7 Tips to Identify MS Symptom Triggers

Identify MS symptom triggers and learn to proactively avoid them. This will enable you to live your life fully without being held hostage by the unpredictability of Multiple Sclerosis.

That’s not to say I don’t get symptoms, I do. But actively troubleshooting potential problems before I do something gives me the opportunity to avoid issues and have the best possible outcome.

It was a hard lesson to learn since living with a chronic illness can sometimes feel like being in competition with yourself to prove you can still do things that you did before having MS. This kind of thinking leads to overdoing things which can provoke symptoms and it can take days to recover from the stress this puts on your body.

Symptoms are a sign to stop and pay attention to what your body is trying to tell you

With MS you ignore your body’s warning signals at your own peril. Regularly pushing your body to its limits can be a good thing under certain circumstances but not when doing so may trigger disruptive cognitive issues, disabling fatigue, or pseudo-flares.

Recognize the warning signs of an MS flare:

  • Sensory changes
  • Increased fatigue
  • Balance & coordination
  • Weakness
  • Pain & spasticity
  • Eye issues
  • Bladder or bowel difficulty
  • Cognitive changes
  • Dizziness or vertigo

Any symptom can be associated with a pseudo-relapse or an exacerbation. The difference is whether the symptom is new, the timing, and the trigger.

A pseudo flare is the recurrence of symptoms because of triggers like stress, fatigue, infection, fever, or hot weather. They don’t happen because of disease progression or new disease activity. A pseudo flare lasts less than 24 hours and usually resolves when the trigger is removed.

An exacerbation is experiencing new symptoms or the worsening of old ones. They occur at least 30 days from the start of the last relapse. A relapse can be sudden, or it can come on slowly over a few days. They last more than 24 hours and may or may not resolve completely.

Identify common symptom triggers:

  • Stress
  • Fatigue
  • Heat or cold
  • Lack of restorative sleep
  • Food sensitivities
  • Poor diet or nutritional deficiencies
  • Infection
  • Smoking

Recognize that you can’t control everything but you can make better choices

Avoiding triggers can be complicated and it’s not always as easy as cooling off in an air-conditioned room after getting too much sun.  Exercise too long or too hard and you might aggravate foot drop, or, you might not be able to make it back to your car before weakened shaky legs give out, putting you at risk for falling injuries.

For people dealing with anxiety or depression, managing triggers is even more difficult. You can’t just flip a switch to control emotions and stress is associated with a significant risk of relapse in people with MS.

Stress is a double whammy because not only is it one of the most common MS triggers, but it also leads to the second most common trigger which is fatigue.

7 Tips to identify triggers and successfully manage MS symptoms:

Keep a journal

Keep a diary to identify and chronicle symptoms, exercise, food, mood, meds, and other possible environmental factors. This will pinpoint patterns and give the information needed to plan deliberate countermeasures to help prevent relapses and improve symptom management. A journal is also a tangible permanent record of disability and progression.

Consciously choose how to spend your time and energy

According to the NMSS, more than 80% of people with MS have fatigue. Make a list and evaluate your energy levels keeping track of activities and emotions that drain you and trigger symptoms of fatigue. Learn your boundaries and recognize when your body is telling you to slow down and rest. You only have a finite amount of daily energy, be smart about how you use it.

Evaluate planned activities to identify possible symptom triggers 

Look for effective options to resolve any possible issues. Adjust expectations and be flexible and adaptable. Having a plan in place will help you to feel in control, therefore alleviating anxiety. Being aware of your triggers allows you to counteract them enabling you to enjoy your life rather than live in fear of the ‘what-ifs.”

Learn to recognize stress

Stress has long been associated with MS but it’s not yet known if it’s the physiological changes of the disease that manifest as stress or if it’s a person’s ability to cope with the challenges of living with the disease. Either way, stress can exacerbate flares. Learn how to recognize stress so that you can pinpoint your personal triggers.

Exercise safely

Physical activity is extremely important and can improve endurance, strength, flexibility, mobility, and cognitive function. The challenge is finding that sweet spot so that you get enough exercise but you don’t push yourself to the point of fatigue.

Avoid extreme temperature changes

People with MS can be intolerant or sensitive to hot or cold temperature fluctuations resulting in temporary worsening of symptoms like headache, dizziness, balance, cognition, slurred speech, blurry vision, numbness, tingling, stiffness, muscle spasms, and pain. The reason for this is that MS damages the nerve cells in the brain and the central nervous system (CNS) leading to problems with nerve conduction and heat can make this worse.

Have a contingency plan in place for outdoor activities and use cooling products such as neck wraps and vests. For those who are most affected by cold; layer and use old-fashioned hot water bottles. They are great for warming cold hands and feet.

The power of restorative sleep

Restorative sleep means completing all five of the sleep cycles. This is important so that the body and brain can repair and restore themselves. During sleep, the brain activates its waste removal system and flushes out toxins that build up during the day. This is vital for a healthy brain.

Sleep deprivation is a definite symptom trigger and can affect mood, memory, and fatigue as well as the integrity of the Blood-Brain Barrier which is crucial for the protection of the CNS from circulatory proteins and toxins that can contribute to neuroinflammation.1  

Keep in mind that sleep can also be impacted by things like anxiety, side effects of medications, pain, or even an overactive bladder.

Get out from behind the eight ball with strategies to identify symptom triggers and manage MS symptoms 

It’s important to note that having symptoms is not our fault and being unable to avoid them or get rid of them, does not mean we failed at something. These tips are simply a reminder to be mindful of how certain actions can affect our health and through making small and calculated changes in our daily habits and adjustments in our environment we can empower ourselves to live better with Multiple Sclerosis.

Stay tuned for next month’s article: Reduce Fatigue and take Back Control of Your day!

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1 https://www.clinicaleducation.org/news/sleep-and-its-detoxing-effect-on-the-brain-and-body/

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