The course of fibromyalgia varies from one person to another and is characterized by remissions
and flare-ups of symptoms. A remission is defined as a period when one's symptoms are
greatly diminished or even absent.

     Remissions can last for days, weeks, months, and even years and often differ from one time to another. A flare-up of symptoms can often be associated with any one or more of the modulating factors that were discussed in the diagnosis and symptoms section (e.g., weather changes, stress,
interrupted sleep, depression, postural strain, etc.).

     Sometimes a flare-up can't be attributed to anything that we're able to identify and can contribute
to a feeling of frustration and lack of control over our health.

     At this point, we need to remember that we can regain a "take charge" attitude over our fibromyalgia and learn to proactively manage the flare-up. The duration, intensity, and type of symptoms will
often vary and may present us with new challenges. The following management guidelines
have been helpful to many experiencing a flare-up and  may help you cope
    more effectively with this distressful part of living with fibromyalgia.
 

Remove or change a modulating factor, if possible.

          Eliminate or reduce repetitive stress.
          Treat other illness.
          Correct posture.
 
 

     Evaluate sleep and discuss other medication options with your physician.

          Change medication or increase dosage of current medication.
          Improve sleep environment.
 

     Practice relaxation/biofeedback.

          Listen to relaxation tape daily.
          Resume practicing of biofeedback.
 

     Rest and be gentle to yourself.

          Take frequent breaks from activity.
          Cancel unnecessary appointments.
          Give yourself permission to take care of your health.
          Try to make activities of daily living as easy as possible.
          Take a nap and/or try to get more sleep at night.
 

     Reduce stress level.

          Identify major stresses and eliminate or modify where you can (both physical and emotional).
          Alter your perception of the stress, when possible.
 

     Apply heat/analgesics.

          Take warm baths or whirlpools or apply warm gel packs.
        Apply topical capsaicin creams.
          Use over-the-counter pain medication as needed for short-term relief.
 

     Try massage/acupressure/acupuncture.

          Consider using theracane and other self-massage tools.
          Sometimes several sessions of physical therapy are prescribed.
 

     Practice gentle stretching.

          Apply heat for 15-20 minutes before stretching.
 

     Decrease duration and intensity of exercise.

          Include not only a stretching and aerobic component, but also a time to sit in a
warm bath or whirlpool.
 
     Positive messages.

          It's easy to feel discouraged, but try repeating these self-affirming messages:

               "I am doing everything necessary to feel better."
               "This flare-up will be over soon."
 

Flare-ups are part of living with fibromyalgia. Though they can be frustrating, discouraging,
and uncomfortable, you can help yourself through them by remembering these strategies.
You will take charge of fibromyalgia once again!