If you have multiple sclerosis (MS), your symptoms may get worse for periods lasting at least 24 hours. Between these flare-ups, you have phases of recovery, called remissions. They might last a few weeks, several months, or longer.
This type of MS is known as relapsing-remitting MS (RRMS). Most people with MS are first diagnosed with RRMS, which often starts when you're in your 20s or 30s. The course of your disease can change over time, though.
How to Maximize Remission
MS flares up because of inflammation in your central nervous system. This interferes with your body's ability to send nerve impulses, which leads to the more obvious symptoms of MS.
The best way to stay in remission as long as possible is to create a treatment plan with your doctor and follow it. Certain medications can reduce relapses. They include:
Injectable medications. These include drugs such as glatiramer acetate (Copaxone, Glatopa), interferon beta-1a (Avonex , Rebif), interferon beta-1b (Betaseron , Extavia), ofatumumab (Kesimpta), and peginterferon beta-1a (Plegridy). You get them in a shot.
Oral medications. You take drugs like cladribine (Mavenclad), dimethyl fumarate (Tecfidera, Vumerity), Gilenya)(Gilenya), monomethyl fumarate (Bafiertam), ponesimod (Ponvory), siponimod (Mayzent), teriflunomide (Aubagio), and ozanimod (Zeposia) as your doctor directs.
Infused medications. Your doctor can give you alemtuzumab (Lemtrada), mitoxantrone (Novantrone), ocrelizumab (Ocrevus), natalizumab (Tysabri), or ublituximab-xiiy (Briumvi) through an IV.
Treatment for Intense Relapses
Some people have severe flare-ups that include intense weakness, vision loss, or trouble with balance. When this happens, many doctors suggest a high dose of corticosteroids to stop the relapse quickly. Your doctor might give you a 3- to 5-day course of methylprednisolone (Solu-Medrol) through an IV, or prednisone (Deltasone) by mouth.
Your doctor could also give you H.P. Acthar Gel, which stimulates your body to produce steroid hormones. This treatment is less common since it’s expensive and harder to get than corticosteroids.
If steroid treatments don't work well for you, your doctor might consider a plasma exchange. In this process, your doctor draws some of your blood, then uses a machine to separate red and white blood cells from the plasma (the liquid part of your blood). The cells are then returned to your body along with a replacement plasma fluid.
These treatments don't slow down the progression of MS. But they can help you achieve remission quicker after a relapse.
When You Don’t Need Treatment
Mild symptoms such as slight numbness, a pins-and-needles feeling, or periods of fatigue may not need treatment. If your relapse doesn’t drastically affect your daily life, the flare-up will usually get better on its own.
Tips for Feeling Good
To stay in remission, pay attention to self-care. Be aware of things that trigger your flare-ups, and take steps to protect yourself from other health problems that could make your MS worse.
Check in with your doctor. Schedule regular checkups. Talk to your doctor about how you’re feeling, your current treatment routine, any new problems you have, or support you may need. Your doctor can also keep you informed about new treatments that are available.
Stop smoking. Smoking can lead to many health problems, which may cause your MS to get worse more quickly. Quitting can help stop some complications of MS.
Eat well. There’s no diet that can stop MS. But foods with omega-3 fatty acids (like salmon, tuna, and walnuts ) are thought to reduce inflammation. A balanced diet can also help you manage MS symptoms like constipation and fatigue.
Move. Studies show that exercise can help with MS symptoms like bowel and bladder problems and fatigue. It can also improve your strength and mobility.
Avoid extreme temperatures. For some people, hot weather or high humidity can make MS symptoms worse. Very cold weather, or big temperature changes, may do the same.
Manage stress. Some research has linked stress to MS flare-ups. Be aware of when you're starting to feel stressed and take steps to manage it. Exercise, talking to supportive friends or family members, and mind-body techniques like yoga or meditation can help.
