Can MS Brain Lesions Heal?

‍MS brain lesions can feel scary or final, but new research shows there may be more hope for healing than we once thought.

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Looking at your MRI results can bring up a lot of emotions: confusion, worry, and fear about what it means for your future. Many people with MS worry that once damage to the brain or spinal cord shows up on a scan, there’s no going back. But the truth is much more nuanced—and a lot more hopeful.

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By the way, have we met? I’m Dr. Gretchen Hawley, a physical therapist and MS-Certified Specialist. I’m the creator of The MSing Link, an online program and book designed to help people with MS improve their mobility, strength, and confidence through targeted, research-backed strategies.

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Today, we’re tackling a big question: Can MS brain lesions heal? I’ll walk you through what the science says, what real healing might look like, and what you can do right now to support your brain health when you have multiple sclerosis. 

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What Are Brain Lesions in MS?

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When you have MS, the immune system mistakenly attacks the protective coating around your nerve fibers called myelin. This coating is essential for helping signals travel from your brain to the rest of your body quickly and efficiently. When myelin is damaged, it creates scar-like patches in your brain or spinal cord called lesions.

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MS brain lesions are responsible for many of the symptoms you might experience—like weakness, numbness, fatigue, and mobility issues. Depending on where the lesions are and how severe they are, they can affect different functions like walking, vision, balance, or memory. 

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Healing MS Brain Lesions: What Does It Mean?

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When we talk about healing an MS-related brain lesion, we’re usually referring to one of two processes:

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• Remyelination: This is when your body repairs or regenerates the damaged myelin around nerve fibers. While the new myelin may not be as thick or durable as the original, it can still help restore signal conduction and protect nerve cells.

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• Neuroplasticity: This is your brain’s amazing ability to rewire itself and form new neural pathways. Even if damage has occurred, your brain can sometimes work around it with the right kind of stimulation and repetition.

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Both of these processes play a role in how people with MS regain function and are reasons to stay hopeful—even if you’ve been living with your condition for decades.

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So… Can MS Brain Lesions Heal?

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Some MS brain lesions can shrink, appear less active, or even disappear entirely on follow-up MRIs. This can happen for several reasons, so let’s take a look.

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• Remyelination: As we just discussed, your body may be able to repair some of the damaged myelin.
• Reduced Inflammation: Disease-modifying therapies (DMTs), lifestyle changes, and time can reduce inflammation, making lesions less visible.
• MRI Sensitivity: In some cases, changes in imaging techniques or the resolution of your MRI may affect how your lesions appear.

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So yes, it is possible for MS brain lesions to improve—and in some cases, even disappear from scans altogether. But even if your lesions don’t visibly change, that doesn’t mean your body isn’t healing or adapting in meaningful ways. 

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Healing can take many forms. Maybe it’s through remyelination that restores function behind the scenes, or neuroplasticity that helps your brain create new pathways to work around damage. With the right support and consistent effort, improvements are possible. And that’s something to feel hopeful about.

How Do Remyelination and Neuroplasticity Work?

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Remyelination: The Body’s Natural Repair System

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Your body has special cells, called oligodendrocyte precursor cells, that can help rebuild damaged myelin. This process happens in every person, but it works the best in early stages of MS or in younger individuals. Over time, factors like chronic inflammation or scarring can slow it down.

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Researchers are actively exploring medications and therapies to support this natural repair process. Two of the most promising for healing MS brain lesions are:

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• PIPE-307 – A drug in clinical trials designed to encourage the maturation of cells that rebuild myelin.
• BTK inhibitors – A newer class of medication that can cross the blood-brain barrier and may help reduce inflammation in the central nervous system—creating a more supportive environment for healing.

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While many therapies are still in clinical trials, the fact that remyelination is even possible is a big deal. It means your brain has the tools it needs to rebuild; it just might need some extra help.

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Neuroplasticity: Creating New Brain Pathways

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As we mentioned above, neuroplasticity is your brain’s ability to adapt—even after damage. With the right type of movement and repetition, your brain can form new connections and reroute signals. This can help you improve coordination, strength, and function. 

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It’s also why MS-specific exercises are so important: they’re not just working your muscles, they’re training your brain too.

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Many of my clients with MS are shocked at the progress they make with consistent practice. Neuroplasticity is about teaching your brain and body to communicate more effectively as a unit, so you can move through daily life with more ease, strength, and confidence.

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Ways to Support Brain Health in MS

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While researchers are hard at work developing treatments that may one day heal MS brain lesions, there’s a lot you can do right now to support your brain and nervous system. 

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Taking these steps may not fully reverse your lesions, but they can protect your brain from further damage, improve the way you move and feel, and set the stage for future progress. 

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Here are some of the best ways to support brain health in MS: 

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1. Stay Active
2. Prioritize Sleep and Recovery
3. Reduce Inflammation Through Everyday Habits

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Stay Active

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Movement is one of the most powerful tools we have. Regular exercise (especially MS-specific movement) can support neuroplasticity and even promote remyelination by increasing the creation and mobility of cells that repair myelin.

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This doesn’t mean pushing yourself to exhaustion. Even seated exercises or light walking can have a big impact when done consistently and correctly. The important part is to move in a way that feels accessible and supportive to your body.

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Prioritize Sleep and Recovery

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Sleep is when your brain does most of its repair work. That’s why I always recommend establishing healthy sleep hygiene and protecting your rest time. This might look like winding down earlier, limiting your screen time at night, creating a cool sleep environment, or practicing calming bedtime rituals. If your sleep is disrupted due to MS symptoms (such as urinary frequency), work with a specialist to help manage those symptoms so you can get better sleep.

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Reduce Inflammation Through Everyday Habits

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Inflammation in the brain and spinal cord is one of the driving forces behind MS progression. While disease-modifying therapies are one of the most effective tools we have to reduce inflammation, they’re not the only option.

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Eating an anti-inflammatory diet, getting quality sleep, managing stress, and moving your body regularly all play a role in calming the nervous system. Even small, consistent changes can have a big impact over time. Think of it as creating a more peaceful, healing environment for your brain to thrive in.

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Progress is Possible—And You’re Not Alone

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Here’s what I want you to remember: your brain is incredibly resilient. With the help of remyelination, neuroplasticity, and science-backed therapies on the horizon, there is real hope for progress and healing. Even more importantly, there’s so much you can do right now to support your brain.

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Through consistent movement, inflammation management, and MS-specific strategies, you can feel stronger, steadier, and more confident in your body. Healing might not always show up as a perfectly clean MRI, but it can look like smoother walking, less fatigue, or simply feeling more in control of your day.

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Inside The MSing Link, I work with people from all walks of life who are on similar journeys. It’s a supportive community filled with encouragement, progress, and practical tools to help you move forward. You don’t have to do this alone—and you shouldn’t have to. If you’re looking for support, I’d love for you to join us!

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‍Have any questions? Feel free to DM me on Instagram @doctor.gretchen—I’d love to connect and support you on your journey.