MS flare-ups can show up when you least expect them… Sudden fatigue, blurry vision, or a new symptom that feels like it came out of nowhere.
They can make any simple task feel harder, leaving you frustrated and unsure of whether it’s a relapse, a flare-up, or just a bad symptom day.
These ups and downs can be overwhelming, but understanding them is the first step to feeling more in control of your health. Today, we’ll cover everything you need to know about MS flares and how to manage (or even reduce) them.
By the way, have we met? I’m Dr. Gretchen, an MS-Specialized Physical Therapist and founder of The MSing Link—an online wellness program and book. I’ve helped thousands of people with MS feel stronger, walk with more confidence, and take control of their health. If you’ve ever felt frustrated by unpredictable symptoms, you’re in the right place.
If you’ve lived with MS for any length of time, chances are you’ve noticed that symptoms can ebb and flow. But what exactly counts as a flare-up? A true flare-up happens when old symptoms worsen significantly for at least 24 to 48 hours, without an obvious trigger like heat or stress.
It’s important to know that flare-ups aren’t the same as the small day-to-day changes we all notice. Fatigue that comes after a particularly busy day or muscle stiffness from not stretching doesn’t always mean you’re having a relapse.
Knowing how to tell the difference between flare-ups, relapses, and temporary fluctuations can help you respond more calmly and take the right steps.
One of the trickiest parts of MS is figuring out if a new or worsening symptom means you’re having a relapse or progression, or if it’s just a temporary flare-up (aka a pseudo-relapse) from things like heat, stress, or fatigue.
My advice? Get curious. Instead of panicking, pause and ask yourself: What else is going on right now that could be a contributing factor?
Sometimes symptoms appear right away after a trigger, but other times there’s a delay—similar to how you can feel sore from a workout a few days later. This means stress, overexertion, or even changes in sleep can trigger MS symptoms days after the fact.
By asking simple questions like “Was I stressed this week?” or “Did I push myself harder than usual?” you can start to connect the dots and feel more confident in your situation.
Even though MS flare-ups can feel sudden, they’re often connected to everyday factors that sometimes go unnoticed at first. Recognizing your triggers is empowering because it helps you know what you can do differently next time.
Remind yourself that you’ve gotten through a flare-up before, and you can do it again.
Some of the most common MS flare-up triggers include heat, fatigue from overexertion, poor sleep, stress, and common infections like UTIs or colds. The tricky part is that new triggers can pop up over time—you may have tolerated heat for years, and suddenly this summer it starts causing problems.
It’s important to stay open-minded and pay attention to how you feel day to day.
Recently on The MSing Link podcast, I covered the key triggers that can worsen MS symptoms, along with helpful strategies to minimize flare-ups and feel more in control. Save the full episode below so you can tune in whenever you have the time, and let’s dive into the next section.
If you’re dealing with a flare-up, it’s completely normal to wonder how long it’ll stick around. Most of the time, a flare will calm down within 24 to 48 hours once the trigger is removed. But if your symptoms last longer than 48 hours, or if you notice a brand-new symptom (not just an old one flaring up), that could be a true relapse.
You should always call your neurologist if you notice new symptoms, a significant worsening of old ones, or if your symptoms don’t ease after removing potential triggers. Sharing details early helps your provider know if interventions are needed or if rest and monitoring would be enough.
When it comes to your health, information is power—especially when you’re living with a chronic illness like multiple sclerosis. Tracking your symptoms provides valuable insights for both you and your healthcare team. Without it, it’s harder to determine whether you’re experiencing a flare-up, a pseudo-relapse, or disease progression.
Here are key details to note when tracking MS flare-ups:
Sharing this kind of data with your neurologist or physical therapist is a lot more useful than saying, “My balance got worse.” It helps them recommend the most effective next steps faster.
For example, noting whether your spasms, numbness, or MS hug episodes happen at a certain time of day gives your provider clearer insight into what’s going on.
Even though you can’t always prevent a flare-up, there’s plenty you can do to reduce its frequency and severity. Small, consistent choices often make the biggest impact—from how you rest and pace yourself to the tools you use each day.
Here are a few practical strategies that have helped MSing Link members:
The most important thing? Celebrate your everyday wins. Recognizing what helps you feel better keeps you motivated and builds confidence over time. Whether it’s making it up the stairs with less effort or feeling steadier when you stand up from a chair, it’s worth celebrating.
Dealing with MS flare-ups can feel discouraging, but you have more control than you think. By learning to recognize triggers, tracking your patterns, and communicating clearly with your healthcare team, you’ll be better equipped to manage these challenges and bounce back faster.
If you’re looking for ways to make tough days easier, my Mobility Tools Guide is a great place to start. Inside, you’ll find direct links to my favorite cooling products, mobility aids, and everyday tools designed to help reduce foot drop, improve mobility, and give you more confidence.
Have questions about MS flare-ups or just want some encouragement? Send me a DM on Instagram @dr.gretchen — I’d love to hear from you!
On the MeSsy Podcast, Dr. Gretchen Hawley joined Christina Applegate and Jamie-Lynn Sigler to unpack the realities of life with MS—covering fatigue, heat intolerance, menopause, and practical strategies that lead to everyday wins. Learn simple, sustainable ways to protect your energy, retrain your brain-body connection, and find hope in steady progress.
Dr. Gretchen Hawley's The MSing Link offers a comprehensive guide to taking control of your MS symptoms and improving your mobility through MS-specific exercises and strategies.
6000+ copies sold in over 13 countries!
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As a physical therapist & Multiple Sclerosis Certified Specialist, I have spent the last 10 years teaching people with MS how to feel more confident & empowered through MS-specific exercises and strategies.
If you want support and encouragement, plus a healthy dose of tough love, come follow me on Instagram (@doctor.gretchen) or on YouTube @DoctorGretchenHawley. It's where I share daily tips, tricks, and information about new offers — plus, you’re bound to feel more empowered, hopeful, & motivated after watching each post and video!
Questions? Email me at Hello@DoctorGretchenHawley.com