How to Treat and Prevent an MS Flare-Up

With multiple sclerosis (MS), you'll have good days and bad days. You might feel fine for weeks or months, and then your symptoms suddenly get worse.

Days when your old symptoms pop up again or new symptoms start are called relapses, attacks, or flare-ups. Everyone's flare-ups are different. Some are mild. Others are severe.

The goal is to prevent relapses. When your symptoms do get worse, know how to treat them so you can feel better faster.

What Causes Flare-Ups?

Flare-ups happen when inflammation in your nervous system damages the layer that covers and protects nerve cells. This damage slows or stops nerve cell signals from getting to the parts of your body where they need to go.

People with relapsing-remitting MS have flare-ups followed by symptom-free periods called remissions. To be a true relapse, the symptom must start at least 30 days after your last flare-up. And the symptom should stick around for at least 24 hours.

What Happens During a Flare-Up?

During a flare-up you'll get new symptoms. Or symptoms you already have will get worse.

You might have one or more of these symptoms:

How to Prevent Flare-Ups

Certain things can start a relapse. Everyone's triggers are different. Learn what brings on your symptoms so you can avoid them.

To prevent flare-ups:

Take your medicines. The drugs your doctor prescribed slow your MS from getting worse and help prevent relapses. If you have side effects from your medicine, don't just stop taking them. Ask your doctor about other options.

Keep up your health. A bout of cold or flu can set off your MS symptoms. A bladder infection can trigger a flare-up, too. Wash your hands with warm water and soap during the day, get your yearly flu shot, and avoid people who look sick. Drink lots of water to keep your bladder healthy. Ask your doctor for other ways to avoid bladder infections.

Don't smoke. It's bad for you in so many ways, and it can make your MS symptoms worse.


Relax. In some people, stress can bring on a relapse. Chill out with meditation, yoga, or anything else that’s good for you and helps you unwind.

Rest. You won't feel well when you're worn out. Sleep problems are common in people with MS. Symptoms like pain and muscle spasms can keep you up at night. Some of the medicines that treat MS interrupt sleep, too. Work with your doctor to get your symptoms under control so you can sleep. Adjust your medicines if they keep you awake.

Ways to Treat a Flare-Up

Your symptoms might go away on their own if they're mild. Even so, let your doctor know what’s going on.

Treating symptoms can shorten your flare-ups and help you recover faster. The goal is to bring down the inflammation that caused your symptoms.

Your doctor will likely prescribe a steroid drug. Steroids curb inflammation and can help you get over a relapse faster.

Some people can't take steroids. Others are bothered by steroid side effects, which include weight gain, mood changes, trouble sleeping, and upset stomach. Another option is ACTH gel (Acthar gel). It's injected into your muscle or under the skin. ACTH triggers your adrenal gland to release natural hormones that bring down inflammation.

For a very severe flare-up that doesn't get better with steroids, you can try plasma exchange. First, a health care professional will take some of your blood. The liquid part, called plasma, is taken out. It's replaced with a substitute plasma fluid or with plasma from a donor. Then, the blood is returned to your body.

During a relapse you might feel more tired than usual. Try to get enough rest. Also avoid heat, which can make your symptoms worse.

What to Do After a Flare-Up

You can recover fully after a relapse, but it might take weeks or months to get over all your symptoms. If you had a lot of nerve damage, some symptoms might not fully go away.

You may need extra help getting back to your normal life. A rehab program can put you back on track. Your rehab team will help you with:

  • Exercise
  • Speech
  • Dressing and personal care
  • Movement
  • Home chores
  • Problems with thinking and memory
WebMD Feature Reviewed by Richard Senelick, MD on December 13, 2015



Cleveland Clinic: "Avoid 8 Common Triggers to Make Your Life with MS Easier."

Multiple Sclerosis Association of America: "Acthar Gel."

Multiple Sclerosis Society (UK): "Managing Relapses," "Relapsing Remitting (RRMS)."

National Multiple Sclerosis Society: "Managing Relapses."

Ontaneda, D. Annals of Indian Academy of Neurology, October-December 2009.

Paturel, A. Neurology Now, January/February 2009.

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