Fibromyalgia Flares: Triggers, Symptoms, and Coping

If you've been diagnosed with fibromyalgia you've probably heard about flares. Or instead, you may be wondering why sometimes your condition gets much worse almost out of the blue. What exactly are fibromyalgia flares, what symptoms may occur, what are the common triggers, and how can you best cope?

Definition

For most people with fibromyalgia, the symptoms vary from day to day. Over time there are periods when the symptoms are at their worst, and other times when they are much milder (short-term or long-term remissions.)

These periods when symptoms become much worse are referred to as fibromyalgia flares (an exacerbation of fibromyalgia) and are a major component of the condition. Despite the frequency of flares, however, we know very little about them.

Unlike day to day variations, flares usually last several days or weeks.

Symptoms

The symptoms of a fibromyalgia flare often differ from the daily symptoms and may have a distinct pattern. Symptoms may include flu-like body aches, pain, fatigue, stiffness, and cognitive dysfunction (fibro fog).

Causes and Triggers

It's not known exactly why flares occur, but several triggers have been identified. These triggers often differ from person to person, but in any one individual, they may be similar to each flare. Possible triggers include:

• Stress, whether physical or emotional
• Overdoing it
• Poor sleep
• Weather changes: Temperature sensitivity is also common
• Menstrual cycle changes: For some people, fibromyalgia flares are tied closely to the menstrual cycle
• Illness
• Major events such as holidays or vacations
• Schedule changes
• Changes in treatment
• Any kind of trauma, including injury, surgery, or getting a tattoo

Managing Flares

Common methods of managing flares include rest, avoiding activity, and avoiding stress. Flares can sometimes be extremely difficult to manage. People may be unable to work and become minimally functional at home.

There are unfortunately few treatments which work to specifically treat flares. Medications for fibromyalgia usually take several weeks to work and therefore are usually ineffective in controlling a flare. Pain medications are also of limited value.

Preparing for Flares

One of the more challenging problems with a flare, beyond coping with symptoms, is managing your household. You may feel that your entire household is thrown into disarray when a flare strikes. Being unable to cope with the mess adds stress, which in turn can worsen your symptoms.

Few people experience fibromyalgia in isolation, and friction sometimes occurs when other family members are called upon to do tasks you ordinarily do yourself.

In addition to reducing your triggers (see prevention below) it's helpful to plan ahead for these periods of time. For example, many people know they will have a flare after major activities such as a vacation or holidays. Learn more about preparing for a fibromyalgia flare from what items to keep on hand to what you can do to pass the time until you feel better.

Living With Flares

In addition to pain, fatigue, work problems, and a messy household, cognitive dysfunction can be severe during a flare. Some people find that they're too disoriented to drive safely and have trouble even putting a sentence together. Multi-tasking? Short-term memory? Forget it. (No pun intended!)

Understanding cognitive dysfunction can make it easier to cope with, and if you are suffering this annoying symptom take a moment to learn more about living with brain fog/fibro fog.

Prevention

It's not always possible to prevent flares but there are things you can do to reduce their frequency and/or severity. Review the common triggers and think about what you can do to modify these. For example, if you suffer from insomnia, talk to your healthcare provider about treatments (this does not necessarily mean medications and cognitive behavioral therapy has shown promise.) Some people have sleep apnea which requires treatment.

Pacing yourself is a key component in prevention. Overdoing it is a common flare trigger, and many people overdo it when they finally feel okay for a while.

Stress is a common trigger, and there are many things you can do to improve your stress management.

It's not usually possible to control the weather or holidays, but you can still prepare ahead, and optimize other measures for reducing flares such as being very careful with your sleep schedule.

If your symptoms are tied to your menstrual cycle, hormonal therapy (or even procedures such as endometrial ablation) may help.

Keeping a journal is very helpful for finding patterns in your disease, such as your common triggers. You may want to chart your diet, exercise, sleep patterns, and give a number between 1 and 10 for the severity of your most common symptoms. In time you're likely to see several patterns, which in turn may help you lessen your flares.

Bottom Line

Flares are something most people with fibromyalgia will have to deal with, but with time and effort, you may be able to identify your triggers to reduce the incidence or severity. Prevention works much better than treatment, and at the current time, we have few specific treatment options for addressing the exacerbation of symptoms which go with a flare.