Flare-ups

Chronic pain: Quality prescribing - A guide for improvement 2026-2029
Scottish Government Effective Prescribing & Therapeutics Division

A flare up is a temporary increase in pain intensity. They can last a few days, weeks or sometimes longer. 

Relationship between pain and flare-ups

  • Flare-ups can occur without warning, often with no set pattern and can feel worrying, overwhelming and difficult to cope with
  • They are temporary, and it may not always be possible to identify the cause
  • They are a common experience in persistent pain and are multifactorial, often due to changes in sensitivity of the nervous system and not necessarily an indication that things are getting worse

Potential strategies: 

  • Each of the non-pharmacological management strategies may be utilised to reduce the impact of a flare up and promote recovery.
  • Personalise advice / strategies to determine the most appropriate approach for the individual.   
  • Provide flare up top tips:
  • Actively listen and validate the individual’s experience.
  • Provide reassurance that flare-ups are common, manageable and will settle.
  • Encourage the individual to be prepared. Creating a flare-up plan when pain levels are manageable can help build confidence at times when pain is more severe.
  • Encourage movement, activity and rest. 
    • Increases in pain may increase fear and avoidance of movement so reduce levels of activity. However, maintain gentle movement during a flare up and gradually return to usual activities as pain subsides.
  • Encourage as much independence as possible (e.g. dressing, getting food shopping), but encourage the individual to seek support or help if needed.
  • Support self-care and self-kindness.
    • Make space and time for things that they find relaxing, provide enjoyment and happiness.
    • Consider use of relaxation or mindfulness.
  • Consider thoughts and emotions: Flare ups often generate negative or unhelpful thoughts. Feeling low, anxious, frustrated and overwhelmed are common. Helpful strategies in managing thoughts and emotions can be found in the links below and in our section on Thoughts and emotions.

Resources: