MS Relapses: Identifying, Treating, and Recovering from a Relapse

Introduction

While the use of DMTs has greatly reduced the risk of relapses, unfortunately, the risk is not eliminated entirely.  

Learning about them is the best way for you to ease your worries about relapses, recognize them when they occur, and get the treatment you need. This article will help you answer the most common questions about relapses.  

What Is an MS Relapse?

MS relapses are identified by three key criteria – and to be sure it’s a relapse, it needs to meet all three: 

1. You are experiencing new or worsening symptoms of MS.  
2. They last more than 24 hours. 
3. They are not due to fever, infection, or another cause. 

Just as MS affects everyone differently, relapses can vary greatly in their symptoms and severity. Typically, relapses tend to appear over several days to a week. Then, you may plateau for several weeks and recover completely or partially over several more weeks or months.  

Call or message your MS doctor if you believe you’re experiencing a relapse.

What Should You Do During a Relapse?

During a relapse: 

• Stay in communication with your healthcare team. You want to be sure that you and your MS provider can monitor progress throughout the relapse. 
• Listen to your body. You may need to rest more than usual during a relapse, and you may need to reduce or adapt your regular activities. Talk to your healthcare team about how you’re feeling so that they can help you modify your activities accordingly. 
• Be aware of the potential side effects of steroids, including mood swings, insomnia, stomach upset, increased appetite and weight gain. Tell your MS provider if you feel any of these side effects. They can be treated!  

Just after a course of steroids, you may experience significant fatigue and a sense of overall weakness. Fortunately, these side effects subside soon after the course of medication is completed. 

If you experience feelings of a change in your emotions, such as sadness, loss or worry that persist after treatment, a mental health professional can help you work through them so you can get back to feeling like yourself again. 

If your relapse is mild, you will likely return to your pre-relapse activities. If your symptoms cause persistent functional changes, you will likely benefit from a re-evaluation, rehabilitation, modification and/or adaptation to your activities. With some relapses, all function returns. With others, there may be mild or significant symptoms that remain (called residual symptoms).
 

What Happens After A Relapse?

Life after you’ve experienced a relapse is challenging, both physically and emotionally.  

• You may have new MS symptoms that interfere with your daily life, like increased fatigue, weakness, imbalance, changes in thinking, or others. Rehabilitation specialists (such as physical therapists, occupational therapists, or speech-language pathologists) can assist you with your physical recovery or help you adapt to any changes in your function. 

• Meanwhile, you might be facing new worries about the future. “Will I recover? Does this mean my disease is getting worse? What will my future look like?” It can feel like you’re going through the same ordeal of worries as when you were first diagnosed with MS. Plus, your family may also experience worry, grief, or sadness when you experience a relapse. 

Discuss these changes with your MS provider. In most cases both can be successfully addressed by rehab specialists or mental health professionals. 

Does This Mean I Need to Change My DMT?

Should a relapse occur, your MS provider may request an MRI to assess for any new activity, or changes in previous areas of MS damage.  

If you are consistently taking a disease-modifying treatment and you experience a relapse, that is a signal that you need to discuss the effectiveness of your DMT with your doctor.  

There are many DMT options and if breakthrough disease activity occurs on one DMT, you may get a better effect from a different DMT. While no DMT is known to stop all MS relapses, it’s important to work with your provider to find the most effective one for you.

Looking To The Future After a Relapse

Relapses are frightening and disruptive. But, your relapse will settle down, leading to complete or partial recovery. You may face challenges, but your MS team will help you face those challenges and move forward. 

Click here to get even more great tips on this topic by viewing our recorded webinar on Recognizing and Rebounding from an MS Relapse.