Recognising a relapse

If someone with MS experiences new symptoms of relapsing MS, or finds old symptoms are aggravated and return for a period of 24 hours or more in the absence of fever or infection, it’s known as a ‘relapse’, or exacerbation.  

During relapses, symptoms develop over a number of hours or days, and can last anything from a few days to many months before fading away.

How can you tell if you’re having one?

Relapses are also known as flare-ups or exacerbations. You might also hear medical staff call them ‘attacks’, ‘worsening’, ‘acute episodes’ or ‘clinical events’.  

All relapses, including mild ones, should be reported to your doctor or MS nurse as soon as possible. 

However, it can sometimes be difficult to tell what is and isn’t a symptom of a relapse – especially if you are recently diagnosed. It’s possible to experience, for example, balance problems or fatigue during remission, but these ‘on-off’ symptoms do not necessarily mean you are relapsing.

Talk to your doctor or MS nurse if you’re not sure and consider keeping a symptom diary, so that you can record the time and duration of your symptoms and how they affect you – this can be a useful reference tool for when you’re talking to your MS nurse or doctor.

“Although it can be difficult or even stressful at first, recognising symptoms of a relapse will get easier over time as you get to know your condition,” says health psychology specialist, Clare Moloney. “After a while, you’ll be able to trust your instincts more and your familiarity with your condition will make it easier to identify what might and might not be a sign of relapse – the more comfortable you are with this process, the less stressful it will be.”

“It can be worrying and sometimes scary developing new symptoms and relapsing, but remember that there is a lot going on inside your body and not all of it is related to MS. Always note down your symptoms and speak to your doctor or MS nurse who will be able to advise you” 

How are relapses treated?

Relapses can vary from mild to severe, and can occur unexpectedly, making life with MS unpredictable.  Many relapses can be managed at home, with the support of your doctor or MS nurse and other healthcare professionals. For severe relapses you may need to be hospitalised for your treatment.

Treatment for MS falls into two categories: 

  1. Treatments designed to manage the disease itself. These are often referred to as ‘disease-modifying’ medications, because they are designed to help reduce the frequency of relapses and to slow the build up of permanent physical symptoms associated with MS.  They are generally intended for use over an extended period of time.
  2. Treatments to manage and alleviate symptoms of MS. Steroids can be used to reduce inflammation, shorten the duration of relapses and help speed recovery – however , they are generally not recommended for regular or prolonged use. Rehabilitation and support such as physiotherapy, occupational therapy and dietary advice can help to reduce the impact of a relapse on day-to-day life.
    Other services, such as at-home support and employment services, can also help during and after a relapse. Ask your doctor or MS nurse about the services in your area.

If MS affects you, you should discuss your preferred and most effective methods of treatment for managing the disease or the symptoms with your doctor or MS nurse.

Be prepared – plan for your next relapse

There are a few simple actions you can take while you’re in remission to help make life a little easier when that next flare-up occurs. Clare has these suggestions:

  • Have the name and number of your doctor or MS nurse near the phone or in your mobile in case you need help or advice. Make sure close family and friends also have these details in case they need to call on your behalf.
  • Discuss your treatment options with your doctor so you both know what’s available in your area and what your preferences for treatment are.
  • Keep a small bag with all your essentials ready in case you need to go to hospital. 
  • Write a list of your medication (for MS and any other conditions) and an overview of your current condition, and keep it on you or in your hospital bag in case you need to show it to hospital or emergency staff in the event of a relapse.
  • Ask a reliable relative or friend to make any necessary calls in the event of a relapse – for example, to your employer – and make sure they have these numbers in advance.

More information on relapses

Talk to your doctor or MS nurse for more support and guidance on managing relapses.

Local MS support groups in your area will also be able to provide more information and advice. Try:

MS Society: A site dedicated to helping improve the lives of people with multiple sclerosis in the UK.

MS Trust: Information & support for people with MS, their friends and families.

Shift MS: A social network run by its users where young MSers meet, share experiences and support each other.

MS Ireland: Information and support for people with MS in Ireland, their families and friends.