When to Get Emergency Care for MS

September 9, 2025

Kimberly Kishpaugh

An illustration of people waiting at an emergency room.

While many symptoms of multiple sclerosis are disruptive, most do not require an immediate trip to the hospital. However, according to Kalina Sanders, a neurologist at Baptist Neurology in Jacksonville, Florida, there may be times when you should seek emergency care if you live with MS.“In general,” Sanders says, “I tell most of my patients that if the symptoms are severe [enough] to significantly impact your function — particularly if your mobility is impacted, you’re unable to walk, or you can’t see out of the eye — we might want to bypass the office and go for more immediate care.”The most common situations that might require immediate medical attention are:

MS relapse
Side effects of medications
Infection
Falls
Any symptom that could indicate a medical emergency, such as a heart attack or stroke

MS relapse
Side effects of medications
Infection
Falls
Any symptom that could indicate a medical emergency, such as a heart attack or stroke

MS Relapse

relapse that may require emergency care. Understanding the differences between the two can help.

Pseudo-relapse: a worsening of symptoms that previously subsided. Pseudo-relapses are often caused by overheating due to physical exertion, infection or fever, but symptoms typically go away when those variables are eliminated.
MS Relapse: an indication of a new inflammatory attack on the central nervous system (CNS). Symptoms in a relapse are typically present when you are overheated or exerted but don’t go away when those factors are removed.

“See if symptoms resolve with changes in your fever or changes in your hydration,” Sanders says. "And if they don’t go away, then that might be an indication that this is a true relapse.”Unfortunately, MS is an unpredictable disease and, despite everything you do, relapses can occur. Sanders says the best thing you can do to prepare for a relapse is to understand how long an MS relapse lasts and anticipate the impact it might have on your family, daily life and employment. Planning can go a long way in lessening anxiety and worry, should you have signs of MS attacks or relapses. For example, make sure you have alternative care for your children and see if you qualify for the Family Medical Leave Act (FMLA) or other accommodations." c-nmssatomrichtext_nmssatomrichtext-host="">

It can be tricky to know whether you are experiencing a pseudo-relapse or a true relapse that may require emergency care. Understanding the differences between the two can help.

Pseudo-relapse: a worsening of symptoms that previously subsided. Pseudo-relapses are often caused by overheating due to physical exertion, infection or fever, but symptoms typically go away when those variables are eliminated.
MS Relapse: an indication of a new inflammatory attack on the central nervous system (CNS). Symptoms in a relapse are typically present when you are overheated or exerted but don’t go away when those factors are removed.

relapse that may require emergency care. Understanding the differences between the two can help.

Pseudo-relapse: a worsening of symptoms that previously subsided. Pseudo-relapses are often caused by overheating due to physical exertion, infection or fever, but symptoms typically go away when those variables are eliminated.
MS Relapse: an indication of a new inflammatory attack on the central nervous system (CNS). Symptoms in a relapse are typically present when you are overheated or exerted but don’t go away when those factors are removed.

It can be tricky to know whether you are experiencing a pseudo-relapse or a true relapse that may require emergency care. Understanding the differences between the two can help.

Pseudo-relapse: a worsening of symptoms that previously subsided. Pseudo-relapses are often caused by overheating due to physical exertion, infection or fever, but symptoms typically go away when those variables are eliminated.
MS Relapse: an indication of a new inflammatory attack on the central nervous system (CNS). Symptoms in a relapse are typically present when you are overheated or exerted but don’t go away when those factors are removed.

MS Relapse or Stroke

Side Effects of Medication

Infection

disease-modifying therapies (DMTs) can lower or alter your immune response to some viruses and bacteria, putting you at greater risk for an infection. Some of the most common infections in people living with MS are:

Infections caused by pressure sores
Urinary tract infections (UTIs)
Upper respiratory tract infections

“Unfortunately, with the disabling aspects of MS, [pressure sores] are a real possibility for a lot of our patients — particularly if they are less mobile,” Sanders says.Pressure sores form when prolonged pressure on one area of your body cuts off the blood supply to your skin, fat and muscle. These can develop if you are sitting in a wheelchair or lying in bed for a long time without being able to move, and they can sometimes worsen into an infection.“That infection [caused by pressure sores] can oftentimes be superficial, or it can get deeper and even impact the bone, and people can develop osteomyelitis,” Sanders says. If the pressure sores become deep or infected, you should seek medical care right away.The best way to prevent pressure sores is to keep moving, changing positions and varying the places where there is pressure. Sanders suggests turning side-to-side and using cushions to change your position if you’re using a wheelchair or in a bed.Because MS affects the CNS, it can also disrupt signals to the bladder. This might result in bladder dysfunction, particularly urinary retention, which can cause UTIs. “If the bladder is holding a lot of urine and you’re having difficulty eliminating it, then you’re more prone to get bacteria,” Sanders says.Common symptoms of a UTI include:

Pain with urination
Frequent urges to urinate
Blood in urine
Fever

Sanders recommends contacting your primary care doctor or neurologist if you are experiencing any of these symptoms. “Many times, people can become what we call ‘septic’ —where that infection is now spreading more into the blood and that might result in changes in their awareness, or they may become more confused, or there is worsening of their MS symptoms. That is when immediate care to a hospital is important.”With respiratory viruses like COVID-19, flu, pneumonia and Respiratory Syncytial Virus (RSV), the main concern is the health of the lungs, Sanders says. You should seek immediate medical care if you experience:

Shortness of breath
High fevers
Coughing to the point where you’re having trouble breathing
A lower reading on an oxygen monitor
A changed level of awareness

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Certain disease-modifying therapies (DMTs) can lower or alter your immune response to some viruses and bacteria, putting you at greater risk for an infection. Some of the most common infections in people living with MS are:

Infections caused by pressure sores
Urinary tract infections (UTIs)
Upper respiratory tract infections

Pain with urination
Frequent urges to urinate
Blood in urine
Fever

Shortness of breath
High fevers
Coughing to the point where you’re having trouble breathing
A lower reading on an oxygen monitor
A changed level of awareness

Infections caused by pressure sores
Urinary tract infections (UTIs)
Upper respiratory tract infections

Pain with urination
Frequent urges to urinate
Blood in urine
Fever

Shortness of breath
High fevers
Coughing to the point where you’re having trouble breathing
A lower reading on an oxygen monitor
A changed level of awareness

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Infections caused by pressure sores
Urinary tract infections (UTIs)
Upper respiratory tract infections

Pain with urination
Frequent urges to urinate
Blood in urine
Fever

Shortness of breath
High fevers
Coughing to the point where you’re having trouble breathing
A lower reading on an oxygen monitor
A changed level of awareness

Falls

balance problems, spasticity and muscle weakness. Determining whether you should seek emergency care depends on the impact or injury from the fall.

Minimal injury: Rest, stay off and rest the limb that was injured.
Mild injury: Rest, ice and notify your primary doctor or neurologist.
Severe injury: Seek emergency care, particularly if you have severe pain when moving a limb (which might indicate a fracture and require additional treatment) or a head injury (regardless of whether you lose consciousness). If a fall occurs and your head is bumped in any way, you should seek immediate medical care as you could have internal bleeding. Internal bleeding is of particular concern if you are taking blood thinning medications.

Preventing falls both inside and outside the home can be challenging. Being cautious when walking around rugs or obstacles, clearing pathways in your home, and using mobility devices can help. But if you are doing those things and still experiencing significant balance issues and frequent falls, Sanders says you may want to seek additional treatment. “I would recommend things like physical therapy to help either coordinate your balance a little better or improve the weakness that you’re having.”" c-nmssatomrichtext_nmssatomrichtext-host="">

Falls are common for people living with MS due to balance problems, spasticity and muscle weakness. Determining whether you should seek emergency care depends on the impact or injury from the fall.

Minimal injury: Rest, stay off and rest the limb that was injured.
Mild injury: Rest, ice and notify your primary doctor or neurologist.
Severe injury: Seek emergency care, particularly if you have severe pain when moving a limb (which might indicate a fracture and require additional treatment) or a head injury (regardless of whether you lose consciousness). If a fall occurs and your head is bumped in any way, you should seek immediate medical care as you could have internal bleeding. Internal bleeding is of particular concern if you are taking blood thinning medications.

balance problems, spasticity and muscle weakness. Determining whether you should seek emergency care depends on the impact or injury from the fall.

Minimal injury: Rest, stay off and rest the limb that was injured.
Mild injury: Rest, ice and notify your primary doctor or neurologist.
Severe injury: Seek emergency care, particularly if you have severe pain when moving a limb (which might indicate a fracture and require additional treatment) or a head injury (regardless of whether you lose consciousness). If a fall occurs and your head is bumped in any way, you should seek immediate medical care as you could have internal bleeding. Internal bleeding is of particular concern if you are taking blood thinning medications.

Falls are common for people living with MS due to balance problems, spasticity and muscle weakness. Determining whether you should seek emergency care depends on the impact or injury from the fall.

Minimal injury: Rest, stay off and rest the limb that was injured.
Mild injury: Rest, ice and notify your primary doctor or neurologist.
Severe injury: Seek emergency care, particularly if you have severe pain when moving a limb (which might indicate a fracture and require additional treatment) or a head injury (regardless of whether you lose consciousness). If a fall occurs and your head is bumped in any way, you should seek immediate medical care as you could have internal bleeding. Internal bleeding is of particular concern if you are taking blood thinning medications.

Have a Plan

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The decision to seek emergency medical care is often difficult, but it helps to have a plan in place.Know what’s normal for you. If you’re experiencing new symptoms, know how to contact your neurologist or primary care doctor about what you should do. “Each clinic and each provider may have their own policies on what to do after hours but it’s important to have that plan set up before [an emergency] happens,” Sanders suggests. You should also talk with the people around you about what to watch out for and how they can best help you in an emergency situation.Finally, it is important to stay calm. “With increased anxiety or panic,” Sanders says, “that may worsen the symptoms that you’re having.”To learn more about when to seek immediate care for MS, watch Ask an MS Expert.

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Kimberly Kishpaugh

Kimberly Kishpaugh is a manager for content development with the National Multiple Sclerosis Society.

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