The majority of people living with multiple sclerosis (MS) are initially diagnosed with relapsing-remitting MS, meaning they experience periods of acute symptoms, called relapses or exacerbations, that are generally followed by periods with minimal, or at least less acute, symptoms, called remissions.
“When a new neurological symptom develops in multiple sclerosis, one that isn’t related to an infection and lasts for more than 24 hours, it is considered to be an MS relapse,” explains Devon Conway, MD, a neurologist at the Mellen Center for Multiple Sclerosis at Cleveland Clinic in Ohio.
Relapses are caused by inflammation in the central nervous system, and remissions occur as the inflammation dies down.
But not every episode of symptom worsening in MS is a relapse. When old symptoms reappear but subside within 24 hours, the episode is referred to as a pseudorelapse or pseudoexacerbation, according to the Multiple Sclerosis Association of America.
While the cause of a relapse or pseudoexacerbation may not always be easily identifiable, there are some common triggers of both, says Matthew McCoyd, MD, a neurologist and associate professor with the Loyola University Health System in Illinois.
Here are some common triggers for MS symptom flares, as well as tips on how to avoid them.
Stress Impacts All Health Conditions, Including MS
“I don’t know of a single medical condition that is not adversely affected by stress, and there is evidence that stress can worsen the symptoms and the disease of MS,” says Robert Fox, MD, a neurologist at the Mellen Center for Multiple Sclerosis at Cleveland Clinic.
A meta-analysis published in Health Psychology Open evaluated how stress impacts MS and found some evidence that stress can be associated with relapses. The authors also found evidence that MS relapses and stress can have a bidirectional relationship. That means that stress may contribute to the development of a relapse and an MS relapse may also cause stress.
Studies included in the analysis indicated that accumulated stress or the presence of many different stressful events increased the risk of relapse compared with a single stressful event. Likewise, chronic stress that lasted more than 48 hours has a greater effect on MS than acute stress.
“Patients can dismiss stress, but it’s another condition, like high blood pressure or diabetes or obesity; it can impact all aspects of your health and it should be attended to,” Dr. Fox says.
The National MS Society recommends a variety of strategies to help manage stress levels, including looking for ways to make your life less stressful, such as saying no to things you don’t have the time or energy to do, and asking for help when you need it. It also recommends regularly practicing a relaxation technique such as deep breathing, meditation, or yoga.
Avoiding MS relapses isn’t the only good reason to reduce the stress in your life or learn to manage it better: Stress can also have a negative effect on your mental health. According to the National Institute of Mental Health, having a chronic disease like MS can make every aspect of life more stressful, and that can increase the risk of depression.
“To read this article in its entirety click this link: Worried About MS Flares? 4 Triggers That Can Worsen Your Symptoms.”