Creating a Flare Up Toolkit
If you haven’t created a list with your "flare up toolkit" yet, I highly recommend doing so. When we’re in pain we can often forget what solutions we can opt for to alleviate symptoms, so having a list as a prompt has been a game changer for me. Below you can find a guide on creating one, plus general strategies I use in my pain relief toolkit, I also have symptom specific pain relief strategies that may prompt you when creating your own lists.
Everyone is unique and will respond to treatments and medications in a different way, please note none of this is medical advice, and is solely a list of general strategies I find help me.
This process may be useful if you have a chronic illness and often find yourself 'going blank' when inundated with pain &/or a symptom and are struggling to manage. It's a simple process that's better helped me to cope over the years and to better implement daily management strategies!
Jot down all management strategies that alleviate pain and symptoms
This list may be developed slowly over time and take lots of trial & error
You can separate them into symptom specific strategies or just use a general list
PS. Also record the strategies that don't work for you! This could be useful especially to report to doctors etc.
Save the lists of strategies somewhere easy to refer to
This may be:
The notes app on your phone
You may handwrite it in a journal
You may like to add the strategies to graphics that you save in an album on your phone
When you notice a symptom, get into the habit of referring to your flare up toolkit with the list of prompts and strategies that you can implement
By referring regularly to your "flare up toolkit", over time you will become more accustomed to altering your behaviour and implementing a range of management strategies that can help to bring some relief to a symptom or pain
General Flare Up Strategies
Pain relief medications
Each and every person will have different pain relief medications that work for them during a flare up. This is of course the most obvious form of pain relief. Often the medications only dull or reduce the pain, but do not fully alleviate the symptom, or perhaps only for a brief time, and this is why the other forms of pain relief below can compliment these medications. There may also be medications for when specific symptoms flare, for example migraine medication.
Topical pain relief
For pain in certain areas you can use topical forms of pain relief that you apply directly to the skin. These can be particularly useful for relieving for muscle or joint pain, arthritis, sprains/strains/subluxations/dislocations. These range from things like ibuprofen gel to tiger balm, deep freeze/heat, CBD balm etc.
* Always patch test these before using and check the directions for use - most can’t be used for more than 7 days
Heat therapy is often recommended in chronic conditions to relax and loosen tissues and stimulate blood flow to the affected areas. There are many types of heat therapy (that I love to mix and match):
- warm baths (with epsom salts)
- hot water bottle (regular, long and wrap around)
- electric blankets or heat pads or area specific pads
- microwaveable heat
*Not recommended after activity, where there is swelling, for an acute injury or for extended periods of time. Always check with a medical practitioner if heat is right for your pain
Cold therapy can be super beneficial as a strategy, particularly for migraines, but also for either alternating between heat and cold on flared up muscles, or if it's an injury cold is often recommended. I always find ice packs that are gel based and can be moulded around the area most useful (as opposed to the hard block packs).
Professional massages may be a strategy that also alleviates pain for you but they can also be super expensive, and hard to book a last minute appointment during a flare up.
For the cost of one professional massage, electric massagers are a brilliant replacement. Five years ago I bought the Reviber Zen Physio Deep Tissue Massager which has been a cheaper alternative to the beneficial effects of massage for muscle pain relief. I've also more recently tried this hot and cold massager also from Reviber that included hot and cold therapy with massage which is also a game changer!
Cushions and pillows
Cushions and pillows play a huge role in my flare up (and preventative flare up) toolkit.
Here are FOUR useful pillows:
This helps alleviate lower back and coccyx pain/inflammation (that occurs due to frequent coccyx or hip subluxations). I can't sit down anywhere without this (unless I want to flare for weeks).
If you have neck issues/subluxations/instability and haven't found the right pillow for you, this can flare symptoms. Equally, sleeping on a different pillow to the one you're used to can also flare up symptoms, this is why I ALWAYS bring it wherever I sleep over, even if it's a little bulky to bring with. Definitely makes a big difference to flare ups keeping my pillow consistent.
This is a cylindrical 'tube' shaped cushion that's deal for use under your knees when sitting with legs up or reclined on your back to support them, align the spine and prevent knee hyperextensions (in hypermobility).
Micro bead roll cushion:
This is a malleable cushion that's filled with tiny beads. It's a similar cylindrical shape to the bolster but smaller and more squishy. It can be ideal for supporting your neck or as a lumbar cushion.
For many people who have varying mobility depending on symptoms, one of the first go-to strategies is rest. But long term, this can be super restrictive to daily life and really debilitate routine and ability to do tasks/activities. Many people find mobility aids can help to bring back the freedom to be able to do more during a flare up. I have this foldable walking stick for travelling. Using the mobility aids available on public transport for example the airport mobility service can really help when travelling. Each person will have different mobility aids that are suitable for them, and potentially different aids for different kinds of flares too.
Supports, orthotics & kinaesthetic tape
These are particularly for conditions like Ehlers Danlos Syndrome with hypermobile joints that may sublux or dislocate frequently. Joint specific supports can help to keep the joints in place when they are being excessively hypermobile / following a recent dislocation or subluxation. Kinaesthethic tape is another method of doing this.
Orthotics can be great for aligning the spine, knees and helping with flat feet, useful in EDS but also are a good general tool to help alleviate further back pain / gait issues. I have a custom made orthotic insole for shoes, but also was recommended birkenstocks as a viable sandal by my podiatrist.
Diet and Nutrition
Now everyone is super different, and so what works for me regarding diet and nutrition will vary from person to person. I am definitely not suggesting that a change in diet will cure chronic illness. However, from my experience, certain diet changes can alleviate symptoms, and vice versa, many foods can trigger symptoms.
I've spent the better part of 3 years developing recipes that are suitable for many elimination diets. With all recipes plant based, gluten free, allium onion & garlic free and refined sugar free (which already covers lots of restrictive diets) there are also options for: nut free, seed free, soy free, low histamine, low FODMAP, gastroparesis friendly and many more diets.
You can find FREE printable recipes on My Accessible Kitchen website, just tap the link below!
Symptom-Specific Flare Up Strategies
I've created some graphics that can be created if you'd like more visual representations to refer to when in pain and save them to an album in your camera roll/phone gallery. These are just some prompts and examples. Use the last image as a template to download, add text and create your own.
What is similar to what you would add? What's different? Creating your own can really help to remind you of the solutions to alleviate pain and symptoms during a flare up (which can definitely be easier said than done when it's happening!)
I hope it helps to provide some solutions during your next flare. Let me know how you get on and reach out, I'd love to hear from you!
The Step Ladder Strategy
Discover more about the Step Ladder Strategy for managing your chronic illness alongside the flare up toolkit. When we are in pain, we may struggle to remember the relief strategies we can use for each symptom or condition. It can help to use a flare up toolkit, which you can find out more about on this page, or on my symptom specific strategies page but this is another useful strategy to have in your toolbox!
You can create your own and it can be personalised and tailored to your own symptoms and experiences. Everyone's strategies will be personal to them but the concept is a visual cue to refer to when you need a prompt. The range of things you can apply the strategy to is super vast! The rules for going up and down the steps will change depending on the situation. For example, you may say that _ days symptom free or _ days with symptoms, and you go up to the next step.
How it works?
You will typically always have the baseline or first option on the bottom step and go up the steps when needed. My examples have four steps but you can as many or as few as you need.
However it can vary in context:
These are some examples where you start on the bottom step as the baseline/safest option when symptoms are at their worst, then work your way up when symptoms ease.
These are some examples where you start with the more basic strategies for symptoms that are less severe and as you go up it's when symptoms have worsened.
Create your own using these templates below
How to fill them in?
Download or screenshot the image. Print them out and fill them in by hand or use an app like Instagram Stories to fill in and save to your device. You may want to store them in a digital album on your phone labelled "Flare Up Resources" to refer to when you need.