If you live with chronic pain, every new ache can trigger the same question: Is this normal soreness—or am I starting a flare? Here's a simple decision tree.

The Anxiety of New Pain

You worked out yesterday. Today, something hurts. For people without chronic conditions, this is simple: "I'm sore from the workout." For those of us with chronic pain, it's never that simple.

Is this DOMS (delayed onset muscle soreness)? Or is this the beginning of a flare that will knock me out for days?

What is DOMS?

DOMS is the muscle soreness that shows up 24-72 hours after exercise, especially if you:

Tried a new exercise
Increased intensity or volume
Did more eccentric movements (lowering phases)

It's caused by microscopic muscle damage—which sounds scary but is actually how muscles get stronger. It's normal, temporary, and usually peaks around 48 hours.

What is a Flare?

A flare is a worsening of your chronic condition symptoms. Depending on your condition, this might include:

Widespread pain (not just the muscles you worked)
Fatigue that rest doesn't fix
Brain fog or cognitive symptoms
Joint swelling or inflammation
Symptoms that last longer than typical DOMS

The Decision Tree

Ask yourself these questions:

1. Where is the pain?

In the specific muscles I worked → Likely DOMS
Widespread or in my usual flare spots → Possibly a flare

2. What kind of pain is it?

Achy, tender when I move or press → Likely DOMS
Burning, sharp, or my "familiar" pain → Possibly a flare

3. Do I have other symptoms?

Just muscle soreness → Likely DOMS
Fatigue, brain fog, mood changes → Possibly a flare

4. When did it start?

24-48 hours after exercise → Likely DOMS
Immediately or much later → Could be either

What to Do: DOMS

Gentle movement: Light walking or stretching can help
Stay hydrated: Water helps with recovery
Heat or massage: Can ease discomfort
Give it time: Usually resolves in 3-5 days
Don't skip your next workout: But maybe go lighter

What to Do: Flare

Rest: Your body is asking for it
Use your flare toolkit: Whatever usually helps (meds, heat, rest)
Don't push through: This isn't the time
Track it: Note what might have triggered it
Communicate: Let your trainer know so you can adjust

Prevention: Training Smarter

The goal is to find the sweet spot where you're challenging your body without triggering flares:

Progress slowly: Small increases in intensity
Build in recovery: Rest days aren't optional
Track your patterns: Learn your personal thresholds
Work with someone who gets it: A trainer who understands chronic conditions

You Know Your Body Best

This decision tree is a guide, not a diagnosis. You've lived in your body through countless flares. You know the difference between "good sore" and "something's wrong." Trust that knowledge.

Book Your Intro Session

Train with someone who understands chronic pain. We'll find your sustainable movement sweet spot together.

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DOMS or Flare? How to Tell the Difference (and What to Do Next)