps before and now it seems like I'm never out of sight of my bed.

    My life has changed long before I thought it would. I always thought I'd live till I was about 117 years old. I'd drive my "77 MGB until I was 116 and I'd go way too fast and be really annoying but I'd get away with it because people would let me off the hook since I was so old and so darn cute. I'd be riding by horseback from coast to coast in my 80's or 90's and I'd never wear clothes that matched. Well, the car has been sold, my "horse life" is a memory, I really wear pajamas most of the time and I'm anything but cute. Last of all, I'm afraid I will live that long.

    I don't mean to be morbid and I've read posts from people so, so much more in pain than I've ever imagined, but this whole thing just snuck up on me and I feel robbed. I finally was getting to the age (I'm 51 now) where I didn't care so much what people thought of me and would do all those things that would have embarrassed me years ago. In the blink of an eye, it's all changed - and the adjustment is something else!

    Don't get me wrong, I know so many people have way more problems and an incredible strength to deal with truly monumental obstacles. I'm also forever changed in a good way by having come in contact with so many people, like you all, who don't have to care about me but do. The doctors, nurses, technicians, hospital volunteers, other family members, parking attendants, the guy that always seems to get stuck wheeling me to surgery - all those people have profoundly changed me in a good way. They've made me want to give back and I hope I can in some small way.

    Jeez, I write way too much! Anyway, it's not what I thought it would be at 51 years. This whole pain thing isn't even what I thought it would be when it all started. I really believe that we'd all be just fine if all we had to do was survive a surgery or two - or injections - or hours of PT. What really gets me though is that it's not really about that - it's everything else around it, in our daily lives that nobody (not even us) gets. That's what keeps me up at night (besides Percocet - cannot sleep when I take it) it's the little things that have stacked up into a seemingly unmovable pile.

    So - if any of you figure this all out, let me know. I'm hoping that my pea-sized brain will expand so that when this is all over, I'll know why I or you had to go through all this. I'm hoping it will become clear - if I could just get that darn pain chart out of my line of sight.

    Sweet dreams! and remember to lift with your knees!


  • Based on a conversation I had yesterday with the pain doc thats going to do my stim trial, pain flares are the exclusive domain of nerve pain. When the nerve gets irritated, whammo--watch out. That's why our medication doesn't seem to help during a flare. Hmmmm Interesting. (Unless, its meds specifically for nerve pain)
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