Before a flare I frequently get a sensation I call mice.....it feels like something is skittering (? is that a word ?) down the nerve from my neck to my shoulder. That sensation itself isn't unpleasant.......it's that I know it signals BAD pain within a few hours. It does help if I can take extra pain meds and lay down/rest right away, but it usually happens when I'm up and out enjoying some occassion that I don't want to cut short or when I'm driving and can't take pain meds, etc.