Flare-up guide
Decide what a bad week looks like while you are having a good one: what you drop, what you keep, who you call. Fill it in once, keep it on the fridge.
A flare is a bad decision-making environment. Everything on your list feels equally urgent, your judgement about what you can manage is running on yesterday’s information, and the person best placed to decide what you should drop is you — last Thursday, when you felt reasonable.
So this one is not a routine. It is eight questions to answer on a good day and keep somewhere you will find them on a bad one. Print it, fill it in by hand, and put it where you would actually look — the fridge, the bedside drawer, a photo on your phone.
Flare-up guide · painfix.ca/plan-flare-up-guide
Fill this in on a good day. It is no use blank, and it is no use written in the middle of a flare. Filled in on
What a flare looks like for me
The early signs, before it is obvious to anyone else.
The point of this box is catching it a day earlier than you usually do. Sleep going first, a shorter fuse, one particular joint starting to talk. Write what actually happens to you rather than what a leaflet says happens.
What I drop first
The things that can wait a week without costing me anything.
Decide this while you are well. In the middle of a flare everything feels equally essential and nothing gets dropped until something breaks. Name the actual class, chore or errand.
What I keep, whatever happens
Medication, sleep routine, the smallest amount of movement.
A flare is not a reason to stop the things holding the floor up. A two-minute version of your movement plan through a bad week is worth more than a perfect week once it is over.
My smaller day
What a Tuesday looks like at a third of normal.
Write it as a day rather than as a rule — when you get up, what you eat, when you lie down. A day you decided on in advance is much easier to follow than one you are negotiating hour by hour while it hurts.
What has helped before
Heat, cold, a bath, TENS, a particular chair or position.
Your own history is better evidence here than anything general. Write down what did not help as well, so you stop spending a bad week paying for it again.
Who I tell, and who I call
Names and numbers. Fill these in now, not at three in the morning.
One person who should know, your doctor’s office, your pharmacy. If you live alone, someone who would notice if you went quiet for two days.
When it is not just a flare
Already filled in. These are the ones that need someone today.
- New weakness or numbness in an arm or leg, or trouble controlling your bladder or bowels — same day.
- Chest pain, or breathlessness that is new to you.
- A fever alongside the pain, or a joint that is hot, red and swollen.
- Sudden severe pain that is not your usual pain in a new place.
- Thoughts of harming yourself. In Canada you can call or text 988 at any hour.
Anything my own doctor has told me to watch for:
These are the things a flare is very good at explaining away. “It is probably just the usual” is the sentence to be suspicious of — if one of these is happening, it is not the usual.
Coming back up
How I return to normal without setting off the next one.
Most flares end the way they started: one good day, spent entirely, followed by three bad ones. Add one thing back at a time and hold it for two days before the next, and write that order down here while you can think straight.
Why a decision made in advance is a better one
The pattern this is built against is the one everybody with a long-term condition recognises: a good day arrives, gets spent in full, and buys three bad ones. Then the bad ones end and the same thing happens again. Pacing research calls it boom and bust, and the reason it is so hard to break is not that people lack discipline — it is that the decision always gets made at the worst possible moment, either mid-flare or mid-relief.
Writing the answers down in advance moves that decision to a day when you can think about it. That is most of what this sheet does, and it is why the boxes ask for specifics: “rest more” is not a plan, and neither is “do less”.
Our write-ups on living with chronic pain in Canada and on pacing an ordinary day go further into it. Pain BC runs free coaching and a support line open to people across the country, which is worth having in the “who I call” box if you do not have anyone else to put there.