Experiencing an MS relapse can be frustrating and scary, especially when your symptoms seem to flare up out of nowhere. But researchers have discovered that flare-ups aren’t random at all – there’s real science behind why relapses happen.
They’re shaped by a mix of factors working together inside your body, including your genes, hormones, immune system, and environment. The more you understand these pieces, the more you can support your body’s natural ability to repair and recover.
If you've been told to "just deal with" symptoms or felt cut off from physical therapy before you were ready, you're not alone – and you deserve better. Let's bridge that gap together.
By the way, have we met? I’m Dr. Gretchen, an MS-Specialized Physical Therapist and founder of The MSing Link – a research-based online program for people with MS, podcast, and book designed to help people with MS feel stronger and more confident. I turn complex research into practical tools and strategies you can use in your everyday life.
I hear this question all the time: is MS something you’re born with, or something that develops later? The answer is somewhere in between. No single gene causes MS. Instead, researchers have found that certain genes (like HLA-DRB1*15:01) can make your immune system more likely to become overactive.
Think of your genes as the foundation of a house. They shape the structure, but they don’t control when a storm comes through or how you reinforce the walls. Environmental factors like infections, low vitamin D, and chronic stress interact with these genes to determine how inflammation behaves.
That’s why two people with similar genetic profiles can have completely different experiences with MS. Your DNA may set the foundation, but your daily choices and environment help decide how strong that foundation stays.
If you’re a MSing Link community member or have met others with MS, you’ve probably noticed that no two people have the same experience. Some go years without a relapse, while others face them more frequently. This difference comes down to a mix of triggers that vary from one person to the next.
Infections are one of the most common triggers. Even a simple cold or urinary tract infection can activate the immune system in a way that sparks new inflammation. Hormone changes, stress, lack of sleep, and heat exposure can also play a part by temporarily increasing inflammation or making symptoms worse.
It’s also important to know the difference between a true MS relapse and a pseudo-relapse. A pseudo-relapse feels similar but happens when an external trigger (like heat, stress, or fatigue) temporarily irritates your nervous system. Symptoms usually settle as your body recovers.
Keep in mind: not every symptom spike means your MS is progressing. Sometimes your immune system is just busy fighting something else. If new symptoms appear, it’s worth checking for infection first before assuming it’s a relapse.
As an MS-Specialized Physical Therapist, this is something I'm passionate about. Research shows that behaviors like sleep, stress management, and physical activity can help regulate inflammation and support your body's natural repair processes. While the exact mechanisms are still being studied, evidence suggests these lifestyle choices may influence how your body responds to MS activity – though they are not a substitute for medical treatment.
Regular movement, restorative sleep, and social connection all help support anti-inflammatory pathways and cellular repair processes that promote healing. Emerging research in animals suggests exercise may help support the brain’s repair environment – potentially improving how cells involved in remyelination function. In humans with MS, exercise is proven to improve mobility, fatigue, and brain health, but direct effects on remyelination are still under investigation.
And the best part? You don’t need to work out intensely for it to count.
Gentle, consistent activity can still encourage your brain to repair itself and improve how your nerves communicate. Your genes might write part of the script, but how you live can support your body's overall resilience and well-being. While lifestyle changes can't control whether relapses occur, they can help optimize your body's ability to manage inflammation and improve how you feel day to day.
Remyelination – the brain’s ability to rebuild the protective coating around nerves – is one of the most exciting (and complex) areas of MS research. While it was once believed that myelin couldn’t regenerate, we now know that the brain may be capable of partial repair. Even small amounts of remyelination can improve symptoms and protect nerve health.
That said, drug-based remyelination therapies remain a work in progress. One Phase 2 clinical trial for a therapy called PIPE-307 recently failed to meet its primary goals, despite showing strong safety. This reinforces how challenging (and early-stage) this field still is.
Researchers continue to study other compounds—including clemastine, bexarotene, and several others—in early clinical trials, but no myelin repair treatment has been approved yet.
The good news? Healthy lifestyle factors like movement, restorative sleep, and managing stress are showing promise in supporting the brain’s repair environment. These may not regrow myelin directly, but they help the brain function at its best — which is crucial between relapses.
When you live with MS, the idea of preventing a relapse can feel overwhelming, especially when so much feels out of your control. But you deserve clear, research-based guidance that actually works in your daily life—and small daily choices can make a real difference.
By supporting your body with rest, movement, and connection, you can help reduce inflammation and give your brain the best chance to repair and recover between relapses.
Here are a few small steps to prioritize:
Remember: your genes may play a part in your MS, but your actions can make a powerful difference in how your body responds.
Going through an MS relapse can feel discouraging…maybe even isolating or defeating. But it doesn't mean your body has stopped trying to heal. You're not stuck, and you're not alone. Research shows that your brain is constantly working to protect and repair itself, even between flare-ups. Understanding your genetic risk helps, but your environment and mindset matter just as much.
If you want to keep learning how to apply the latest MS research in a way that actually makes sense for your life, my MS Research Made Simple course was made for you. It takes 26+ hours of complex science and turns it into 10 easy-to-understand lessons you can use right away to feel more confident in your care and support your brain’s natural ability to heal.
Have any questions about MS relapses, or just want to say hi? Send me a DM @doctor.gretchen – I’d love to hear from you!
Disclaimer: This post reflects the most current research available as of December 2025. Information about clinical trials, drug development, and MS research changes frequently. Please consult with your neurologist before making any medical decisions or lifestyle changes. This content is for informational purposes only and does not constitute medical advice.
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
%20(1).png)
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!
