What causes painful Fibromyalgia flare ups?

What is a Fibromyalgia Flare Up?

Fibromyalgia is a chronic condition that affects several systems in the body, and causes widespread pain. It is associated with a wide range of daily symptoms, from fatigue to sleep disturbances. This article will explore what causes fibromyalgia flare ups and how someone dealing with a flare up can try to cope with what’s going on. 

Flare ups happen when the usual fibromyalgia symptoms are aggravated; resulting in increased duration and/or severity of symptoms. Often, additional symptoms that are unique to flares will surface, too.

Overall, flare ups are painful, debilitating, and stressful. Figuring out what causes them, and how to cope with them can make flare ups more manageable. You can learn how to recognize your flare triggers and work towards avoiding them and/or preparing for unavoidable flares. 

How is a Fibromyalgia flare up different from normal symptoms?

Flare ups (also called setbacks) are different from the usual day-to-day symptoms of fibromyalgia. 

To understand how flares differ from typical fibromyalgia symptoms, we must first highlight what symptoms are associated with fibromyalgia. 

Fibromyalgia symptoms include: 

• Widespread pain throughout the body 
• Brain fog (difficulty concentrating, thinking, or remembering) 
• Troubles with sleep 
• Fatigue and tiredness 
• Nerve pain, tingling, numbness 
• Mental health challenges, like depression and anxiety
• Headaches and migraines 
• Digestive issues, like IBS and nausea 

When someone is experiencing a flare up, these symptoms may be exaggerated. They may be worse in severity, duration, or frequency. Additionally, they usually impact the person’s ability to fully engage in their daily activities. 

Flare ups are different for each person living with fibromyalgia, as are the set of symptoms that they experience regularly. Some people may also have certain symptoms that they only get when in a flare. 

Flare up symptoms may also include: 

• Flu-like symptoms (e.g., full-body aches, fever, etc.)
• Different pain than they’re used to (e.g., stabbing rather than dull)
• Mobility issues beyond what is typical for the individual
• Extreme depression, anxiety, and grief

What causes a Fibromyalgia flare up?

Sometimes, flares can feel like they’re coming out of nowhere. The triggers may not always be clear, and can take you completely off guard. 

Triggers may differ from person-to-person. However, understanding common triggers may help you decipher which triggers affect you. 

Some common triggers for a fibromyalgia flare up include:

• Hormonal changes 
• Changes in weather 
• Stress (emotional or physical) 
• Changes in diet 
• A lack of sleep 
• Starting a new treatment regime, or changing an existing one (e.g., new/different medications) 

In a qualitative study of people living with fibromyalgia, researchers were able to group common perceived triggers of flares into four categories: 

1. Stress 
2. Overdoing it* 
3. Poor Sleep 
4. Changes in Weather 

*Overdoing it was defined as doing more than one typically would, either physically, socially, or mentally. For example, seeing more friends than usual, doing more chores than usual, studying really hard for an exam (coupled with stress), going on a long social outing, etc. 

How to identify your triggers

The best way to narrow down your triggers is to keep a log or a diary of your symptoms, activity level, and any out-of-the-ordinary changes. 

You could also retroactively analyze what may have triggered a flare-up. Ask yourself the following questions to narrow it down: 

• Was I stressed more than normal? 
• Did something significant happen to me in my personal life/at work? 
• Was I overexerting myself? 
• Did I get a good amount of rest and quality sleep? 
• Did I eat anything different or change the frequency of my meals? 
• How has my mental health been recently? 
• Has there been a recent drastic change in weather (e.g., temperature, humidity, pressure, precipitation)? 
• Did I socialize, exercise, or work more than usual in a short amount of time? 
• Did I use substances like alcohol, tobacco, caffeine, more than usual? 

Another way to narrow down triggers is to speak with other people living with fibromyalgia. Ask them if they know what triggers their flare ups. Understanding what others go through can help you better understand your own experience. A great place to connect with other people living with chronic pain conditions, like fibromyalgia, is in online communities. 

Even if their experiences aren’t applicable to yours, finding others who understand the frustrations of pain flares can help you feel validated and less alone. 

How to prevent a Fibromyalgia flare

Preventing all flares may not be realistic. However, there are steps you can take to work toward reducing the frequency or severity of future flares. 

The first step is to understand your triggers. Then, you can either reduce your exposure to those triggers (e.g., burn out) or prepare for unavoidable triggers (e.g., weather changes). 

For example, if you know you flare after a bout of poor sleep, you can take steps each day to prioritize quality sleep. To better understand the ways to avoid your triggers, it may take some trial and error. Begin by making a list of your known triggers and brainstorm ways to avoid them. 

Here are a few ideas for the four main categories theorized in the previous section. 

Stress: 

• Work proactive relaxation into your routine
• Communicate your needs to those around you so there’s no unnecessary tension 
• Set intentional boundaries to protect your peace 

Overdoing it: 

• Try pacing your activities 
• Don’t overfill your schedule 
• Say no to any unnecessary outings or activities (especially if you’ve already reached your limit for the week) 
• Ask for help with chores and errands 

Poor Sleep: 

• Prioritize sleep promoting activities (e.g., morning sunlight, light exercise, etc.) 
• Avoid stimulants like caffeine or nicotine, especially in the evening 
• Build solid consistent routines 

Weather Changes: 

• Ramp up self-care during seasonal changes 
• Employ extra pain management techniques when you predict the weather might affect you poorly

Conclusion

Fibromyalgia flare ups are debilitating and stressful. Understanding what causes them can help you manage them. The pain and symptoms during a flare can cause a lot of stress and anxiety, leading to worse symptoms. So, along with pain management techniques, be sure to get emotional support, too. Speaking with others who get it can help you feel less isolated and better understood.

Sources

Nichols, H. (March 20, 2018). How to recognise fibromyalgia flares. Medical News Today. Retrieved from: here 

Okifuji, A., Goa, J., Bokat, C., Hare, B.D. (July 2016). Management of fibromyalgia syndrome in 2016. Pain Management, 6(4): 383-400. doi: https://dx.doi.org/10.2217%2Fpmt-2016-0006 

Vincent, A., Whipple, M.O., Rhudy, L.M. (March 2016). Fibromyalgia Flares: A Qualitative Analysis. Pain Medicine, 17(3): 463-468. doi: https://doi.org/10.1111/pme.12676