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Multiple Sclerosis Community
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5987839 tn?1381922502

Relapse vs "Flare"?

I'm still in my freshman year here and sometimes it takes either (a) reading something the 20th time, or (b) having someone say it JUST the right way, in order for a concept to click.

A relapse is a new MS attack, right?
A flare is a symptom caused by stress, or an infection, or over-heating, or ... etc

I have an appt with me MS Neuro next week, after dealing with 2 of the nurses over the phone and getting frustrated. Perhaps I made the mistake of saying "I've been incredibly stressed lately" because they both shoo'd me off the phone, saying to de-stress. (although .. for the record, my stress has been crazy .. my 14-mo old is having some breathing issues, and is going for surgery next week, among other things)

Yet, this feeling in my arm is .. well, worrisome. So I called the doc.

Facts:

- Pre-diagnosis, I had some "tired" feeling in my right upper arm, and numbness in lower arm
- Pre-diagnosis, I had an episode that my primary doc called Shingles. I was never convinced, there were no lesions on my skin .. but my right arm felt like it had been scraped along the pavement for several weeks
- At diagnosis, I had a couple lesions on my thoracic spine

- Now in my 3rd week of this new (?) symptom, the right upper arm has pain and is tired. I feel like it'd be happier just hanging there.
- It has full strength (that I know of) and no tingles
- Ibuprofen/Aleve do not help it

- Every morning, I feel it was soon as I wake up in my upper arm
- By mid-morning, I usually can feel it in my lower arm, too
- By late evening, it is usually gone? I cannot tell if I just am not paying attention to it, or if it is gone
- Sometimes at night it is back ... and ALWAYS it is there when I wake up
- No, I do NOT sleep on that side. I have a hip problem and it's not comfortable.


Questions:
- Do either relapses or stress-flares have this behavior of ALWAYS being there in the morning, but by late evening, being gone? (when the nurse heard that, she ruled out a relapse)
- So stress flares last several weeks, every single day?

1 Responses
Avatar universal
Hey there. I see you are confused or even extremely confused! Fear not, that's what this forum is for.

A flare, a relapse, an exacerbation---all the same thing, just different terminology. It means new symptoms or the return of old symptoms that last a minimum of 24 hours, with some doctors saying 48. That doesn't mean 24 hours a day or constantly, and it doesn't matter if symptoms are worse at a given time of day. It does mean a pattern that keeps recurring fairly frequently. Symptoms can come on gradually or all at once. It can be subtle at first, or it can hit you like a freight train.

A pseudo-exacerbation, on the other hand, is a worsening of symptoms that is quite temporary. Usually this involves some environmental factor such as being outside on a very hot day. When the outside factor is eliminated, the symptoms also go away. Changes in the body's core temperature, even tiny changes, can do a number on already compromised nerves and nerve signals.

Stress is a complicating factor. Many MS experts believe that prolonged stress can bring on a relapse, though few assert that it can bring on MS to begin with.

If I were you I wouldn't focus on stress, but on the symptoms you are experiencing. If they meet the definition of a relapse, then you're having a relapse. This is all predicated, of course, on a confirmed diagnosis of MS to begin with.

Hang in there.

ess

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