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Multiple sclerosis (MS) is a long-term condition that affects the central nervous system. Medical advances have meant that in many cases, a person with MS can live as long as someone without MS. The symptoms can vary in severity from mild to debilitating, but treatments and strategies can help.

Multiple sclerosis (MS) is a progressive disease, which means the symptoms gradually worsen. The condition is an immune reaction that gradually damages the myelin sheath that covers a person’s brain and spinal cord nerves.

Depending on the type, MS can also involve remissions and flares, so people with certain types of MS often feel better for a while before symptoms appear again. In rarer cases, a person may lose their ability to walk and talk.

The first symptoms of MS typically emerge between ages 20–40.

The National Institute of Neurological Disorders and Stroke (NINDS) says that a person with MS could expect to live as long as a person without the condition. However, this conclusion is fairly recent.

Because of the way MS impacts the central nervous system, doctors previously considered MS to be untreatable.

This chart summarizes the general MS progression timeline:

How MS progressesWhat it means
inflammation White blood cells begin to damage the cells in the brain and spinal cord.
demyelinationThe damage reaches the myelin covering around nerves.
axonal degenerationDegeneration and death of brain neurons occur.
remyelinationThe body tries to repair the myelin, but mostly unsuccessfully.
glial scar formationScars develop in the brain and spinal cord.

While it is rare for a person to reach the final stages of MS, signs of MS progression include:

  • a gradual loss of mobility
  • loss of speech
  • other disabling symptoms that may become more disabling over time

However, in the last 2–3 decades, new therapies have emerged that can slow the progression of MS and manage symptoms more effectively in some people.

Today, MS is rarely fatal, though the National MS Society estimates that MS can shorten a person’s life by 7 years.

Nevertheless, many people with MS can still expect to live more active lives than was possible in the past.

The outlook for historically marginalized groups

A 2020 review of studies shows that some African Americans have genetic mutations that place them at a higher risk of earlier onset of the disease.

In addition, Black males under age 45 appear to have a higher risk of mortality from MS than people of other groups or females.

The research also shows that both African Americans and Hispanic people may have a higher risk of more severe disease progression.

More research needs to happen to understand the relationship between the social and biological factors that cause people of color to experience a poorer outlook with this disease. One reason for this may be inequities in healthcare.

There are slight differences in life expectancy depending on the type of MS a person has. Most people with MS have relapsing-remitting MS (RRMS).

After symptoms first appear, on average, a person may experience a relapse once a year but may get them more frequently. Between relapses, their condition typically remains stable.

According to a 60-year longitudinal population study published in 2017, the life expectancy for RRMS is 77.8 years.

Many people with RRMS will eventually develop secondary progressive MS (SPMS). This means they continue to have alternating flares and periods of recovery but will experience a steady worsening of symptoms.

However, if a person has primary progressive MS (PPMS), their life expectancy is slightly lower at 71.4 years. This is because PPMS involves progressing symptoms that never go into remission, and it can be harder to treat.

Learn more about the four types of MS.

Can you live a normal life with MS?

In addition to the types of MS, various other factors can affect a person’s quality of life and their life expectancy when they have the disease. These factors include:

  • the severity of their symptoms or flares
  • how quickly the symptoms progress
  • the length of time between flares
  • what treatment they receive
  • if they have any comorbidities, or co-occurring conditions

With a few strategies in place, a person may be able to live as close to a typical life as possible.

According to a 60-year population study, developments in multiple sclerosis treatments have had a positive impact on the outlook for people living with an MS diagnosis. In addition, there are steps a person can take to reduce symptoms and improve their quality of life with the disease.

Disease-modifying treatments

Treatments that target the specific changes that occur in relapsing MS are known as disease-modifying therapies (DMTs).

There is strong evidence that if a person uses a DMT from the early stages of MS, it can help prevent relapses and slow the progression of the disease.

The Food and Drug Administration (FDA) has approved 17 different DMTs for use with MS.

In 2018, the American Academy of Neurology (AAN) issued new guidelines for using DMTs to treat MS. These guidelines suggest using a DMT as a first-line treatment and as ongoing therapy, possibly in combination with corticosteroids.

Learn more about DMTs and other medications for multiple sclerosis.

Targeted therapies

As different people vary in their response to MS and its treatments, doctors and researchers are now focusing on ways to target medication to suit individuals.

This involves identifying variations in genes that may play a role in MS. It can also involve collecting molecular biomarkers on a person’s health and their unique disease progression.

For example, if damage to a specific gene results in symptoms for one person, then targeting that gene could provide effective treatment but with less unnecessary damage to other genes.

Another example of targeted therapy focuses on B cells, which are important in the development of immune-mediated diseases such as MS.

There is not enough research to estimate more precisely the impact of such treatments on life expectancy with MS. However, if a person finds that their current treatment option is not helping, they may wish to speak with their doctor about trying another type.

Learn more about treatments for MS and research on slowing MS progression.

Relapse management

MS involves periods of remission and relapse. A relapse, or flare, is when symptoms suddenly return after a period of improvement. During a time of remission, symptoms may lessen or disappear.

Recognizing when a person is having a flare is crucial for getting prompt treatment. This is important because a 2015 systematic review shows that more frequent or more severe relapses may lead to more severe disease progression.

However, it is not always easy to spot a relapse before symptoms become severe. Symptoms can occur without warning.

Possible triggers for relapse include stress and infection. If a person knows one of these conditions has occurred, they can be ready to ask for treatment as soon as their MS symptoms arise.

The person may notice changes in their:

  • vision, such as blurring or dimming
  • sensations, such as prickling or numbness
  • thinking, such as difficulty paying attention or focusing on tasks
  • bladder control, leading to an increased urgency to urinate

A doctor will need to decide whether or not the symptoms represent a relapse before recommending treatment.

The doctor will consider:

  • whether the symptoms remain for at least 24 hours without any fever or infection
  • if there could be any other possible reason for the symptoms

If the symptoms appear to be due to an MS relapse, the doctor may suggest a corticosteroid injection to reduce the inflammation.

In the past, corticosteroids played a key role in the treatment of MS. However, they can have adverse effects if people use them long-term, and they may be less effective than some of the newer drugs.

Learn how to manage MS relapses.

Treatment of comorbidities

Researchers suggest that typically it is not the direct impact of MS that may shorten a person’s life but the arising complications or comorbidities.

A 2015 study shows that having comorbidities with MS increases a person’s mortality risk. The comorbidities that can most impact the risk of death, according to the study, are both physical and psychological. They include:

Physical

Psychological

Other comorbidities that are common with MS include:

The higher incidence of these comorbidities may not be due to MS itself, but due to risk factors that are more common in people with MS.

Reduced mobility, for example, can lead to excess weight, and this can impact the risk of cardiovascular disease and diabetes.

In addition, the risk of suicide in people with MS is also high and may be related to depression or anxiety that may co-occur with the physically disabling symptoms of the disease.

A person with MS may want to monitor and care for their mental health and receive regular checkups for additional physical conditions so that they may receive the best possible treatment.

Improvement of mobility

MS affects a person’s mobility, and this increases the risk of falls.

A study published in NeuroRehabilitation notes that 52–63% of people with MS fall at least once over periods of 3–6 months, resulting in pain, discomfort, and fear of falling again. This can also result in greater long-term disability, which can negatively impact a person’s outlook.

Getting appropriate physical therapy and using adaptations and aids at home, such as grab bars, can help prevent falls and keep a person more mobile and self-reliant. This can result not only in better physical health, but may also help reduce any symptoms of depression or anxiety.

Eating a balanced, nutritious diet and exercising regularly can also help in this regard.

The National MS Society notes that some types of exercise may help improve the following:

  • cardiovascular health
  • physical strength
  • bladder and bowel function
  • energy levels
  • mood
  • social life

Low activity levels, on the other hand, can contribute to:

  • heart disease
  • muscle weakness
  • low bone density
  • inefficient breathing
  • depression

Eating a nutritious diet and maintaining a moderate activity level when possible can contribute to improving a person’s life expectancy.

Learn more about the best exercises for MS.

What is the outlook for men vs. women with MS?

Women with MS appear to live about 5 years longer than men with the disease. In addition, disease progression seems to be slower in women than in men. However, researchers believe that this may only reflect the difference in life expectancy among men and women in general.

Does having COVID-19 impact MS outlook?

There is not enough research on the risk of a person with MS developing COVID-19. However, according to a 2021 study, if a person has a condition that impacts their mobility and they do get the virus, they are at a higher risk of severe COVID-19 and even death. While the study did not establish a direct link between MS and either COVID-19 severity or mortality, the impact on mobility was a clear risk of more severe COVID-19.

Can the COVID-19 vaccine affect MS outlook?

Researchers have reported only a few instances of MS relapses in people recently vaccinated for COVID-19. This is likely very rare, and it is not yet clear how it impacts MS progression. Both research and the National MS Society recommend that people with MS get vaccinated for COVID-19.

MS is a serious, lifelong illness, and it can be challenging to live with. In the past, it has contributed to a lower life expectancy.

However, in the last few decades, new medications and rehabilitation techniques are making it possible to have a better quality of life with MS, and life expectancy for many is the same as for a person without the condition.

Having a support system that understands what it is like to have a diagnosis of and live with MS is vital. Bezzy MS is a free app that provides support through one-on-one conversations and live group discussions with people who understand the experience of living with MS.