Multiple sclerosis (MS) is a condition that affects the central nervous system. MS can cause a wide range of symptoms, from numbness in your arms and legs, to paralysis in its most severe state.

Relapsing-remitting MS (RRMS) is the most common form. With this type, MS symptoms can come and go over time. A return of symptoms can be classified as an exacerbation.

According to the National Multiple Sclerosis Society, an exacerbation causes new MS symptoms or worsens old symptoms. An exacerbation can also be called:

  • a relapse
  • a flare-up
  • an attack

Read on to learn more about MS exacerbations and how to treat and possibly prevent them.

In order to understand what an MS exacerbation is, you first need to know the symptoms of MS. One of the most common symptoms of MS is a feeling of numbness or tingling in your arms or legs.

Other symptoms can include:

  • pain or weakness in your limbs
  • vision problems
  • loss of coordination and balance
  • fatigue or dizziness

In serious cases, MS can also lead to vision loss. This often occurs in just one eye.

How can you tell whether the symptoms you’re having are regular signs of your MS or an exacerbation?

According to the National Multiple Sclerosis Society, symptoms only qualify as exacerbations if:

  • They occur at least 30 days from an earlier flare-up.
  • They last for 24 hours or longer.

MS flare-ups can last months at a time. Most stretch out for multiple days or weeks. They can range from mild to serious in severity. You may also have different symptoms during different exacerbations.

According to some research, most people with RRMS experience exacerbations throughout the course of their disease.

While you can’t prevent all exacerbations, there are known triggers that can prompt them. Two of the most common ones are stress and infection.


Different studies have shown that stress can increase the occurrence of MS exacerbations.

In one study, researchers reported that when MS patients experienced stressful events in their lives, they also experienced increased flare-ups. The increase was significant. According to the study, stress caused the rate of exacerbations to double.

Keep in mind that stress is a fact of life. However, there are steps you can take to reduce it. Here are some things you can do to help lower your stress levels:


Studies have shown that common infections, such as the flu or a cold, can cause MS exacerbations.

While upper respiratory infections are common in the winter, you can take steps to reduce your risk, including:

Some MS exacerbations may not need to be treated. If symptom flare-ups occur but don’t affect your quality of life, many doctors would recommend a wait-and-see approach.

But some exacerbations cause more severe symptoms, such as extreme weakness, and require treatment. Your doctor may recommend:

  • Corticosteroids:These drugs can help bring down inflammation in the short-term.
  • H.P. Acthar gel: This injectable medication is generally used only when corticosteroids have not been effective.
  • Plasma exchange:This treatment, which replaces your blood plasma with new plasma, is used only for very severe flare-ups when other treatments have not worked.

If your exacerbation is very severe, your doctor may suggest restorative rehabilitation. This treatment may include:

Over time, multiple relapses can lead to complications. Treating and preventing MS exacerbations is an important part of managing your condition. It can help improve your quality of life, as well as help prevent progression.

Work with your doctor to create a care plan to manage your MS symptoms — those that occur during exacerbations and at other times. If you have questions or concerns about your symptoms or condition, be sure to talk to your doctor.