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What’s the Hidden Cause Behind YOUR Fibromyalgia Flares?

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Have you noticed that we fibromyalgia people have our own lexicon for what we experience? We’re called fibro folk, fibromites, spoonies or other names. We live in our own fibro worlds and share our circumstances with our fibro friends. Whatever we happen to forget is caused by fibro fog and then there’s the ever-evolving topic of fibro flares ….

Does anyone else out there have fibro flares, or is that just me?

Oh yeah. We all do.

What differs for each of us is the cause, the duration, and the intensity of our flares. Today’s article will focus on the topic of “the cause.”

That’s a misnomer already. If there’s anything that you remember from this article (despite the waxing and waning fibro fog) I hope that you grasp that there is no ONE single cause of a flare (or even of fibromyalgia in the first place). But let’s not get ahead of ourselves.

Here’s a simple demonstration of a fibro flare:

You wake up with a crick in your neck that’s worse than whatever you term your “daily normal stiffness quotient.” You go through the rigmarole of getting ready for the day and feel a dull headache coming on. You vaguely wonder if there’s a weather change afoot. When you’re fixing breakfast and reach up into a cupboard, that crick in your neck becomes more of a small lightning bolt. It now radiates down your back, shoulder, and through your chest. You start to feel a bit woozy. You say to yourself, “Oh, here it comes….”

You quickly flip through your agenda for the day in your head. You filter out the non-essential tasks from those that are absolutely essential. You whittle everything down to the bare minimum. You’ve now prepared yourself to have a “flare day.”

You’re oh-so familiar with your flares. You recognize one when it’s headed your way. You can’t say it’s a friend, but it’s definitely an old acquaintance.

But what ARE flares? And, what brings them on?
First of all, it’s F-L-A-R-E and not “flair” (the latter describes something much more fun).

A flare of symptoms (a fibro flare, specifically), is an accumulation or a cascade effect of aches, pains, spasms, imbalances, and overall systemic disturbances. A flare is an unplanned hurricane of symptoms. Of course, some flares are more like thundershowers than hurricanes, but the fact that they “rain” on our plans is universal.

When I see a client who mentions a recent flare, I ask her to go along with me on a symptom archeological dig. We determine when the accumulation of symptoms first occurred. We speculate on what was going on at the time. I often ask questions that clients feel are completely unrelated, but I ask for patience. You see, there are many not-so-obvious factors that can contribute to a flare.

Here are a few common causes that come to mind:

  • A recent fall, stumble, or startle to the body (even minor events)
  • A recent injury whether major or minor
  • Recent changes in prescribed medications
  • Recent changes in over-the-counter medications
  • Weather-related changes (yes, some studies state this is hooey while others state it as fact. I don’t care. I feel physical changes with barometric weather changes as do my clients, relatives, and fibro friends)
  • Recent doctor’s visits (including MDs, physical therapists, dentists, etc.!)
  • Recent travel (air, bus, train, car, etc.)
  • A recent change in sleep patterns (too little, too much, changed location/pillows, etc.)
  • Other physical changes

Here are some that may take a bit of increased awareness:

  • Recent changes/additions in hormone medications, creams, supplements, etc.
  • Eating foods that don’t “agree” with you and your nutrition type
  • Recent changes in diet/nutrition
  • Lack of fitness routines (a sedentary lifestyle leaves the body vulnerable to muscle pulls, pinched nerves, spinal alignment issues, etc.)
  • Recent cold, flu, or infections especially when connected to taking a course of antibiotics
  • A recent upsetting “discussion” or disagreement with a close family member, co-worker, or friend
  • A recent personal discovery or revelation that feels overwhelming, saddening, or devastating, (i.e. finding out that your child who planned to attend a local college, now plans to attend school out of state, or, obviously, something worse)
  • Any negative, unhealthy, cyclical, critical, judgmental thoughts about yourself and others
  • Recent external toxic exposures (to pesticides, carpet cleaners, air fresheners, candles, scented laundry products, perfumed items, hair and skin care products, remodeling supplies [i.e., paint, varnish, adhesives, etc.]), etc.
  • Recent internal toxic exposures to chemicals found in packaged and processed foods, drinks, pharmaceuticals, over the counter medications, dental work, immunizations, and more

Additionally, here are chronic versions of issues that can build like tinder just waiting to flare:

  • Chronic generalized worries, stress, anxiety
  • Chronic relationship issues and worries
  • Chronic financial issues and worries
  • Chronic concerns and fears of future health and/or disability issues
  • Any fear or worry that escalates into a chronic state
Anything that has the potential to worsen symptoms,
can provide the catalyst to a fibromyalgia flare.

Here’s a more detailed illustration of how a flare can happen.

Faye is a 43 year old woman with fibromyalgia. Faye has recently changed her position at work to one that requires less travel. She was no longer able to “handle” the constant shuffling from rental car companies to airports to hotels.

Faye is frustrated by her physical limitations and made the job decision by default rather than by choice. Thinking about these frustrations, she packs up her office late on a Friday night after everyone has gone home so she can be alone. Her new job is on a lower floor of her building – not to mention at a lower pay. She’ll have to move into the new office on Monday morning. She puts her few personal possessions into a small box and only packs what fits inside. She carries it under one arm as she hurries to the elevator.

Across her office parking lot, she tiptoes through seeping mud-filled puddles and regrets leaving her large umbrella in the office. When she gets to her car, she avoids putting the box down onto the wet blacktop to locate her keys, and instead balances it along with her purse and a book bag. She successfully fishes her keys from her purse and while swinging her car door open, she loses her grip on everything. Gritting her teeth, she watches the box, its contents, her purse, and her books fall onto the filthy, soaked ground.

By the time she’s collected her things and climbed into her car, she’s soaking wet and in pain. Her anger and frustrations fuel her thoughts all the way home. She walks into her small apartment and is too upset to do anything but turn on the TV for distraction. The achiness in her back, neck, and shoulders increases. Her muscles stiffen. Her knees, hips and wrists are sore from crawling around on the parking lot. She knows that a flare is imminent. She mutters to herself, “Oh, here it comes … and this one’s gonna be a doozy.”

Can you relate?

Of course, for illustration purposes, this story combines multiple “flare factors.” Faye had definite physical injuries and potential impairments of muscles, joints, and surface abrasions. She was probably achy already from the rain. On the emotional side of things, her fears and worries included money, career, job security, embarrassment, anxiety over loss of physical mobility, self-identity changes, isolation, relationship issues, and more.

While this may be an exaggerated depiction, remember this –

A fibro flare is never “caused” by just one thing.

A set of circumstances throws a flare into action.

So, the next time that you’re in a flare, or if you think back to a recent flare, go beyond the obvious. Besides the injury, think about what was going on in your thoughts at the time. Were you frustrated, angry, or upset?

Understanding the connection between all of these factors gives YOU the power to better predict as well as manage your flares.

What combination of flare factors affects you the most?


Sue Ingebretson (www.RebuildingWellness.com) is an author, speaker, certified holistic health care practitioner and the director of program development for the Fibromyalgia and Chronic Pain Center at California State University, Fullerton. She is also a Patient Advocate/Fibromyalgia Expert for the Alliance Health website and a Fibromyalgia writer for the ProHealth website community.

Her #1 Amazon best-selling chronic illness book, FibroWHYalgia, details her own journey from chronic illness to chronic wellness. She is also the creator of the FibroFrog™– a therapeutic stress-relieving tool which provides powerful healing benefits with fun and whimsy.

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12 thoughts on “What’s the Hidden Cause Behind YOUR Fibromyalgia Flares?”

  1. AHeart says:

    I thought we’ve got past all this horse crap?

  2. connie99 says:

    Inner turmoil, indecision, family stresses. Sometimes a chemical exposure, like cooking on a gas range or someone’s use of home fragrances or candles.,

  3. lspens says:

    You just about described me in that example you shared. I too am being forced to change positions against my will and at a lower rate of pay. I will simply need to move the contents of my cubicle to another location in the office, so there won’t be any of the outdoor issues you described. But I can tell you that I had a flare that lasted about a week after I was told I need to change positions. And now I am going to be looking for another job after over 23 years at my current company.

  4. Suze54 says:

    I find sudden drops in Barometric Pressure trigger overall weakness. I also find overwork can throw me into a three day pit. When I have the rare time I feel good; I overdo anything I can because I don’t know the next time I’ll ever have any energy! Frustration and Depression pull me in to a downward spiral of inactivity which leaves me weak and angry with myself for lacking discipline.

  5. bettyannw2006 says:

    I don’t understand the rubbish response. I enjoyed the article. It helps me remember that others go through this too and realize that I can have a little control over my situation.

  6. CarolBuck says:

    It doesn’t matter what time of the day or year it is for me that I’m not prepared for most eventualities. Yes, I live in Hawaii, but at 3,000 ft. The temp can be 40 in the a.m., 85 in the mid-day. So, I carry 3 different jacket weights and layer my upper clothes. Im able to go to my car when necessary to get what I need, or I can put most of my extra stuff either in my purse or my cubby. You can carry a small umbrella in your purse or briefcase. I always carry some of all my medications, also keeping a small amount of my asthma meds at work. When in a large city, you should also have a pair of walking shoes available in your desk, or under it. I keep up my tests for thyroid and D-3 levels, and I take 4000-6000 I.U.s per day to keep my pain levels down. If I am having allergy problems, or will be doing something at work that might cause an allergy attack, I make sure to have some chewable vit.C tablets available in my little meds purse. I also carry a change of underwear in a little plastic zipper bag, just in case. For those who may have to carry a heavy bag or box each day, as I do, I will either take a box or shopping bag, which is collapsible. For flare-ups, I make sure I’m taking the D-3 tabs every morning, under the tongue, and I always have a large supply of colostrum at home. I follow the CDC guidelines that were published perhaps 15 years ago on the web site. I have copies, if you want them. I am almost always prepared for emergencies, since they can happen at any time, especially at work.

  7. Twixy says:

    I relate to the example you posted. I start my day with pain between my shoulder caps and tension on my upper neck. I have 5 beautiful children that I have to attend to with or with out pain. As I attend to them my pain goes all the way down to my tailbone. I start thinking about the weather at that point my hands are tingling…falling asleep. And I start thinking when is this gonna stop. It’s an everyday thing. I am 34 years old and feel a lot older. My depression hits me most days. And the last time I went to my primary she told me she didn’t want to get me addicted to pain killers… she had prescribed several but none worked… my pain is chronic. At this point I’m living with this pain without medication, and without insurance.I really don’t know what to do. This is my main frustration.

  8. Kamatsu says:

    I recently had another UTI and a day after finishing the antibiotic, I am experiencing a very nasty flare. I read that an infection can cause a flare and wonder if it is so. I also have CRPS and Chiari which makes it hard to know just exactly is going on.

    I would like advice on how to get over this. Unfortunately, I know I push myself too hard. I am afraid if I don’t keep going I won’t be able to.



  9. Pookie33 says:

    I’ve been my own worst enemy when it comes to flares. I work in a busy dialysis unit and, although I’ve had to cut my hours, try to fit 13 hours work into the 10 I now do…..it doesn’t work! So after doing a pain management programme which taught me pacing, acceptance, and mindfulness, I work to my own speed depending on how well I feel.
    I now cope well enough that I can go to the gym after work and swim to stretch my back out and the spa pool also works wonders :)My attitude to life has changed, I’m much more relaxed about issue that would have stressed me out before and push me into flares.
    I’ve made an effort to put myself first often, I’ve learnt to say no!
    If I forget about taking things more slowly and gently the pain between my shoulder pain kicks in within an hour or so.
    I’m going to keep being more mindful about my own health needs, this seems to be the way forward for me. With this in mind I’ve downloaded guided meditations onto my phone so when I start to get stressed I can slip off to the loo and do a 5min meditation which brings me back down to normal stress levels.

  10. Genesandoval says:

    I follow the advice of my primary care provider such as exercise, vitamins, behavioral therapy, rest, lyrica and an antidepressant for my symptoms. However with all the advice I take I’m still experiencing at least 3 or 4 flare ups a week. My flare ups start first thing as soon as I wake, they last all day or several days with symptoms ranging from severe stiffness, extreme fatigue and the increased body pain which is at this point is not controlled by lyrica. However with the addition of xanax to my meds it has helped combined with the lyrica. I also will use my fitness center’s hydrotherapy massage bed to relax my muscles..hope this helped and I welcome suggestions as well

  11. Genesandoval says:

    I follow the advice of my primary care provider such as exercise, vitamins, behavioral therapy, rest, lyrica and an antidepressant for my symptoms. However with all the advice I take I’m still experiencing at least 3 or 4 flare ups a week. My flare ups start first thing as soon as I wake, they last all day or several days with symptoms ranging from severe stiffness, extreme fatigue and the increased body pain which is at this point is not controlled by lyrica. However with the addition of xanax to my meds it has helped combined with the lyrica. I also will use my fitness center’s hydrotherapy massage bed to relax my muscles..hope this helped and I welcome suggestions as well

  12. Nancy N Ray says:

    I know this is an older article and probably won’t be seen by many, but I want to post here to see if anyone agrees with me. I recently had two Covid vaccinations (Moderna). The side effects were pretty bad and lasted for two days. I was expecting this, but what I wasn’t expecting was that I’m now having a fibro flare – something I haven’t experienced in years.

    This is all new since Covid has been around for only a year and vaccinations for a few months. I wonder if anyone else has experienced this. I’m not thrilled that my fibro pain is back, but since I’m in a “vulnerable” category, there was no choice of not taking the vaccination.

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