Physical therapy can play an important role in helping people with multiple sclerosis manage the condition. Its benefits include strengthening the body, preventing symptoms from getting worse, and helping a person regain lost function.
Multiple sclerosis (MS) is a progressive disease of the central nervous system that causes the immune system to attack the protective covering of the nerves, called myelin.
Myelin allows electrical signals to move quickly through the nerves. When the myelin becomes damaged, it forms scar tissue, which disrupts these signals from the brain. This disruption can lead to various symptoms, including pain, impaired coordination, and fatigue.
There are four recognized types of MS, which progress in different ways. The type of MS, alongside other factors, will determine the exact pattern MS takes throughout a person’s life. The pattern varies from person to person and tends to be unpredictable.
There is no outright cure for MS, so treatment typically focuses on slowing disease progression. Different forms of rehabilitation therapy, including physical therapy, play a role in helping ease the symptoms of MS. Physical therapy may encourage a person to learn about their body, handle bodily changes, and retain their independence.
In this article, we take a closer look at physical therapy for MS, including why it is helpful, how it works during the different stages of MS, and where to find treatment.
Physical therapy is a form of noninvasive care that helps ease pain and improve physical function.
The goals of physical therapy will depend on the person and their reason for needing care. Examples of goals include regaining physical function after an injury or retraining a muscle to move correctly.
Physical therapy generally combines exercises, stretches, and manual therapy to help meet these goals.
Physical therapy helps people with MS adapt to changes throughout the course of the disease.
An article in the journal Lancet Neurology notes that exercise can help people with MS by:
- reducing symptoms or making them easier to manage
- restoring function
- improving general wellness
- boosting quality of life
- increasing activity levels
A 2021 review notes some evidence that suggests that physical activity has an association with an anti-inflammatory effect and possibly even with a larger brain volume.
Experts say that exercise and physical therapy are safe for people with MS and that these activities may play an important role in all stages of the disease, from preventing its development to managing symptoms. However, they point out that people with MS tend to be less physically active than other groups of people.
The structure of a physical therapy program may allow people with MS to increase their overall levels of physical activity.
These programs do not overexert or endanger a person. Instead, they focus on individual needs and goals. These may include:
- improving how a person walks, known as their gait pattern
- avoiding making symptoms worse
- learning to adapt to physical changes
- regaining function and abilities after a relapse
- developing strength and endurance over time
- improving or easing specific symptoms, such as muscle spasms
- increasing range of motion and flexibility
- correctly using movement devices, such as canes, mobility scooters, or other aids
A specialist can help tailor a physical therapy program to a person’s needs. Personalization may help increase the likelihood of them sticking to the program in the long term.
Physical therapy is important at all stages of MS. However, the stage of the disease will determine the specific goals of physical therapy.
After diagnosis
Initially, physical therapy may involve educating the person about this type of therapy and how it may help with MS.
A physical examination will also be important to establish a baseline for the person’s fitness levels and identify areas for improvement.
From there, the physical therapist can help the person set reasonable goals and work toward them.
During remission periods
When MS is stable and the person is not experiencing a relapse, the physical therapist may play a more passive role. For example, they may check in with the person every few months to make sure that they are working through their exercise program and noting issues as they arise.
During these remission periods, it is important to stay consistent with any workout program to help build strength and increase physical functioning.
During a relapse
During and immediately after a relapse, physical therapy will focus on regaining physical function as much as possible. How this looks can vary greatly in each case. Some people may struggle with basic tasks, such as walking or cooking, after a relapse.
The physical therapist will work closely with the person to help them regain function. They may conduct a new physical examination and compare it with the initial exam, using their findings to structure a program that gets the person back to optimal functioning.
Progressive MS
Progressive MS causes a steady decline in physical ability as the disease progresses. In time, the person may need mobility and stability equipment, such as a cane or shower bar.
Physical therapy will continue to focus on exercise and physical activity. However, the specialist will adapt the program to fit the person’s needs and abilities. The frequency and intensity of sessions may also change.
Advanced MS
People with advanced MS may have greater difficulty with movement. They may not be able to move without assistance from a person or mobility equipment. The therapist will adapt the program to factor in any limitations that the person has.
Exercises may include simple ways to stretch the body, increase range of motion, or keep the core stable.
Physical therapy can start right after diagnosis. It can take place in several locations and will continue throughout the course of the disease. Options include:
- Inpatient: Inpatient physical therapy happens in a hospital or another care facility. It may occur after a fall or other MS-related injury, or if the person is in a permanent care facility. Some people may wish to attend a rehabilitation unit, where they will get about 3 hours of physical therapy a day.
- Outpatient: Outpatient physical therapy occurs in a specialist’s office. Outpatient appointments may take place after a relapse.
- At home: At-home physical therapy may include visits from a specialist. At-home visits may be helpful for people with advanced MS, particularly those who are unable to drive or are not very mobile.
It is important for each person with MS to work directly with their specialist soon after their diagnosis. This way, the specialist can keep track of disease progression and make recommendations for physical therapy.
The treatment plan will focus on the specific areas of movement with which a person has difficulty. The physical therapist will adapt it over time if there are changes in the person’s condition.
MS is a progressive condition that can affect the body in many ways. Physical therapy plays a role in helping strengthen the body and improving physical function.
The goals of physical therapy for people with MS will shift as the disease progresses.
By working with a physical therapist, people with MS may see improvements in bodily functions and a reduction in some symptoms, such as pain and fatigue.