MS Flare Up: 5 Tips for Management & Prevention

Discover the critical steps you can make today to reduce MS flare up occurrence and regain control of your health.

Written by MasterHealth Staff

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An MS flare up is any activation or re-activation of new or pre-existing symptoms. In order to clinically qualify as a Multiple Sclerosis-specific flare-up, the symptoms must:

  • Last for at least 24 hours or occur multiple times over the course of 3-4 days;
  • Occur at least 30 days after the initial flare up;
  • Not be a result of illness or infection.

MS flare up symptoms often vary from person to person, and can be influenced by specific environmental triggers at any given moment.


Some of the more common symptoms include:

  • Dysesthesia, including tingling, numbness, or burning sensations in the extremities;
  • Blurry or double vision in one or both eyes, with or without eye pain;
  • Dizziness;
  • An electrical shock feeling along your spine when you tilt your chin to your chest (called “Lhermitte’s sign”);
  • Sudden lack of balance or coordination;
  • Tightness around your abdomen or chest (known as the MS hug);
  • Slurred speech or trouble swallowing;
  • Bladder issues, including the frequent need to urinate.

There isn’t a clear-cut answer to how long an MS flare up can last. Depending on the flare up, it can last anywhere from 24h to several months before it revolves.


An MS flare up can be constant throughout the day or week, such as tingling in the limbs, or occur one or more times a day, over multiple days, such as the Lhermitte’s sign (an electrical feeling that travels from your neck down your spine when you tilt your chin to your chest).


When an MS flare up continues long-term, it’s no longer considered a flare up and becomes a more general MS symptom.

Calming an MS flare up is not as easy as it sounds, and like any other hypersensitivity reaction, it’s important to remove the cause of the trigger immediately.


Often times, increased inflammation or stress will be partly or fully responsible for an autoimmune or MS flare up, which is why it’s so important that you stay alert to the trigger so that you can take necessary precautions to avoid it in the future. 

An MS flare up is most often symptoms caused by increased inflammation that reactivates an existing lesion or forms a new MS lesion.


Cigarette smoke, a diet high in processed and/or sugary foods with a low vegetable intake, inadequate sleep, and a high-stress life can all contribute to an autoimmune and MS flare up.

Heat intolerance is extremely common when you are living with MS.


It may seem like a cause of your MS flare up, but the heat-sensitivity in MS is most often transient. This means as soon as you cool down, your symptoms will return to normal. Since an MS flare up lasts 24 hours or longer, this doesn’t qualify as a flare-up, but rather a symptom of heat sensitivity.


Ever heard of Uhthoff’s phenomenon?

It’s the exaggeration of symptoms following an increase in body temperature. Also helpful to know that it doesn’t necessarily mean your MS is progressing.


It’s simply a response to heat being applied to pre-existing inflammation – similar to the way a sunburn can feel worse with heat, but it doesn’t mean the sunburn is getting worse.

An MS flare up can also be triggered by physical or psychological stressors, especially ones that interfere with your body’s rest-digest-heal state – a.k.a the parasympathetic state. 


The parasympathetic nervous system, and the opposite sympathetic nervous system (fight-flight-freeze) are regulated by the hypothalamic-pituitary-adrenal axis (HPA axis). The HPA axis is a system of organs that help to regulate the body’s response to stress by controlling the release of various stress hormones, like adrenaline and cortisol.

ms flare up stress

The HPA axis becomes deregulated when we’re in more chronic states of mental or physical stress (i.e. consistently inadequate sleep, common in shift workers). This causes an increase in the levels of adrenaline and cortisol.


When there is excess cortisol in the bloodstream, it not only creates an increase in inflammation, it also begins to break down proteins (the building blocks of life). This can cause muscle wasting, organ damage, and changes in brain structure and function. An MS flare up becomes the inevitable result of chronic stress and the associated inflammation.

  1. If you know what caused the flare up, remove the trigger. For example, cool down if you’re overheating or eliminate the triggering food from your diet.

  2. Schedule in some time to rest from physical, mental or emotional stressors.

  3. Try to go to sleep and wake up at around the same time every night. This helps to keep your circadian rhythm in sync which can improve your overall quality of rest and repair. Set an alarm on your phone to remind you when bedtime is approaching.

  4. Aim for 8-9 hours of sleep every night, aiming to be asleep by 10pm (critical time for healing). This ensures that your body gets enough time to rest and recover.

  5. Drink an anti-inflammatory tea, like chamomile before bed or throughout the day.
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