Tips to Identify Pain Triggers

Pain is multifaceted and presents differently for each person. It is a signal from the central nervous system indicating something is wrong. A pain flare is a period of heightened pain and worsening symptoms. It includes increased inflammation and stiffness, and can last from a few days up to weeks.

Triggers are typically the cause of pain flare-ups, which can vary in duration, frequency and intensity. Identifying your triggers is the most valuable approach to manage or prevent flare-ups.

Examples of triggers

Pain triggers can consist of almost anything, and they vary depending on the type of chronic pain. Tapering, stopping or skipping medications is the most common trigger that causes pain flare-ups. Other examples of pain triggers include, but are not limited to, the following:

• Activities (new, lack of, or revisions), including standing, sitting, repetitive movements, overexertion, exercising, crossing legs, lying down, driving, sleeping, showering, household chores, etc.
• Stress, PTSD, poor sleep, sexual intercourse, etc.
• Infection, such as colds, flu, allergies, bacteria, virus, etc.
• Foods, drinks, diet changes, smells, sounds, etc.
• Injuries, including skin injuries, falls, car accidents, etc.
• Clothing and accessories, such as wearing a restrictive bra or pants, carrying a purse on the shoulder, ill-fitting shoes, etc.
• Smoking, drinking alcohol, weight gain, dehydration
• Certain medications
• Weather, altitude, temperatures, and changes in barometric pressure

Identifying triggers

Many people are unaware of their triggers; however, pain is better managed by avoiding them. While some triggers are easy to establish and prevent, others are extremely difficult to identify. Oftentimes, there is more than one pain trigger. Tips to identify them include journaling, being detailed, paying attention to changes, and taking note of different pain levels.

• Journal. Keeping a pain journal is the best way to determine what is causing your increased discomfort. This should include when, where, intensity, current emotions, medications, dosage, time taking medications, activities performed, etc. Keeping a journal of your pain is easier when using an app, which can also be viewed with a health care professional who can help you determine triggers. PainScale has an app available that can be found by going to the App Store and searching PainScale - Pain Tracker Diary. PainScale is committed to continuously enhance the app with more features to help chronic patients effectively manage their pain journey. Information about the PainScale app can be found here. You can also find instructions on how to add triggers here.
• Be detailed. It is imperative to be detailed in your pain journey to identify your triggers. It may be something as simple as watching a television show that causes emotional strain, such as stress, sadness, aggression, etc. The more information collected, the easier triggers will be identified.
• Pay attention. Changes may be small, but should be noticed. For example, if back pain flares up every Sunday, be mindful of any activities that are done on Saturday, such as vacuuming, mopping, mowing, etc. Perhaps your family enjoys pizza and a movie every Friday night, and you notice your pain is worse on Saturdays. Something as simple as a pizza ingredient could trigger your chronic pain. Be mindful of anything that could potentially worsen pain in order to have control over it.
• Note changes in pain levels. If lying down decreases or increases your pain, it could be the mattress or pillow, or the fact that you are standing too long. If sitting increases pain, it could be your chair. It is important to take into account anything that eases or intensifies pain to determine possible triggers.