A fibromyalgia flare (or flare-up) is a temporary increase in the number and/or intensity of symptoms. Worsening pain and fatigue are generally the first two symptoms noticed in a fibro-flare. But other symptoms like poor sleep, increased cognitive dysfunction and digestive disturbances are often experienced as well.
Some flares only last for a day or two but others may continue for several weeks or even months. It's those long flares that are the hardest to deal with because it feels like they will never end. When you start to feel discouraged in the midst of a long flare, it's important to remind yourself that flares are temporary. They will eventually begin to subside.
The best way to prevent FM flares is to identify what causes them and when possible, try to avoid the circumstances that trigger them. Keep in mind that a flare may not occur for up to 48 hours after the event that triggered it.
Causes of Fibromyalgia Flares
In my experience, 10 of the most common causes for fibromyalgia flares are:
1. Weather changes. Possibly the most common cause of short-term fibro-flares can be attributed to changes in the weather. Whenever the barometric pressure changes and a new front passes through, many people with FM experience an increase in their symptoms - particularly in their pain level. Fortunately, these flares usually only last for a day or two.
2. Over-exertion. Any time we push ourselves too far physically, we're in danger of triggering a flare. On those rare days when we feel pretty good, it's so hard not to try to catch up with all of the chores and activities we've been unable to do for the past month or two. But overdoing, even when you feel good, will usually come back and bite you in the form of a fibro-flare. It's better to increase your activity level gradually so that hopefully you'll have more good days with fewer setbacks.
3. Stress. Stress may be the granddaddy of fibro-flare triggers. We're always hearing how prolonged stress negatively affects our health and can lead to heart attacks and strokes. What we don't always realize is that stress can have a significant impact on fibromyalgia symptoms as well.
Stress can be a particularly insidious culprit when it comes to fibro-flare triggers because it often sneaks up on us. Our responsibilities gradually increase, the economy gets worse, our child gets sick — without consciously thinking about it our stress levels have gone through the roof. Then one day we find ourselves in the midst of a major flare and wonder what caused it. It's been my experience that stress-related flares often last the longest because they can be the most difficult to identify and then find ways by which we can manage the stress.
4. Illness or injury. Just as an illness or injury often triggers the onset of fibromyalgia, another illness or injury can trigger a flare of FM symptoms. Even something as simple as the common cold can result in a fibro-flare.
5. Hormonal changes. A number of women report experiencing FM flares related to their menstrual cycles and menopause. Whether or not hormone replacement therapy is appropriate or even would be helpful in these cases is something that each individual would have to discuss with her doctor.
6. Temperature change. Many people with FM find that they are extremely sensitive to cold or heat or both. Being exposed to those uncomfortable temperatures, even for relatively short periods of time, can sometimes trigger a flare.
7. Lack of sleep or changes in sleep routine. Getting quality, restful, restorative sleep is an ongoing challenge for people with fibromyalgia. Whenever that sleep is disrupted or there are changes to an individual's normal sleep patterns - particularly over a period of time - a fibro-flare may not be far behind. It's important to find a sleep routine that works for you and stick to it as closely as you can.
8. Treatment changes. While changes to your medications or other treatment protocols are intended to bring about an improvement in your symptoms, sometimes those changes can result in a flare of your symptoms. It can be tricky to determine whether the flare was actually caused by the change itself or was coincidental. It may take a period of trial and error, working with your doctor, to figure out whether the treatment change is to blame or if some other factor triggered the flare.
9. Traveling. Traveling is seldom easy for someone with fibromyalgia and even the best trip may be followed by a fibro-flare. One reason this happens I suspect is because travel so often involves one or more other common flare triggers such as weather changes, temperature changes, stress and the disruption of sleep routines. Try to plan plenty of rest time during your trip as well as allowing a day before you leave and at least a day or two after you return to rest. While this may not completely prevent a flare, it may help minimize its severity.
10. Individual sensitivities. Often people with fibromyalgia have a number of sensitivities such as allergies or sensitivity to light, noise and/or smells. Exposure to the things they are sensitive to - like bright lights or strong perfumes - may trigger a fibro-flare.
Preventing Fibromyalgia Flares
Although it's not possible to prevent all fibro-flares, identifying what causes most of your flares and taking steps to try to prevent those triggers can help reduce the number and intensity of flares significantly.
Journaling or keeping a log is an excellent way of identifying possible triggers because you can go back and compare what you did prior to a current flare with other previous flares. Just take a few minutes each day to jot down your activities for the day, any new medications or other therapies started, changes to your diet, weather or temperature changes, how and when you slept - anything that could help you pinpoint changes or themes that could account for your flares.