What Causes an MS Flare-Up?

Medically Reviewed by Christopher Melinosky, MD on June 07, 2021

Multiple sclerosis (MS) flare-ups have common triggers. Preparation for them can help lower your chance of getting one.

With relapsing-remitting MS, flare-ups can bring new symptoms or make ones you already have worse. They come on suddenly over 24 hours and usually get better slowly over weeks or months.

These happen because part of your central nervous system gets inflamed. The inflammation slows or disrupts nerve signals. That brings things like numbness, pain, and dizziness.

What triggers a flare-up is different from person to person. Most of the time, a cause cannot be found. Still, to lower your chance of a flare-up, do your best to avoid the things that make them more likely for you. For example:


It’s a part of life, but doing what you can to manage it can lower your chance of a relapse. Meditation, yoga, and counseling are all ways to lower stress and better equip yourself to handle it. In one study, MS patients reported their stress level cut nearly in half after 6 weeks of yoga.


Lack of sleep can bring a flare-up. Making sleep a priority will help lower your chance of symptoms. Try to get 7-8 hours each night.


High temperatures may trigger a relapse. If you’re one of those people affected by warm surroundings, you should skip saunas, hot tubs, and hot showers and baths. Most of the time hot weather causes fatigue. Also, do what you can to avoid being outdoors on hot days.

A cool bath and air conditioning are two things that can help. Special hats or clothes that hold ice packs or frozen gel packs can also keep you comfortable. There are also special vests that use a motorized system to circulate cold water around the body. If you have an exercise goal, divide the time you exercise into smaller segments, with rest after each one.


They cause a third of MS flare-ups. To lower your risk:

  • Wash your hands.
  • Do what you can to avoid people who are ill.
  • Make sure food you eat is fully cooked.
  • Practice safe sex.
  • Get your annual flu shot.

Even minor infections like the cold or flu can trigger a flare-up.

If you have an infection, treat it early.


Eat foods rich in omega-3 fatty acids. They’re believed to fight inflammation. Also, get plenty of fiber and stay away from foods with saturated and trans fats.

A healthy diet helps keep your immune system strong.


Skipping your MS medicine can increase your risk for a flare-up. One study found about 25% of MS patients who stopped taking their medications suffered a relapse. Certain medications for Crohn’s disease or rheumatoid arthritis may cause MS-like symptoms. So can drug interactions.

Check with your doctor to see if there are medications you’re taking that could be interacting with one another.


Smoking is a major risk factor for flare-ups. Stop and you’ll lower your chances of them. Your doctor can help you figure out a game plan.

Show Sources


National Multiple Sclerosis Society: “Managing Relapses.”

Cleveland Clinic: “Avoid 8 Common Triggers to Make Your Life With MS Easier.”

MS Society (UK): “Relapsing Remitting (RRMS).”

Johns Hopkins Medicine: “Relapsing-Remitting Multiple Sclerosis.”

American Academy of Family Physicians: “Multiple Sclerosis.”

NYU Langone Medical Center: “What Happens When Multiple Sclerosis Patients Stop Taking Their Medication?”

Stress and Health: "Impact of Integrative Restoration (iRest) Meditation on Perceived Stress Levels in Multiple Sclerosis and Cancer Outpatients."

MSFocus Magazine: “Be Cool with Active and Passive Cooling Garments Options for People with MS.”

British Medical Journal: "Association between stressful life events and exacerbation in multiple sclerosis: a meta-analysis."

Neurology Research International: "Meditation as an Adjunct to the Management of Multiple Sclerosis."

Herb Karpatkin, PT, DSc, assistant professor, Hunter College, New York.

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