How to Manage a Pelvic Pain Flare

Pelvic pain flares can be incredibly disruptive. Pain levels rise, symptoms become more noticeable, and even simple daily routines can feel harder to manage. For many women, pelvic pain flares seem to appear without warning and can last anywhere from a few hours to several days or even weeks.

If this sounds familiar, you are not alone. One of the most effective ways to navigate a flare is to have a clear, practical plan in place before it happens. In this blog, I will explain what a pelvic pain flare is, why they happen, and how to create a simple, personalised flare plan to support yourself when symptoms increase.

What is a flare?

A flare is a temporary increase in pelvic pain or related symptoms. This might include:
- A sudden rise in pelvic or lower abdominal pain
- Increased bladder urgency or frequency
- Heaviness or pressure in the pelvic area
- Changes in bowel function or pain with sitting, movement, or intercourse

Flares can be triggered by a range of factors, such as stress, hormonal changes, overactivity, prolonged sitting, travel, certain foods, or a combination of these. Sometimes, there is no clear cause at all. That unpredictability is part of what makes flares so difficult to manage.

It is important to remember that flares are temporary. They do not mean you are going backwards in your recovery, and with the right support, symptoms can settle.

Why a flare plan helps

When you are in the middle of a flare, it can feel difficult to think clearly or know what to do next. Pain can increase the nervous system’s sensitivity, making decision-making feel harder than usual.

A flare plan gives you a clear set of strategies to follow, so you are not relying on memory or problem-solving in the moment. It allows you to act with confidence, using tools and supports you have already identified as helpful.

Identify your personal flare strategies

Start by listing 2–3 strategies that help your body feel more settled. These will vary from person to person, but should be practical, familiar, and easy to implement.

Examples include:
- Diaphragmatic breathing
- Warm bath or heat pack
- Gentle pelvic stretches or supported rest positions
- Listening to a guided relaxation
- Minimising sensory input (lights, noise, stimulation)

These types of strategies can help reduce the intensity of symptoms by calming the nervous system.

Know who to contact

During a flare, it is common to cancel appointments or withdraw. But this is often the time when professional support can be most helpful. Your healthcare team can provide early intervention, reduce symptom severity, and guide your management moving forward.

Consider keeping contact details handy for:
- Your pelvic health physiotherapist
- GP or specialist
- Allied health providers (e.g. psychologist, massage therapist, acupuncturist, chiropractor)

The importance of sleep

Sleep plays a vital role in how your body manages pain. During a flare, poor sleep can increase sensitivity and make it harder to recover. Prioritising rest and aiming for better quality sleep, even if it is broken or inconsistent, can support the healing process.

Simple sleep strategies include:
- Keeping regular bed and wake times
- Reducing screen use before bed
- Creating a quiet, cool sleep environment
- Practising gentle breathing or a relaxation routine before sleep

Even small adjustments to your sleep routine can help reduce the intensity and duration of a flare.

Incorporate gentle movement

While rest is important, gentle movement can also support recovery. Prolonged stillness can sometimes increase stiffness and pain. Movement that is slow and controlled may help reduce tension, support circulation, and calm the nervous system.

You might try:
- Short walks
- Pelvic tilts
- Gentle yoga or supported stretching
- Mobility exercises suited to your comfort

The key is to move in a way that feels safe and manageable. If you are unsure what is appropriate, your pelvic health physiotherapist can guide you with tailored suggestions.

Mindfulness during a flare

Mindfulness can be a helpful way to stay connected to your body during a flare. It involves noticing your experience in the present moment without trying to change it or judge it. This can reduce the nervous system’s threat response and help you feel more in control.

Mindfulness practices might include:
- Focused breathing
- Body scans
- Observing thoughts and sensations without reacting
- Using a guided meditation app or audio

These strategies can help settle both physical and emotional symptoms, even when pain is present.

Reflect once symptoms settle

Once symptoms begin to ease, take a moment to reflect. You might ask:
- Did anything change in my routine?
- Was there extra stress, poor sleep, or more sitting?
- Were there dietary or hormonal shifts?

Sometimes patterns emerge, and other times they do not. That is okay. Keeping a brief symptom log or journal can support greater awareness over time and be useful during appointments.

A flare does not mean you have lost all your progress. It is a common part of managing persistent pelvic pain and does not erase the improvements you have made. With the right strategies in place, flares can be managed, and recovery can continue.

During a flare, try to:
- Follow your plan
- Prioritise rest and gentle support strategies
- Reach out to your care team
- Remind yourself that this is temporary

If you are feeling unsure or overwhelmed, you don’t have to manage it alone, reach out to your care team and together you can develop some strategies that work best for you.