Flare-ups (also called MS attacks, flares, or relapses) are times when the disease is active, and symptoms are more severe. Remission phases occur when the disease is not active or minimally active. A person in remission may experience minor symptoms or show no signs of MS illness.
This article will discuss MS remission and what you can expect during remission and flare-ups.
Treatment During Remission
MS symptoms must be significantly reduced or entirely gone for the disease to be considered in remission or no longer active.
Providers can prescribe different types of medications to treat MS, including medicines to:
Delay the progression of the diseasePrevent flare-upsTreat symptoms and flare-ups
Your provider may instruct you to continue using medication during remission to prevent flare-ups and delay MS progression. In some cases, medicines used to treat MS symptoms, such as steroids, may be discontinued during remission since they are unnecessary and can cause side effects.
Research is limited regarding when to stop using disease-modifying therapy (DMT), which are medications to prevent flare-ups and delay disease progression, so this is a decision that the patient and medical providers make together.
Treatment During Flare-Ups
Flare-ups are classified as MS symptoms lasting at least 24 hours or more and occurring at least 30 days after the previous flare-up.
Medications to suppress the immune system and decrease disease activity during flare-ups include:
Rayos or Prednisone Intensol (prednisone): Steroid used temporarily for mild to moderate flare-ups Solu-Medrol (methylprednisone): Steroid used temporarily for severe flare-ups H. P. Acthar (adrenocorticotropic hormone, ACTH, or corticotropin): An alternative to steroids
People with MS may also use medications to treat flare-up symptoms like depression, pain, and bladder dysfunction. In addition to medications, complementary medicine options and behavioral and lifestyle changes may help manage symptoms.
What Causes Flare-Ups?
The cause of MS flare-ups is not clearly defined. Research has shown that genetics plays a role in MS, and various factors can affect genetics and lead to symptoms.
Depression Difficulty thinking clearly Fatigue Lack of coordination Needing to urinate urgently Numbness, especially in feet Sensitivity to heat Trouble seeing Trouble with balance
MS flare-ups may be triggered by:
Epstein–Barr virus Getting older Low levels of vitamin D Pregnancy Smoking
Preventing Flare-Ups
Medications may be used to prevent MS flare-ups. For example, Aubagio (teriflunomide) is a medication that effectively prevents flare-ups by suppressing the immune system.
Aside from medications, people with MS can prevent flare-ups with healthy behaviors and lifestyle choices. Viruses, smoking, and low levels of vitamin D can trigger flare-ups, so regular handwashing, quitting smoking, and getting enough vitamin D are good practices to minimize the risk of MS flares.
Relaxation and regular stress relief practices may help prevent emotional stress from leading to flare-ups.
MS Timeline: What to Expect
MS has no set timeline because different people experience the condition differently. However, most people with relapse-remitting MS begin to experience symptoms in their 20s or 30s.
Summary
Multiple sclerosis is a lifelong illness characterized by phases of flare-ups (active symptoms) and remission (mild to no symptoms). You may not need treatment during remission. During flare-ups, medications may be used to suppress the immune system, decrease disease activity, and treat symptoms. There are ways to prevent flare-ups, such as continuing medications and making healthy behavior and lifestyle choices.
A Word From Verywell
Suspecting, being diagnosed with, and living with multiple sclerosis can be challenging, especially during flare-ups. If you or someone you know is experiencing MS symptoms, help is available. It is possible to manage symptoms, achieve remission, and prevent future flare-ups. Reach out to a healthcare provider for support.
