What Exactly Is a Flare-Up, and How Do You Navigate One?

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Years after I broke my back, I was hit with another flare-up. I now understood the term ‘pain management’ - that’s all I seemed to be doing; just trying to hurt less. I was so far from feeling good. Laundry did it this time. Folding clothes - that’s what broke my spirit again. I went from a highly capable strong young man to folding clothes being too much for my spine to handle.

I still remember walking into a new pain management center thinking they could help me through this flare-up, searching for a fresh opinion because every other doctor had left me feeling hopeless. The place smelled sterile, like cleaning fluids and hospital linens. The waiting area was packed with people twice my age, some shuffling around with canes or walkers—my mind jumped straight to the thought, Is this my future?

After filling out the intake form and waiting for what felt like an eternity, I looked down at my legs. Of course I was wearing two different socks - my life was a mess, and my outfit resembled that. My socks didn’t match—one striped, one plain—but I didn’t care. I had stains on my clothes because chores were hell to me at that point so I just stopped doing laundry. I was so tired of hurting that every mundane chore felt like a battle. I laughed under my breath, but it wasn’t that funny. It was just a trauma response and me laughing to brush off the crushing thought circling through my brain – If I can’t even manage my outfit, how could I manage the rest of my life?

A nurse, after struggling a few times to pronounce my name, called me back. As I sat in the exam room waiting for the miracle working doctor to come in, I clutched a battle-worn faded manila folder stuffed with physical therapy routines, test results, and all the questions I was burning to ask. I kept folding and unfolding the corner edges of that folder hoping to make sense of the chaos in my head and body.

The doctor knocks and enters the room. “Well, Mr. Crispino, I’ve reviewed your file and there’s nothing wrong with you, so why are you here?” he says with a lightness as if he just cracked the case.

I wanted to rage. Anger felt like a more useful emotion than despair. But underneath it, I was just sad—deep, hollow sadness that had settled in after years of relentless back pain. I was only twenty three, scraping by on fifteen dollars an hour and student loans. Now, it felt like any shred of independence was slipping away. A horrifying thought crept in: Am I going to have to move back home with my parents, hide in their basement, and rot away?

I felt my eyes glaze over. Disassociating felt better than letting hopelessness consume me. All of the questions I had prepared myself for, only made sense if the doctor was willing to take this problem as seriously as I was. My mind spiraled, jumping from the fear of not being able to work, to the dread of never feeling normal again, to the frustration of not being taken seriously by yet another medical professional.

No one in that office could see how desperate I was. If someone had told me, “We have a magic cure for your pain, but it’ll cost everything,” I’d have thrown my wallet at them without hesitation. The tears almost came, but I pushed them back as I often did and forced myself to breathe. Don’t cry here. Wait until you’re alone again to break down.

In that moment, I felt utterly alone, convinced nobody truly understood how badly I was hurting. I’d never wanted an end to pain so desperately. Another wave of hopelessness crashed in, whispering Maybe I just can’t do this anymore…

That’s the day I realized how deep chronic pain can burrow into your life. It’s more than physical discomfort—it’s a slow unraveling of hope. At the time, I had no clue my pain might be coming from a “protective loop” within my nervous system. No one had spent the time to teach me about what flare-ups really are. I thought pain was black-and-white: either you’re injured, or you’re not. I thought pain was only a signal that there’s damage.

In that cold exam room, I would have given anything for someone to explain why “healed” didn’t feel healed at all.

And yet, that soul-crushing visit was the beginning of something unexpected: it set me on a path to understand the hidden layers of pain—beyond bones, nerves, tissue damage and muscles. If you’re reading this and feel a pang of recognition, I want you to know: I see you. I’ve felt that despair, and I’m here to tell you there’s more to the story than a dismissive shrug or a spotless scan. Let’s explore exactly what a flare-up is, why it happens, and how you can reclaim the parts of yourself you thought were lost. There is a way forward, and it starts with understanding because you can’t solve a problem you don’t understand.

After that exam-room letdown, I stumbled through years of trial and error, convinced my back was a ticking time bomb. I’d brace for pain with every move—laundry, driving, even sitting—waiting for the inevitable flare-up. If my spine was so broken, shouldn’t it hurt the same way every time? Some days, folding clothes was agony; others, I’d manage fine. Driving could cripple me one morning, then feel bearable a few days later. Bending forward would always hurt, but some days way more than others. What was the variable? Why did my body pick and choose when to scream?

The answer to these questions came one ordinary day, mid-routine, as I powered through a bridge exercise from the program I now teach. I hated this exercise, it lit up my lower back like a flare gun—every rep a reminder of how weak and broken I felt. I’d grit my teeth, tense every muscle, hyper-focus on bracing my core, and predict the pain before it even hit. This spotlight on my limitations was emotional torture. That day, I was mid-bridge, feeling the knife-like stabbing burn, when my four-year-old son burst in. He’s a riot—always has been—and started chatting me up with his goofy, terrible jokes. I couldn’t help but laugh. While I was doing bridges, a Discovery channel nature program about gorillas was playing. The narrator, none other than Dave Attenborough, was going on and on about how strong gorillas are. I asked my son, “If you had to choose, where would you take a punch from a gorilla?” I thought he’d choose an arm or a leg, maybe if he was being silly he’d say the face. Immediately without thinking said, “Africa.” He wasn’t even trying to be funny, but I found this unexpected response hilarious. We both belly laughed so hard. I was still doing the bridge, chuckling, watching his little face light up—and then it hit me: Wait. I’m not hurting.

For years, bridges were almost a guaranteed flare-up. But in that moment—distracted, light, laughing with my kid—I felt nothing. No pain. I was moving freely, naturally, without the usual vice grip of tension. As soon as I noticed, I shifted focus back to the exercise. Am I bracing enough? Am I doing it right? What’s different?! Boom—pain rushed in like I’d flipped a switch.

That was it: the turning point. If my back was structurally wrecked, why did placing my attention differently turn off the pain? Why did my focus decide what I felt? What did my mind have to do with a “physical” "structural" problem?

That day kicked off a new search—not for a cure, but for understanding. I dove into pain science, desperate to unravel why “healed” didn’t feel healed. What I found flipped everything I thought I knew: flare-ups aren’t always about damage, in fact they most never are. They’re often the brain’s overprotective alarm, stuck on high alert, screaming “Danger!”, even when there’s no fire. Modern research—like from Dr. Lorimer Moseley, Alan Gordon and others—shows pain isn’t just a body signal; it’s a brain decision, shaped by fear, stress, and memory. For those who suffer from chronic pain, fMRI’s are showing people feel pain in their memory and learning centers of the brain, which is entirely different from how someone with a true active injury processes pain. My flare-ups weren’t my back betraying me; they were my nervous system trying to shield me, long after the threat was gone.

If you’ve ever wondered why your pain flares up unpredictably—why it’s brutal one day and quiet the next—I’ve been there. And here’s the truth I wish I’d known in that sterile exam room: you’re not broken. Your body’s just speaking a language you haven’t learned yet. Let’s decode it together—starting with what a flare-up really is.

Picture your nervous system as a smoke alarm, something that is designed to get your attention when there is a problem. When you break a bone—like I did my back—it blares to protect you: “Rest! Heal!” That’s acute pain doing its job, a loud but helpful warning during the active injury window—those days or weeks when swelling, bruising, or tissue repair are still in play. But what happens when the injury’s healed, the smoke’s cleared, and the alarm keeps shrieking anyway? That’s a flare-up: your brain, stuck in “threat mode,” cranking out pain that feels as real, or worse, as the original injury, even when there’s no fresh damage to guard against. It's not your body turning against you—it’s your nervous system playing an overzealous bodyguard. What starts as a helpful shield during an active injury can morph into a stubborn, misguided defense, running wild long after the threat’s gone.

Teaching people about this feels like balancing on a tightrope—tricky, delicate, and loaded with stakes—and here’s why:

First, when people hear that the brain can produce pain without an active injury, it can feel like a gut punch—like someone’s saying, “It’s all in your head,” dismissing years of suffering. I’ve been there. Five years after my back healed, a doctor shrugged at my clean scans and implied my pain wasn’t real. I wanted to scream. If you’re feeling that sting right now, please hear me: your pain is real. Every twinge, every ache—it’s not imaginary. You’re not making it up. What’s happening is neuroplasticity gone rogue—your brain’s gotten so good at “learning” pain, it’s turned it into a habit, firing off signals to keep you safe, even when the danger’s long gone. This isn’t about invalidating you; it’s about understanding why you hurt so we can fight it together.

And here’s where it gets wild: this is exactly how trauma works. If you’ve ever been through something shattering—a car accident, abuse, a loss, a moment that shook your core—you know how it lingers. Years later, a loud noise, a crowded room, a word, or even a familiar smell can hit you like a freight train. Your heart races, your chest tightens, and suddenly you’re right back there, feeling every ounce of that old fear—even though you could be objectively safe right now, it feels like you aren’t. That’s your brain, stuck on a loop, replaying the alarm because it’s convinced danger’s still around. It’s not weakness; it’s protection gone overboard.

So why can’t pain work the same way? Let’s say in your case, a nasty fall breaks your ankle. It heals, but months later, a new ankle exercise, long walk or helping a friend move you feel a sharp, real, urgent sensation. Or my back: long after the fracture mended and the herniations healed, bending for laundry could drop me to my knees. If trauma can make a safe moment feel threatening, why wouldn’t an old injury make a healed body feel broken? It’s the same machinery—your nervous system, wired to shield you, hitting repeat on a song that doesn’t need to play anymore. Pain and trauma aren’t twins, but they’re cousins, born from the brain’s relentless drive to keep you alive. Once I saw that, it clicked: my flare-ups weren’t proof I was fragile—they were echoes of a bodyguard who didn’t know the fight was over.

Second, pain feels so physical. When your back’s raging or your knee’s throbbing, it’s hard to swallow that the brain—way up in your skull—could be behind that fire in your foot or hip. I get it—it’s a mental stretch. For years, I thought my back pain lived in my spine, a structural curse I’d carry forever. I remember seeing my broken back on a light up X-ray board thinking that’s the only place the problem is. But here’s the truth: your nerves don’t feel pain—they’re just messengers, sending signals like “pressure” or “stretch” to your brain. Your brain’s the editor, deciding, “Danger!” or “No big deal.” When it’s stuck in threat mode, it can crank out pain anywhere, anytime—knee, hip, toe—based on memory or fear, not just injury.

That’s why my laundry flares were random: my brain, not my back, was running the show.

Take my bridge moment. I’d tense up, expecting agony, and my brain delivered—until laughter with my son flipped the script. If pain was purely physical, distraction wouldn’t touch it. But it did. Researchers like Dr. Lorimer Moseley call this the brain’s “protective illusion”—real pain, wrong reason. It’s a tough pill, I know. But here’s the flip side: if your brain’s calling the shots, you’ve got a way in. You can talk back to it. That’s where hope lives—and that’s what we’re unpacking next.

Take my laundry conundrum. Bending to grab a shirt sometimes hurt—sometimes didn’t. If my spine was the issue, wouldn’t it be consistent? Pain science says no. Researchers like Dr. Vania Apkarian have shown chronic pain lights up brain areas tied to emotion and memory, not just injury. My brain had linked bending to danger, so it hit the panic button—unless I was distracted, calm, or feeling safe. That’s the kicker: flare-ups often hinge on perception, not structure.

Think of it like a berry mishap. You eat strawberries, get a stomachache, and suddenly your brain bans berries, blaming them for the pain. But what if it was a random bug, not the fruit? Your brain’s still convinced strawberries were the cause, not some invisible virus you picked up, therefore wiring a “danger” loop. Same with movement: an old injury—or even stress—teaches your brain to yell “Stop!” when you stretch, lift, or twist. Over time, that yell becomes automatic. That’s a flare-up: real pain, wrong reason.

For me, bridges were the bogeyman. I’d tense up, expecting agony, and my brain delivered—until my son’s jokes proved it didn’t have to. Here’s the good news: if your brain can learn pain, it can unlearn it. That’s not wishful thinking—it’s neuroscience. And it starts with shifting how you see those flare-ups—not as proof you’re fragile, but as a sign your system’s overeager to protect you.

Understanding flare-ups is step one; navigating them is where the rubber meets the road. For years, I fought pain like an enemy—tensing up, avoiding moves, or freezing in fear. Sound familiar? Those are the brain’s defaults: fight, flight, freeze. They’re human, but they fuel the fire. Fighting tensed my back worse. Fleeing led me to quitting and avoiding movement which further left me stiff and weak. Freezing trapped me in a loop of second guessing myself. All the while, my nervous system stayed in “threat mode,” amplifying every twinge.

Then, I found a fourth way: rest and reset. It’s your parasympathetic system—calm, safe, rest, digest and heal. But here’s the catch: it only kicks in when your brain feels secure. That’s where somatic tracking and reframing come in—tools I’ve honed in my 31-day mindset program and workshops. They don’t erase pain overnight; they retrain your brain, step by step, to dial down the alarm. Here’s how I use them—and how you can too.

Below are the exact somatic tracking techniques from my workshops—detailed, practical, and ready for you to use. These aren’t quick fixes; they’re skills to practice, like learning to ride a bike. Start light, stay curious, and give your brain time to rewire. Here’s how to do each one, straight from my sessions:
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This one’s all about tuning into your body like a calm observer—no pressure, no rush, no expectation. Here’s how it works: you notice a sensation, name it with a word, and then note it—let what you notice pass by without jumping in. It’s a tool from meditation: observe, label, let go. The goal isn’t to chase the pain away—it’s to watch it without getting caught up.

Picture this: you’re sitting on the bank of a slow-moving river. Your sensations—pain, tightness, whatever—are like leaves floating on the water. You see one drift by, maybe it’s ‘sharp.’ You name it—‘sharp’—and note it, watching it glide past. You don’t yell, ‘There it is!’ and dive in, splashing around to grab it. You stay chill, sitting there, letting it flow by. That’s the vibe—calm, cool, unbothered. Over time, this tells your brain, ‘No threat here,’ and the pain signal can start to relax.

Here’s how to do it:

Why it works: Each time you notice, name, and note, you’re creating space between you and what you feel. You’re no longer consumed by sensation but putting much-needed distance between you and it. It’s in this space that we train the brain that it's okay to feel something without sounding the alarm bells. You’re making room for sensation, allowing it—and in that allowance, a change can begin.
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This builds on the first one. It’s simple but powerful—using your breath to bring ease to a painful spot. Oxygen calms nerves, and breathing creates movement, which is huge when pain feels fixed and permanent.

Here’s how:

This is about playing with your focus to shake up how your brain sees pain. Sometimes we get so locked onto a sore spot—like it’s the only thing that matters—that it takes over. I’ve been there—after breaking my back, I trained my brain to hyper-fixate on it. Every twinge became my whole story. This flips that.

Here’s how:

This is perfect for an exercise with a static hold—like a wall sit or plank. You track the sensation, tag it with a word, and reframe it, all while staying curious.

Try it with a squat hold:

This is tracking in motion with a playful, powerful twist—flipping the story mid-stride. Pain hits, and your brain defaults to ‘WARNING!!!’ We’re flipping that to safety and gratitude.

Try it with a third set of a hold or a dynamic move inside the program:

This builds on Zoom In and Out, now with a challenge move—like a tough stretch or lift. I used to fixate—‘my back, my back, my back’—until I learned there’s more to the story.
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Try it:

To close this out, chronic pain can feel like a thief—stealing your energy, your plans, your sense of self. I know that ache, not just in my back but in my soul, from the days I thought I’d never climb out of that basement despair. If you’re there right now—hurting, doubting, wondering if this is forever—I see you. You’re not alone in this, and you’re not broken. Your flare-ups? They’re not your enemy; they’re your nervous system’s loud, clumsy way of trying to keep you safe. They’re teachers, if we let them be, showing us where the old loops live so we can rewrite them.
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This isn’t about overnight miracles—I wish it were that simple. It’s about small steps, quiet wins, and giving yourself grace when the pain shouts louder than you’d like. Those tools above? They’re yours to try, to play with, to lean on when you’re ready. Maybe today you just notice a twinge without fighting it. Maybe tomorrow you breathe into it a little softer. That’s progress—real, honest progress—and it builds. I’ve walked this road and so you can.
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You don’t have to figure it all out today. Start where you are—messy, tired, hopeful, whatever it is. Your body’s still got a story to tell, and it’s not done yet. I’m rooting for you, every step, because if I could find a way through, so can you. Take that first breath, try that first tool, and let’s keep going—together.
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Mindset Program: Please check out my 31 day mindset program where I guide you through day by day on how to fundamentally change your relationship with pain signals to lower the high alert level your brain might be stuck on.
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Workshops: I’ve hosted several workshops where I go deeper with these topics if you’re wanting more depth and context on the science behind flare ups, the nervous system, and proven techniques to help you navigate pain. I personally recommend you check out these three to start:

If you’re a nerd like I am and want to dive ever further into understanding the nervous system with chronic pain, I recommend checking out these two books. Sidenote: These books heavily focus on the nervous system posing it as the root source of all problems, always. Please, don’t forget every mind has a body, and every body has a mind. Sticking with this program to improve movement and muscle imbalance and simultaneously working on regulating your nervous system is the most balanced approach you can take. Put all your efforts into those two buckets and I’m confident you’ll get the results you are looking for.