Managing MS: Should You Worry About New, Changing Symptoms?

If your multiple sclerosis (MS) was diagnosed some time ago, you’ve probably learned how to control it fairly well. But you may still sometimes wonder whether new or changing symptoms are a cause for concern.

As a complex illness with a range of symptoms that affect multiple parts of your body, MS can be difficult to manage. It’s sometimes hard to tell what all your symptoms mean, and whether it’s time to talk to your doctor.

What’s the difference between fluctuations and relapses?

“In general, we divide new symptoms into two categories,” says neurologist Robert Bermel, MD.

1. Fluctuations (sometimes called pseudorelapses or flares). It’s common for symptoms to come and go, related to impaired electrical conduction through chronic multiple sclerosis scars or old damage.

Other things that are going on with you, both physically and psychologically, sometimes bring on symptom fluctuations. Possible triggers include:

• Viruses.
• Upper respiratory infection.
• Urinary tract infection.
• Work stress.
• Relationship problems.

One hallmark of pseudorelapses is sometimes that multiple symptoms all seem to get worse at the same time. The good news is that increased MS symptoms in these cases are temporary. “When the patient recovers from the illness or gets past the stressful period, the neurological symptoms will improve,” says Dr. Bermel.

2. Relapses. These last longer than 24 hours, and are related to new inflammation or new lesions in the brain, spinal cord or optic nerve.

They tend to bring on symptoms that you may not have experienced before. For example, you might notice new signs of:

• Weakness.
• Numbness or tingling.
• Vision problems.
• Balance or coordination problems.

Dr. Bermel offers guidance about when to talk to your doctor.

“Talk to your MS care team about any new symptom lasting longer than 24 hours, especially if it is disabling or focal (involving one particular part or function of the nervous system),” he says.

It’s rare for MS to require emergency medical treatment. However, it’s probably time to head to the ER if you experience a new symptom that impairs your ability to take care of yourself, walk, eat or drink.

How to take control of your MS

Can you take steps to proactively manage your MS? Absolutely.

“We now recognize that wellness is an important contributor to prevent MS symptom fluctuations and relapses,” Dr. Bermel says.

His best advice? Don’t smoke, get regular exercise and follow a healthy diet to help stabilize your MS symptoms. It’s also helpful if you address other health problems, such as high blood pressure, diabetes and high cholesterol — all of which can affect your MS.

Dr. Bermel has hopeful words for people with relapsing-remitting MS.

“Achieving stability of the disease ― or what is called ‘no evidence of disease activity’ ― is now a realistic treatment goal,” he says. While current treatments can’t reverse the damage that’s been done, they can, when coupled with a healthy lifestyle, effectively stop the disease from progressing.

Dr. Bermel notes that it’s important to get regular magnetic resonance imaging (MRI) scans to monitor your MS. This is the best indicator of disease control.

Knowing what to expect from your MS and what steps you can take to manage it can make a dramatic difference in your symptoms. Taking care of other health problems, reducing stress and knowing when to talk to your doctor can help keep MS symptoms in check and keep you enjoying your life.