Treating flares

Sometimes, flare-ups may need to be treated at the hospital - eg. because your usual painkillers aren't helping and you need to "break" the cycle of pain that you're in with stronger painkillers.
There are different ways of treating flare-ups, and they can differ from one hospital to another. The treatment choice also depends on the underlying illness as well as your individual situation. Here are a few examples that I can think of:

In some cases, the pain can be managed with oral medication (pills or tablets), usually some kind of opioid. The doctor may prescribe a higher dose than usual for a few days to see if that will break the cycle of pain.

If oral medication isn't effective enough, the next step is usually IV medication. As I've written in an earlier post, morphine injections are usually not a good idea, since they only alleviate the pain for a short period of time. A single injection is rarely enough to break the pain cycle. Giving several injections might lead to potentially dangerous side-effects and increase the risk for dependency. For this reason, infusions tend to be a better choice. This means that the medication is given intravenously at a steady rate, which prevents "peaks" and "valleys" of the drug in your bloodstream.

Two of the most common meds that can be given as infusions are morphine and ketamine (or esketamine). Ketamine/esketamine are actually anesthetics used to sedate people for surgery, but when given in much lower doses, they can be used as painkillers. Ketamine/esketamine is especially good for people with an opioid tolerance or dependency who would need very high doses of morphine to relieve their pain. As an NMDA-receptor antagonist, it also has the ability to "reboot" the body's pain centers that have become overly sensitive, thus breaking the flare. It can also be used in combination with opioids, if needed. For more detailed information about esketamine, go to CHRONIC PAIN -> TREATMENT -> PHARMACOLOGICAL TREATMENT.

Depending on the location of the pain, some hospitals/clinics prefer to use nerve blocks - anesthetics that are injected onto (or near) a nerve and interrupt the pain signals that are traveling along it. 2 common examples are epidural anesthesia (often used during c-sections) and paracervical blocks (which numbs the nerves around the cervix).