Chronic pain flare-ups: causes and tips for pain relief

Living with chronic pain often means dealing with unpredictable ups and downs. Stretches of good days can be interrupted by flare-ups — periods of time when pain or other symptoms suddenly get worse. Unlike acute pain, which usually follows an injury and resolves within a few weeks or months, chronic pain can linger and tends to ebb and flow.

“Chronic pain may start after an injury or be linked to a medical condition, but it can also happen and recur without a clear cause,” explains Elle Carlson, PT, DPT, a physical therapist at Hinge Health. For many people with chronic pain, pain isn’t constant — it comes and goes. In part because of their unpredictability, pain flare-ups can make daily life more challenging.

Recognizing the early signs of a pain flare-up and understanding what might trigger your symptoms can help you take action and get relief. Gentle movement, stress management, and other simple strategies can make pain flares easier to manage and help you keep up with your regular activities as your pain flare eases.

Read on to learn what happens during chronic pain flare-ups and get tips from Hinge Health physical therapists on how to manage them.

What is a pain flare-up?

A pain flare-up is a period of time when pain suddenly becomes worse, often along with other symptoms, such as increased stiffness, fatigue, changes in mood, or decreased mobility. “Depending on your condition and situation, pain flares can be widespread or focused in one area, and they’re often unpredictable,” says Dr. Carlson.

Chronic pain flare-ups often aren’t due to a single event. Instead, they result from a mix of physical, emotional, and environmental factors — such as increased stress, changes in routine, or lack of sleep — that make your body more sensitive to pain signals. 

During a flare-up, muscles around the painful area may tense or stiffen, inflammation may increase, and your nervous system may become more alert to even mild discomfort. These changes can also drain your energy, affect your mood, and disrupt your sleep.

Symptoms of a pain flare-up can vary from person to person — or even from one flare-up to the next — but may include:

• Increased pain intensity

• Stiffness

• Fatigue

• Reduced ability to be active

• Changes in mood, such as anxiety or feeling down

• Low motivation

• Difficulty sleeping

Even though flare-ups can be discouraging, remember that they are temporary. It’s normal to feel frustrated or overwhelmed when your pain gets worse. With the right tools and support, you can get through these challenging moments and find relief. Having a toolkit of practical strategies can help you feel more comfortable and confident, even on hard days.

Causes of chronic pain flare-ups 

Sometimes the trigger for a pain flare-up may feel obvious, like doing more physical activity than usual. Other times, pain may seem to flare up at random. In reality, flare-ups are usually your body’s way of responding to some type of stress — and this stress is often more complex than it seems at first. It isn’t always a sudden injury or tough workout. Often, it’s a mix of subtle changes such as sleepless nights, emotional strain, changes in weather, or illness that can tip the balance.

“Whether it’s physical or emotional, any added stress on your system can increase your sensitivity to pain,” explains Dr. Carlson. Common triggers of pain flare-ups include: 

• Physical overexertion. “Regular physical activity is important for preventing and managing pain, but doing more than your body is prepared for can sometimes have the opposite effect,” says Dr. Carlson. For example, lifting weights that are heavier than what you’re ready for, jumping back into intense exercise after time off, or pushing through a workout when you’re feeling fatigued or sore can trigger a flare-up. 

• Injury. New injuries — such as a sprain or strain — anywhere in your body can cause an existing pain condition to flare up. “An acute injury can trigger inflammation, which may heighten your body’s sensitivity to pain and worsen chronic symptoms,” explains Dr. Carlson. This means that sometimes, pain flares up not just at the site of the new injury, but also in areas where you already experience chronic pain. 

• Stress. Any form of emotional strain — like anxiety, sadness, or feeling overwhelmed — can contribute to pain flare-ups. Everyday stressors, such as a tough day at work, relationship issues, or financial worries, can increase muscle tension and make your body more sensitive to pain. “When your mind is under stress, your body often responds physically, which can amplify chronic pain symptoms,” says Dr. Carlson.

• Poor sleep or fatigue. Your body relies on quality sleep to repair and recover. Without enough rest, your body has a harder time healing, managing inflammation, and coping with stress. This can make pain worse and increase the risk of a flare-up.

• Weather changes. Shifts in the weather — such as changes in temperature, humidity, barometric pressure, or incoming storms — can make a noticeable difference in pain levels for some people. Although the reasons aren’t fully understood, some people experience increased stiffness or achiness when it gets cold or damp, while others find their symptoms worsen with heat or sudden weather shifts. 

• Infections or illnesses. Even minor illnesses — like a cold or stomach bug — as well as more serious viruses can put extra strain on your body. Fighting off infection can cause inflammation, weaken your immune system, and drain your energy reserves, all of which can make you more sensitive to pain and trigger flare-ups. For many people with chronic pain, being sick also disrupts routines and sleep, which may further worsen symptoms.

While it’s not always possible to predict a pain flare-up, understanding your personal chronic pain triggers can help you better manage and prevent future episodes.

Biopsychosocial influences on pain flares

Pain flares usually don’t happen in isolation. They’re influenced by a mix of biological, psychological, and social factors — a concept known as the biopsychosocial model of pain. Recognizing these different layers can help you identify patterns in your own pain and take steps to ease your symptoms.

• Biological factors. Inflammation from injury or illness, muscle tightness or overuse, sleep disruptions, hormonal changes, and medication changes can all increase pain sensitivity or trigger flares.

• Psychological factors. High levels of stress and anxiety can kick your body’s “fight or flight” response into overdrive, increasing muscle tension and pain sensitivity. Low mood or depression can intensify the experience of pain, while fear of movement can make discomfort worse.

• Social factors. Feeling isolated, lacking support from friends or family, dealing with job or financial pressure, or having trouble accessing healthcare can all add to pain levels and make flare-ups harder to manage.

The impact of pain flare-ups

Flare-ups can have a wide-ranging impact on daily life. When symptoms intensify, even simple activities — like walking, getting dressed, or concentrating at work — can become difficult or exhausting. This sudden change can disrupt routines, lead to missed social plans, or affect your ability to keep up with responsibilities at home or work.

“A pain flare can lead you to avoid activities you enjoy, which ultimately affects your mood and mental well-being. That also makes it more difficult to stay active, which is one of the best things you can do to help relieve a pain flare,” says Dr. Carlson. 

While flare-ups can affect both your body and your mood, learning what specific approaches help you cope — such as pacing activities, getting rest, or reaching out for support — can make these periods of increased pain more manageable, says Dr. Carlson. With time and the right strategies, many people find they can better handle flare-ups and continue to enjoy meaningful activities, even on difficult days.

It’s natural to want to rest when pain flares up. Movement — and exercise routines and sports in particular — can feel intimidating or uncomfortable. However, gentle, targeted exercises can provide real relief during a flare. These movements recommended by Hinge Health physical therapists help by keeping your joints and muscles mobile, which can reduce stiffness and ease discomfort. Exercise also encourages the release of natural pain-relieving chemicals in your body and helps manage stress and anxiety, which are common contributors to pain. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for a chronic pain flare-up

Managing a pain flare can feel overwhelming, especially when symptoms come on suddenly or start to build. Learning to recognize the early signs of a flare gives you the chance to act quickly. “Taking action as soon as you notice your pain coming back can help stop it from getting more intense or lasting longer,” says Dr. Carlson. By building your own set of simple, home-based strategies, you can feel more prepared and in control. 

Here are tips to help you manage a pain flare:

• Try physical therapy and targeted exercises. Targeted exercises help strengthen and stretch the muscles around the area where you’re having pain. This can provide support to sore joints, reduce pain, and improve your flexibility and movement. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth or video visit. 

• Stay active. It may be understandably challenging to stay active when you’re in pain. Exercises targeted to your area of pain are designed to help with recovery, but any type of movement — like walking, stretching, or even simple household chores — can improve pain symptoms during a flare-up. “Start with a comfortable activity you can manage, and gradually increase your activity as you move through the flare,” suggests Dr. Carlson.

• Use ice and heat. Both can be effective for soothing a chronic pain flare-up, depending on your symptoms. Applying a warm compress, heating pad, or taking a warm bath can help relax tight or sore muscles. If you notice swelling, an ice pack may reduce inflammation and ease discomfort. “Use whichever option feels best for you,” says Dr. Carlson. To prevent skin irritation, be sure to place a barrier between your skin and the heat or ice, and keep each session to 15–20 minutes.

• Practice relaxation techniques. Research shows that relaxation techniques can reduce the severity of pain and improve overall well-being for people with chronic pain. Deep breathing, meditation, or gentle, calming activities can help lower stress — one of the main factors that can make pain flares feel more intense, says Dr. Carlson. These practices not only ease tension in your body but also help quiet your mind, making it easier to cope with pain. It can be tough to relax when you’re in the middle of a flare, but even a few minutes of these techniques can provide noticeable relief.

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can perform your targeted exercises and stay active when you have a pain flare-up. Other options include topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce pain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

• Complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for pain relief, such as massage, acupuncture, or chiropractic care.

How to prevent a flare-up

While pain flares can sometimes feel unpredictable, there are steps you can take to help reduce how often they occur. Simple habits — like staying active, managing stress as best as you can, and following a balanced daily routine — can go a long way in preventing flare-ups. If you take medication, maintaining a consistent schedule is important. Always follow your healthcare provider’s advice about routines or treatments that can help manage and prevent pain symptoms. Here are tips from Hinge Health physical therapists to prevent  pain flare-ups: 

• Make relaxation part of your routine. Regularly practicing techniques like deep breathing, gentle stretching, or meditation can help ease tension before it builds up and triggers a pain flare. Even small moments of calm throughout your day can help you manage stress and support your body’s ability to cope with pain over time.

• Maintain steady routines. Consistency helps your body function more smoothly, which is especially important when dealing with chronic pain. Sudden changes in your daily schedule — like shifts in activity level or sleep patterns — can sometimes trigger pain flares. For example, staying up much later than usual on weekends, or skipping your usual morning walk, may lead to increased discomfort the next day. Dr. Carlson recommends keeping a regular routine for your activities, rest, and self-care whenever possible. Predictable patterns help your body adjust and respond more calmly to stress, making it easier to manage and prevent flares.

• Prioritize nutrition. Eating a balanced, nutrient-rich diet supports your body’s natural healing processes. Focus on foods like fruits, vegetables, fatty fish, nuts, seeds, and whole grains. These foods help reduce inflammation and offer nutrients that support tissue repair, such as omega-3 fatty acids and vitamins C and D. For individualized guidance, consider working with a registered dietitian.

• Listen to your body. Paying attention to how you feel day-to-day can help you spot the early warning signs of a pain flare, giving you the chance to address symptoms before they get worse. Noticing subtle changes — like increased soreness, fatigue, or tension — allows you to adjust your activities or self-care routines early, which may help prevent a full-blown flare.

When to see a doctor

Pain flare-ups often improve on their own with simple, at-home treatments. But if your pain is severe, getting worse, or making it hard to do everyday activities, see a healthcare provider. It’s also a good idea to get care if you have:

• Tried at-home treatments for a few weeks with no noticeable improvement

• Symptoms that are increasingly affecting your quality of life or daily functioning

• Symptoms that are very different from your usual flare-ups

• Pain that is much more severe than normal

PT tip: Find your movement sweet spot 

Your movement sweet spot — the level and type of activity that feels manageable without making your pain worse — can change from day to day, especially during a pain flare. “If activities that usually feel good are too much right now, that’s okay,” says Dr. Carlson. “Pay attention to what feels manageable in the moment and adjust your routine as needed, whether that means swapping your regular workout for gentle stretching, a short walk, or other simple movements you enjoy.”

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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3. Hannibal, K. E., & Bishop, M. D. (2014). Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation. Physical Therapy, 94(12), 1816–1825. doi:10.2522/ptj.20130597

4. Diez, G. G., Anitua, E., Castellanos, N., Vázquez, C., Galindo-Villardón, P., & Alkhraisat, M. H. (2022). The effect of mindfulness on the inflammatory, psychological and biomechanical domains of adult patients with low back pain: A randomized controlled clinical trial. PLOS ONE, 17(11), e0276734. doi:10.1371/journal.pone.0276734

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