Tuesday, April 3, 2012

Pain Flare Vs Breakthrough Pain

This past weekend I mentioned to a family member that I was in a pain flare, that had started last Wednesday. She said "Oh, so you have to take more pain medicine to keep the pain away then?". I told her no, then explained the difference between a pain flare, and breakthrough pain.

So, what is the difference between a pain flare and breakthrough pain? A flare simply means an excaburation of symptoms. If your pain level is normally a 1 or a 2, and then it goes up to a 7 or an 8, then that's a flare. Usually with a flare, the usual pain medicine you take doesn't give you as effective relief as when you're not in a flare. A flare doesn't have to be related to just pain either. It can also be a flare in fatigue, fibro fog, or any other symptom. Basically, any symptom that you have, that intensifies without relief, is a flare. For your doctor to consider you to be in a true flare, your increased symptoms have to last for at least 24 hours.

With breakthrough pain, you may take a pain pill for your pain then before time for your next pill, the pain comes back. Once you take the pill again, your symptoms again settle down. This type of scenario is considered breakthrough pain.

Sometimes you can break a flare, just by increasing your rest and decreasing your activities. Sometimes you may need a short dose of steroids or a shot of cortisone. Sometimes an increase in pain meds will help. When all else fails, sometimes you just have to tuff it out until it breaks on it's own.

Last Wednesday, I started a flare. By late Thursday night, I was ready to call my rheumatologist. I didn't call on Friday though, because I knew that I wouldn't be able to be seen until at least Monday. My rheumatologist is at The Cleveland Clinic, in Cleveland, OH and it's approx. a 2 hour drive from me. My husband wouldn't be able to take the day off to get me there with that short of notice. Thankfully, my pain flare finally broke on it's own, on Sunday. This was the worst and longest pain flare I've ever had. The fibro fog that accompanied the flare was bad. It left me feeling drained, depressed and alone.

Although pain flares are to be expected when you have Fibro, CFS, Lupus, Arthritis, etc., it's still hard to deal with the symptoms when one hits. Try to figure out what caused your flare. Did you exercise too much? Were you in a stressful situation? If you can figure out your triggers for a pain flare, then you're better able to control the situations around you, that may cause a flare. I still haven't figured out what caused this last one I had. Rest assured, I'll pay more attention in the future though!


  1. I have not been able to figure out what causes my Crohns to flare. Fortionately since my last bad flare I've started a new medication and have had only a couple minor breakthrough situations.
    As for the migraines...my biggest issue is breatkthough pain. Usually I can control the pain with my at home medication. When that fails to control the pain (breakthrough) then I need rescue medication. This is where my problems start. I know what works best for my break though pain. My doctors disagree. It is a never ending battle. One that I am getting tired of fighting.

    I'm glad that you're flare has passed! It's such a blesssed peace when the pain lets go.

  2. Shelli, Doctors can infuriate me. How in the world can they disagree on what helps YOUR pain?! They aren't the ones with your pain. They aren't the ones that feel relief/don't feel relief when something is taken or not taken. I'm so angry for you! I'm so happy that you've only had some minor breakthrough situations with your Crohn's. -Of course, I'd be even happier yet if you had NO pain at all. Sending you a hug.