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Treating relapses and symptoms

Some treatments do not change the course of MS but ease its effects, by shortening a relapse or by helping with walking, stiffness or bladder problems. They also show researchers what goes wrong in damaged nerves.
Module 11 · Lesson 10 of 11 · 2 min · Interactive · Sources checked October 2026 · Not yet reviewed by an MS specialist
Clay illustration for Treating relapses and symptoms

Relapses

High-dose steroids, given for a few days, are the standard treatment for a disabling relapse. They speed recovery from the attack but have not been shown to change the long-term outcome. When a severe relapse does not respond, plasma exchange, which filters antibodies and other proteins out of the blood, is an option that guidelines support. Evidence is insufficient to determine whether intravenous immunoglobulin helps treat relapses.

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High-dose steroids, given for a few days, are the standard treatment for a disabling relapse. They speed recovery from the attack but have not been shown to change the long-term outcome. When a severe relapse does not respond, plasma exchange, which filters antibodies and other proteins out of the blood, is an option that guidelines support. Evidence is insufficient to determine whether intravenous immunoglobulin helps treat relapses.

Walking: a medicine that acts on the nerve

Fampridine shows how symptom treatment can follow directly from biology. When myelin is lost, potassium channels that are normally covered by it are exposed, and the current leaking through them weakens the nerve signal. Fampridine blocks these channels. In its trials a subset of people walked consistently faster while taking it, and others had no benefit.

Stiffness, bladder and other symptoms

Spasticity, the stiffness and spasms caused by damage to the nerve pathways that control muscles, is treated with medicines such as baclofen and gabapentin, with cannabis-based medicines and with physiotherapy. Bladder problems, fatigue, pain and low mood each have their own treatments, and NICE recommends that a regular review of MS covers all of them.

Rehabilitation

Exercise, physiotherapy and other rehabilitation improve fitness, mobility and daily function, and NICE recommends supervised exercise programmes for people with MS.

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In the research now

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Key terms

Myelin
The fatty sheath wrapped around many nerve fibres in the brain and spinal cord. It lets signals jump quickly along the fibre. MS damages it.
Relapse (attack)
New or worsening symptoms lasting at least 24 hours, without fever or infection to explain them.

References

  1. 1. Cochrane · Corticosteroids or ACTH for acute exacerbations in multiple sclerosis (CD001331)
  2. 2. American Academy of Neurology · Evidence-based guideline update: plasmapheresis in neurologic disorders (2011)
  3. 3. Cochrane · Immunoglobulins for multiple sclerosis (CD002936)
  4. 4. Goodman et al. · Sustained-release oral fampridine in multiple sclerosis: a randomised, double-blind, controlled trial. Lancet (2009)
  5. 5. NICE NG220 · Multiple sclerosis in adults: management

Next · Lesson 11 of 11

What the medicines have taught us

Six lessons from thirty years of MS medicines.

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