MS patient doing stretching exercises with a therapist

Multiple Sclerosis Attacks & Flare Up Symptoms

If you are a multiple sclerosis patient and have been feeling well for several days or weeks, but symptoms show up again, you may be having what physicians refer to as a relapse or flare-up. Around two-thirds of the approximately 1 million people with MS in the United States experience alternating periods of severe flare-ups and very mild symptoms.

It’s important for MS patients to participate in neurorehabilitation programs, as well as observe flare-ups and manage their causes. Flare-ups often result from inflammation in the central nervous system that damages myelin or nerve fibers.

Though “relapse” and “flare” are often used interchangeably, for a relapse to be considered a “true” flare, it must occur at least 30 days after the previous flare.

What does an MS flare look like?

MS affects the central nervous system (spinal cord and brain), resulting in challenges in the transmission of electric signals along related nerve cells.

During severe flare-ups, MS patients may experience:

  • Eye inflammation
  • Challenges with balance
  • Fatigue
  • Tingling
  • Numbness

However, these symptoms are not necessarily all present during each flare-up. Patients can experience a fluctuation of symptoms, with some days being symptom-free (remission) and others within longer periods of discomfort (relapse) – severe enough to cause challenges to daily living. This is a specific type of MS known as relapsing-remitting MS.

What causes an MS flare-up?

Causes, or triggers, of a flare-up can be difficult to identify, and can vary from person to person. However, there are some common factors that increase the chances of flare-ups. Dieting habits, smoking, and medications can all trigger flare-ups. So can:


Stress has a negative effect on the body – negatively impacting and exacerbating many diseases and disorders. Thus, stress management is essential. MS is no different. Research shows that stress can be a trigger for MS relapses and vice-versa – relapses can lead to increased stress, which can cause a cycle of flare-ups.

Although stress is part of life, making an effort to reduce them is critical to minimizing flare-ups. Counseling, yoga, meditation, and exercise can help reduce relapses.


Sleep deprivation is unhealthy for anybody, and people with MS already have limited energy reserves. Getting sufficient rest and sleep can be challenging for people with MS due to temperature dysregulation, urinary or bowel symptoms, and restless leg syndrome can all inhibit proper resting and sleep. These symptoms can prevent effective rest, ultimately worsening the condition.


Infection, sometimes accompanied by a fever, can severely worsen MS symptoms, leading to frequent relapses and flare-ups. Urinary Tract Infections are commonly associated with MS flare-ups and some people, though any type of infection that weakens the immune system – including a cold or a strand of flu – can contribute to flare-ups.


Extreme temperatures can worsen MS symptoms. In many instances, spending extended time in hot environments can lead to fatigue – resulting in frequent relapses and flares. Air conditioning systems, fans, and cool baths can help reduce body temperatures, lowering the frequency of relapses.

How long does an MS flare last?

The duration of flare-ups is often different for each patient, each flare-up, and each symptom. Relapses and flare-ups can last from a few days to several weeks.

Do I need to go to the hospital for a flare-up?

Even if your MS is being well-managed at a rehabilitation or recovery center, some symptoms need immediate attention. Some MS flare-ups can be managed through home care, and symptoms like fatigue, mental fog, and tingling generally disappear over time once the trigger is eliminated. Nevertheless, excruciating or ongoing symptoms may require emergency attention.

Whether symptoms are MS-related or not, there are some specific indicators that may require emergency medical support. This list is not comprehensive, and it’s important to speak with your physician about how your specific condition should be addressed in emergency situations.

Some symptoms that may require an ER visit:

  • Severe, unexpected side effects of your MS medications
  • Difficulty breathing
  • Fainting and dizziness
  • Severe pain
  • Uncontrolled bleeding
  • Persistent vomiting or diarrhea
  • Signs of stroke or heart attack

How can I prevent MS relapses?

When you or your loved one has MS, the best thing you can do – with regard to daily care – is to prevent new relapses. New neurological symptoms imply only partial treatment of the initial symptoms. Relapses can be unpredictable and can’t be entirely prevented. However, avoiding potential triggers and practicing certain prevention methods can help reduce the chances of relapses.

Be sure to:

  • Maintain your doctor’s treatment plan
  • Follow your prescription instructions and schedule
  • Maintain sufficient vitamin D levels
  • Learn effective stress reduction mechanisms
  • Be aware of potential mood disorders
  • Observe a healthy diet
  • Create a safe routine for physical exercise

What are the treatment options for MS flare-ups?

There is no cure for multiple sclerosis. Most treatment for MS flare-ups is designed to hasten recovery from attacks, slow disease progression, and manage symptoms. A major aim is to reduce the inflammation caused by MS and its symptoms.

Your care provider may recommend a steroid medication for curbing inflammation to help you recover faster. However, this medication cannot undo existing damage, nor can it slow down the disease’s progression. Some people avoid taking steroids due to possible side effects such as mood change, sleeping problems, stomach upset, and weight gain.

Some physicians will prescribe a plasma exchange when steroid treatments are not improving symptoms. During that procedure, a physician will replace your own plasma with a donor substitute.

Other treatment options may include:

  • Infusion treatments
  • Physical therapy
  • Muscle relaxation techniques & medications

Manage MS flare-ups at Brooks Rehabilitation

Managing MS flare-ups can be daunting. Most triggers are unpredictable and different in each flare-up, making them challenging to manage. Your doctor can tell you whether you’re having real flare-ups or if something else may be contributing to your MS symptoms.

It’s critical to have professional assistance when relapses occur. Rehabilitation facilities for MS patients help prevent worsening symptoms and the effects of relapses.

Brooks Rehabilitation can help you manage your multiple sclerosis through evidence-based treatments, expert physicians, state-of-the-art technology, and our Adaptive Wellness Program. We provide individualized care to help each patient handle specific triggers and learn to manage their care in the best way possible.

Contact us to begin finding ways to reduce and treat MS relapses.

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