Multiple sclerosis is a disease in which a person's immune system targets the central nervous system and the transmission of information between the brain and the body. There are different types, some of which involve attacks or flare-ups of symptoms.
Sometimes, a person is unable to predict the timing and physical effects of an MS flare-up, which can make it difficult for them to manage their disease.
A person with MS will not always require treatment, particularly if the symptoms are not painful or disruptive. There are some lifestyle changes and interventions that people with MS can make to help control the disease and positively impact their overall health.
Many of these changes are simple lifestyle choices that a person can work into their daily routine. Others may require more input from a doctor or therapeutic care.
In this article, we look at how to recover from an MS attack, and the steps a person should take to maintain as much quality of life as possible.
People with MS will often experience flares, which doctors also call relapses or attacks. A flare might involve an escalation of existing symptoms or the appearance of new ones.
The disease often presents differently in different people, so it is often difficult for a person or a doctor to predict the severity, frequency, or personal impact of an MS attack.
Severe relapses can disrupt day-to-day living for a person with MS and their family. After a relapse, a person with MS might experience extreme stress as they try to resume their routine.
After a flare, a person may need additional rest and recovery time. If the flare is severe, consulting with a physical and occupational therapist might help to restore mobility and independence.
A person might also take medications to control the effects of MS throughout their body. However, not all attacks are severe, and an individual may recover without taking drugs.
Not all MS flare-ups require treatment. When they are mild, they can often resolve with rest alone.
When symptoms during a flare-up are severe enough to reduce a person's daily function, doctors often advise taking a multipronged approach to management. A person might be able to manage an attack of symptoms through medication, physical therapy, and lifestyle changes.
Some medications focus on reducing relapses. Reducing the number of relapses increases the amount of time between periods of intense symptoms. These are called disease-modifying therapies (DMTs), and they are usually a first-line treatment for people who experience MS symptoms as flares.
Other medications are used to speed recovery from an MS attack.
Some of the medications that a doctor might prescribe for relapses or attacks of MS include:
- A 3-to-5-day course of corticosteroids to treat inflammation and reduce the duration of the attack.
- H. P. Acthar gel, which is an extremely pure preparation of a hormone that the brain usually produces in the pituitary gland. It is a short-term treatment for MS flares.
It is important to note that corticosteroids do not have an impact on long-term disease progression. They can only address short-term inflammation and flares.
Medications also aim to slow the progression of the disease as well as address disruptive individual symptoms, such as:
- muscle spasms
- bladder and bowel problems
- sexual dysfunction
Living with MS involves taking care of physical and emotional well-being. People with MS can adopt a variety of lifestyle changes and therapies to help manage their symptoms and maintain good health.
Rehabilitation can form an important part of preserving a person's quality of life during and following a relapse. Rehabilitation involves a team of multi-disciplinary therapists working together to help people with MS resume normal function.
It is best to start rehabilitation early on in the progression of the disease, as people may find it easier to implement when their symptoms are less severe.
A person with MS can consider taking the following steps to manage their symptoms.
Many people with MS receive physical therapy. A physical therapist can educate a person with MS how to do specific stretches that can help relieve pain and exercises to strengthen weakened muscles and regain movement.
A physical therapist can also teach people with MS how to engage with daily tasks in a way that reduces discomfort and fatigue.
This type of therapy can help a person with MS readjust to life in the workplace and when socializing.
An occupational therapist can help support independent living and help people continue with their regular routines. Occupational therapists focus on teaching daily living skills, such as eating and dressing, and also target work skills, such as using a keyboard.
They can also help an individual adjust their office chair to a comfortable, orthopedically safe position that can help them return to work.
Occupational therapy also aims to support independent living, mobility, and overall fitness. Occupational therapy can also teach a person new ways to do activities to conserve energy and reduce fatigue.
MS exacerbations can affect speech processing, volume, and clarity, so people may need speech therapy to support vocal strength, communication, and pronunciation.
Speech therapists also have the training to help people with MS alleviate swallowing difficulties (dysphagia).
Psychotherapy and counseling
They may benefit from visiting a psychologist or counselor. Psychotherapy can help people with MS reconnect socially, build a support network, and develop coping mechanisms for the physical and emotional discomfort that might accompany an attack of symptoms.
Some people who have MS might find that they need to adapt their daily routine to accommodate the symptoms of a particular attack, which some people may find emotionally and physically disruptive.
Those with the disease may have to alter their habits and activities to account for reduced energy and physical movement.
It is essential that people with MS get enough rest. Establishing a good bedtime routine will help ensure they get restful sleep.
MS can cause debilitating fatigue. Although getting plenty of sleep can help, one symptom of fatigue is waking up from rest feeling unrefreshed.
Sleeping for longer before potentially demanding, draining, or important events can also help a person with MS preserve energy.
During a relapse of symptoms, a person with MS may need more sleep and rest than usual and should allow for extra sleep time at the end of their day.
The World Health Organization (WHO) recommend that all adults do at least
For people with MS, exercise can reduce the impact of symptoms by:
- improving cardiovascular health
- reducing weakness and better strength and movement
- improving function in the bowel and bladder
- promoting better mood and reducing fatigue
- encouraging participation in social events and engagements
Some forms of exercise, such as yoga, can also help relieve painful muscle spasms. Exercise can also counter MS-related fatigue and boost mood.
While there is mixed research around the links between stress and relapses of MS, experts think that managing stress can still play a significant role in reducing the impact of the disease on everyday life.
Scientists are not clear whether stress might cause MS symptoms. It can, however, make symptoms feel worse on an individual basis.
Steps to reduce stress with MS include:
- Planning for particularly stressful or demanding situations. This might involve taking a distraction, such as a book, to appointments that might require waiting.
- Reducing pressure from daily chores and tasks. People experiencing an MS relapse who are having difficulties adjusting to tasks need to assess the importance of the task and the standards it requires. Asking for help can also relieve stress during these times.
- Handling less pleasant tasks earlier in the day can help a person with MS maintain energy for more enjoyable tasks and activities.
- Ordering more medication before it runs out to avoid the stress of a shortage.
- Recognizing signs of stress, such as shallow breathing, and taking measures to relax. Practicing controlled breathing can help a person alleviate this symptom of stress.
- Engaging in at least one enjoyable activity every day.
- Avoiding extremely hot or cold temperatures to reduce discomfort. Although some people with MS may be susceptible to temperature changes, heat usually only worsens symptoms for a limited period.
- Stress management techniques, such as guided meditation, deep breathing, and yoga might help relieve stress in times of emotional discomfort.
More detailed guidance is available on the National MS Society website.
Improving bladder control
Many people with MS experience bladder issues, such as urinary incontinence, difficulties starting urination, problems emptying their bladder, and bladder urgency, which is the sensation of wanting to urinate frequently even when there is very little urine in the bladder.
Anyone experiencing bladder problems should inform their doctor who will likely check for a urinary tract infection (UTI).
Scheduled voiding, or going to the bathroom at a set time, can help train the bladder to hold urine for a longer time. This may decrease persistent feelings of needing to urinate. Also, medications are available that may help with bladder symptoms.
People with MS have a high risk of depression, isolation, and feelings of loneliness, especially during a relapse. People with MS might choose to talk to a counselor or support group to help cope with depression and feelings of anger over the disease.
Many people with MS find it helpful to develop a network of people who can help with the remitting effects of the disease.
Healthline offers an app called MS Buddy that can help connect people with MS for emotional and practical support.
People with MS should take extra care to stick to a high-fiber, low-fat diet. As MS is an inflammatory condition, a diet rich in anti-inflammatory foods can help.
Some foods have specific benefits that can support symptom management during flare-ups.
While there is no specific diet that doctors recommend for people with MS, include the following foods as part of a healthful diet.
- leafy greens, such as spinach, kale, and Romaine lettuce
- fatty fish, including salmon and tuna
- olive oil
- coconut oil
- whole grains, including oats, quinoa, and brown rice
The National Multiple Sclerosis Society caution against following any particular diet plan, as there is no evidence to support any specific diet as being safe and effective for managing MS. However, they do recommend consuming enough fiber and omega-3 fatty acids.
Knowing how to help a loved one with MS can be challenging for caregivers. Because the disease can be unpredictable, caregivers may have to adapt their schedule and lifestyle on short notice.
Ways to support a loved one with MS include:
- accompanying them to medical appointments
- helping with household tasks, such as cleaning, childcare, and preparing meals
- encouraging hobbies and leisure activities
- helping with primary care, including dressing and bathing during flares
- offering emotional support and companionship
Caregivers should also take steps to meet their own physical and emotional needs when caring for a loved one with MS.
Maintaining self-care might be challenging when caring for a loved one with a chronic illness. However, taking the necessary time out when possible can be helpful for both the caregiver and the individual with MS.