HNPP · Mental Health · Physical Health

HNPP and chronic pain flare-ups

Like lightning, chronic pain can strike you down at any point during the day let alone the week. 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. Therefore it is essential to keep a strategy in place to manage the pain.

So what is a ‘flare-up’?

The London Pain Clinic describes chronic pain as a pain that persists for an unusually long period of time, which goes beyond the expected time of healing. It can lead to a series of long-term consequences such as loss of physical activity and sleep, a sense of uncertainty and insecurity about the future and feelings of despair and helplessness.

Pain flare-ups typically refer to those times when the chronic pain is more intense than usual. Flare-ups are often triggered by overdoing things, although the effects might not be felt until later, moving or sleeping awkwardly, or cold weather. From a statistical viewpoint, if pain is being measured on a 0 to 10 pain intensity scale, with the zero level implying no pain, a flare-up will mean episodes in which the pain is at level 7 or higher.

It can last from a few seconds to several hours, appearing in various guises such as muscle spasms, migraines, cramps, sharp and jabbing sensations and the like.

Brittani Daniels started up pamper company called Spoonie Essential Box after being hospitalised with the chronic illnesses, Crohn’s Diseases, Lupus, as well as colon cancer. More information about boxes below.

So what’s the plan?

Obviously, the old adage “prevention is better than cure” is an important notion when seeking to manage chronic pain flare-ups. First of all, it’s important to analyse the pattern in which the flare-up occurs and then develop a plan around it. Make a list of steps you will take the moment you recognise a flare-up. Keep the plan handy and resort to it immediately when you feel a flare-up rising.

  • Positive environment – keep affirming to yourself your will power to sail through the painful episode. Research shows that individuals who retain their self-confidence and positive attitude are able to handle the flare-up episodes much better. Think about what has made you feel better in the past and try utilise this during this time.
  • Alternative medicines – consult your healthcare provider beforehand and make note of any changes required to your medications during the flare-ups. Generally, short-term changes to the medicines are required in case of intense chronic pain flare-ups.
  • Monitor your breathing – tensed muscles and a quickened and shallow breathing immediately precede pain flare-ups. To help control the aggravation of a flare-up, it is important that you concentrate hard on the pace of your breathing and learn to take a deep breath.
  • Create a ‘spoonie box’ – 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 likely increase your pain. If your pain is already severe, by having easy access to food and water, you’re preventing it from getting worse. While there are many companies that provide pamper spoonie boxes, you can probably prepare one yourself at home. Items to consider include:
    • Snacks – from cereal bars and rice cakes to assorted nuts (obviously not if you’re allergic), having a stash of snacks can help get you through several hours without having to get up and raid the cupboard. This, however, isn’t a meal replacement. If push comes to shove, there are meal replacement drinks if it’s too difficult to heat up some soup. Some great spoonie boxes keep popcorn for those who just want to lie in bed and watch some Netflix. Chocolates are a significant part of my stash.
    • Bottle of water – essential while you’re in pain to keep drinking water and avoid getting dehydrated. If you have a thermos, then some chamomile or herbal tea maybe handy.
    • Additional medication / supplements – you may already have a pill box that helps divide up your medication for the week, but having an additional box for your recovery cache will save you from dealing with opening bottles and popping tablets.
    • Sleep masks and ear plugs – for those wanting a peaceful slumber without the blaring and glaring of the outside world.
    • Affirmations – positive messages during this time can help remind you that this is expected and not to give yourself a hard time for ‘failing to perform’. Even the Serenity Prayer is useful for this situation.
      • “I seek the serenity to accept what I cannot change; the courage to change what I can; and the wisdom to know the difference.”
      • “I know it hurts right now but I have been through this before. I know I can handle it because this will settle in time”.
      • “Stay calm, and relaxed. Tension isn’t going to help. Keep breathing slowly and deeply”.
      • “The pain is quite bad now, but I can get the better of this and stay positive. I must remember what I have done in the past which has helped to distract me for a while”.
    • Slipper socks – if they are loose and padded, these are literally the most comfortable pieces of footwear on earth.
    • Baths – sitting in a bubble bath is not everyone’s cup of tea, but for those who want to treat themselves to a luxury ‘spa’ type of day, then keeping bath bombs in your box can help distract you from what this day is all about.
    • Hot water bottles and cool packs – always useful for nerve or muscular related flare-ups.
    • Books, and DVDs – to pass the time, keep that film you want to watch or that book you want to read for during this time. If you’re in too much pain, revert back to sleep mode.
    • TENS machine – if you have one, these are known to provide quite a lot of help easing pain.
  • Alternative treatments – if it’s possible, getting a massage or some other type of holistic treatment may be beneficial.  You can hire professional services for the same, or request a friend or a family member. A gentle massage of the affected area could help reduce tension and pain – but do ask your medical practitioner in case this may aggravate your pain instead.
  • Stress management – prioritise what you will be able to do depending on the day. It’s a reminder that these things might be possible on a good day. Think about what has made you feel better in the past. As you learn to cope with the flare-ups, you should try and set only realistic pain goals or else you are likely to experience a sense of frustration and failure.. It is important to keep the stress levels under control, if you want to minimise the scope of flare-ups. Stress and anxiety aggravate chronic pain and might worsen the situation further.
  • Don’t ignore the pain – this is a given, and it’s unlikely most people can ignore a flare-up. Immediately begin the treatment of a flare-up as it happens, else it might worsen.
  • Make a diary – it helps to make a diary and make regular notes of your experience with the flare-up. It is worthwhile to note down the activities that preceded the flare-up, the mood-swings, medication taken and any other such information.
  • Don’t stop all activity – there is a high chance your pain will get a little better if you force yourself to get out of bed and shower. Getting out of bed with time, can increase your circulation, decrease headaches, and realign your 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. It is actually advisable to continue doing some gentle form of activity that does not cause too much of stress. 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. Even going to the garden, and walking around for several minutes can help lift your mood. If the pain gets worse, then do not forget to rest.
  • Relaxation techniques – if getting out of bed is not a possibility that day, consider downloading relaxation apps. These apps may help lower your stress and anxiety by guiding you through meditation and relaxation when sometimes it’s hard to do yourself.
  • Appointing friends and family to help – if you have the option, call a friend and let them help you in anyway suitable. This may include helping around with certain chores, taking a light walk, or just generally keeping you company. It is totally your prerogative to ask for support.

Unfortunately, learning to manage pain isn’t always a prioritised discussion with healthcare 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.

While medical professionals are only just beginning to understand the impact of chronic pain on daily lives, learning to master the pain yourself will give you a head start.


Read: Relaxation Techniques to Help HNPP Sufferers

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