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Ordinary Fatigue or MS Relapse?

If you’re overworked, stressed, or not getting enough sleep, MS symptoms may trouble you more than usual. Rest and take extra time for yourself to get back on track.

If fatigue goes on even after you’ve rested -- especially if it’s extreme and keeps you from your regular activities -- check with your neurologist. Continued fatigue can be a sign of a flare-up.

How to Prevent a Flare

Nothing can completely prevent relapses of MS. However, starting medicine right after you're diagnosed with MS helps reduce how many flare-ups you have.

In addition to taking your medicine as directed, these steps may help.

  • Closely track your symptoms. "If you notice subtle breakthrough events, it may mean that your medication isn’t working for you, and we need to make a change," Cohen says.
  • Stop smoking. " Smoking is extremely bad for MS," Fox says. Smokers lose brain tissue much faster than those who don't smoke, he says. Ask your doctor about nicotine patches, gums, or lozenges. They don't seem to cause the same damage as tobacco and can help you kick the habit.
  • Live healthy. Eat a balanced diet. Exercise most days of the week. Try to lower the stress in your life. You'll be healthier, which may make it easier to manage MS. Working out and relaxation may also help control your symptoms.


Ask your neurologist how quickly you should call when you notice new symptoms. Some may require more than simply getting extra rest or using other coping strategies on your own.

These are the ways your doctor will usually treat a flare-up.

  • Steroids. If you've lost some vision or suddenly can't walk, your doctor may suggest this type of drug. "Steroids [help] make the patient better faster," says Mark Keegan, MD, of the Mayo Clinic. You'll need an IV for 3 to 5 days, or a lot of pills over a few days.
  • Physical therapy. These precise exercises help you recover the use of a hand or leg. Fox says PT works especially well while you're taking steroids. The combination helps you get back to your normal strength and motion.
  • Plasma exchange. This may help treat a severe flare-up -- for example, you were walking fine, and now you can’t walk at all -- when high-dose steroids aren’t working.