Part of living with multiple sclerosis (MS) is dealing with flares. A flare, also called a relapse, is when MS symptoms recur or worsen.1 The change in symptoms lasts for at least 24 hours, but often much longer.1 Flares throw a wrench into daily life and plans. They are challenging to manage. Curious about how you handle flares, we recently posed this prompt to our MultipleSclerosis.net Facebook community: “You feel a flare coming on. What is the first thing you do?”
How to prepare for an MS flare
“I can’t tell when I’m getting one” was the response for many of you. But those who could tell had some insights to share.
Rest and comfort
Preparing for rest as a flare sets in was the top response. A flare means higher levels of fatigue are coming. The body needs extra rest to endure the symptoms. Making yourself as comfortable as possible and choosing favorite movies or shows to binge helps you manage.
“Cancel plans and prepare to rest and treat symptoms as needed.”
“Change the bedsheets. If I’m going to be spending some extra time in bed, I might as well do it with fresh sheets.”
“Get some comfy PJs on, lounge, watch TV, sleep, and eliminate as much stress as possible. Sleep is my number 1 in combating a flare if caught early.”
Begin steroid treatment
Corticosteroids, taken orally or by iv, are the leading treatment for flares.2 Many of you find that the sooner you begin a steroid course, the quicker your flare will ease. At the first sign of a flare, you contact your doctor.
“Call my doctor to ask if I can have oral steroids or if I have to go to the hospital for IV steroids.”
“Throw down 20 mg of prednisone.”
Steroids work to reduce inflammation of the central nervous system during flares. The difficulty is the risks and side effects that come with long-term use. Steroids can be hard on the stomach. They can also lead to loss of bone density over time, among other symptoms.2 Some of you mentioned this in your responses.
“I know steroids help quickly and temporarily, but they can be irreversibly damaging to the body.”
Upping water intake is vital as a flare begins. As mentioned, fatigue increases during a flare. Dehydration can also heighten feelings of fatigue.3 It is important to hydrate to keep symptoms from getting worse.
“Drink plenty of water; try not to stress.”
“Grab 2 packets of Emergen-C in water, follow with more water, and hope it doesn’t set in.”
“Water, water, water, nap, water, water, water.”
When a flare comes on, it feels discouraging. Everything becomes more complicated, plans get canceled, and rest is the name of the game. You feel mad. You feel defeated. Once more, MS is interfering with life. Some of you find relief in expressing these feelings.
“Use every word in the book … twice.”
“Cry softly into my pillow.”
We appreciate everyone who shared their responses to the onset of a flare. We are grateful for everyone’s presence in the community!
1. Treating Multiple Sclerosis Relapses. Multiple Sclerosis Association of America. Available at https://mymsaa.org/ms-information/treatments/relapses. Accessed 5/6/2021.
2. Krieger S, Sorrells SF, Nickerson M, Pace TWW. Mechanistic insights into corticosteroids in multiple sclerosis: war horse or chameleon? Clinical Neurology and Neurosurgery. 2014;119:6-16. doi:10.1016/j.clineuro.2013.12.021.
3. Hydration – What Do You Really Need? MS Focus Magazine. Available at https://msfocusmagazine.org/Magazine/Magazine-Items/Posted/Hydration-What-Do-You-Really-Need. Accessed 5/6/2021.