One of the hardest things about living with multiple sclerosis (MS) is its unpredictability. Symptoms can suddenly worsen. New ones can appear. Some people call these episodes flare-ups, relapses, or attacks. And they can be physically and emotionally challenging.
I often hear from my patients that they feel scared or frustrated when a flare strikes. That’s understandable. Learning about MS flare-ups can help you better understand what’s going on in your body. That can give you greater confidence in managing your disease.
What is an MS flare-up?
An MS flare-up is a term people use to describe episodes when their symptoms worsen for a variety of reasons. These can include:
Pseudo-relapses. These flare-ups of your existing MS symptoms tend to fade quickly. You might be able to trace them back to a trigger, such as:
- Stress
- A urinary tract infection or other illness
- Exposure to heat, such as taking a walk on a hot day
While frustrating, these episodes don’t cause new inflammation or damage to your nervous system.
Relapses. An MS relapse is developing new symptoms that last for at least 24 hours and aren’t caused by a fever or infection. It’s a sign your immune system is attacking the protective covering (myelin) around nerves in the brain, spinal cord, and optic nerve, causing inflammation. This damage disrupts the signals between your brain and body, which leads to symptoms.
As I tell my patients, what a true MS flare-up feels like can vary widely, depending on where the inflammation is attacking the nervous system. For example, some people experience one or more of these signs and symptoms:
- Vision changes
- Numbness, tingling, or increased pain
- Balance problems
- Weakness in an arm or leg
- Problems with bladder or bowel control
A relapse typically develops over days to a couple of weeks without a clear trigger. They may last as briefly as a few days or as long as a few months.
Flare-ups are most common in relapsing-remitting MS. They sometimes occur with secondary progressive MS. You can learn more about the different types of MS and get answers to many common questions people have about MS by reading this blog.
Feeling better when you have a flare-up
The way we manage an MS flare-up depends in part on the type of attack it is.
Flare-ups brought on by triggers like heat exposure, stress, fatigue, or infections usually last as long as the underlying trigger is still there. Addressing the triggers that cause them should help you feel better. For example, if stress triggers your symptoms, managing that stress may help. If heat is a trigger for you, lifestyle changes, such as taking cooler showers or wearing a cooling vest, may help.
If you’re having a true relapse — experiencing a new symptom is a strong indicator — we may need to take a different approach. The treatment depends on the severity of your symptoms.
Some relapses are mild and don’t interfere with daily life. They often improve on their own over time. For more severe relapses, like those that cause vision loss or balance problems, I often recommend a short course of corticosteroids. These medicines reduce inflammation and can speed recovery from the flare-up. I might prescribe an intravenous (IV) steroid like methylprednisolone or a high dose of an oral steroid such as prednisone.
Corticosteroids are quite effective in helping people recover from an MS episode. However, some people can have lingering symptoms.
Preventing future flare-ups
Flare-ups can’t always be prevented. But treatment may reduce their likelihood. Staying on the right disease-modifying therapy (DMT) is one of the most effective ways to control MS. DMTs are medications that can reduce the number of relapses a person has and slow the progression of their disease.
In addition, I often recommend that my patients do the following:
- Manage stress and get enough sleep
- Get a yearly flu shot to help prevent infections
- Stay active and eat a balanced diet
- Avoid smoking
Get expert care from an MS specialist
If you’re experiencing a worsening of your MS symptoms, schedule an appointment or call 800-TEMPLE-MED (800-836-7536) to connect with a Temple neurologist who specializes in MS.
The Temple Multiple Sclerosis Program is home to the latest treatments for MS. Whether you need help managing chronic or relapsing symptoms, a team of experts is there to help you thrive.
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