Multiple sclerosis is a chronic disease that affects the central nervous system. In multiple sclerosis, the immune system attacks and damages the protective coating that surrounds the nerves. The damaged coating disrupts the communication between the central nervous system (CNS), which consists of the brain, spinal cord, and optic nerves, and the rest of the body. This results in a wide variety of symptoms.
The exact cause of multiple sclerosis (MS) is unknown, but researchers believe it involves certain genetic and environmental factors.
There is no cure for MS. However, doctors can recommend several treatments to slow its progression, ease symptoms, and improve the quality of life for people with the condition. Treatment is not always necessary and people may prefer to forego it given the potential side effects of some medications.
Keep reading to learn more about the treatments and therapies available for MS.
As there is no cure for MS, treatment will aim to:
- slow the disease course
- manage MS symptoms
- treat MS relapses, also called attacks
- improve and maintain a person’s day-to-day functioning
Most people with MS have a team of healthcare professionals working on their care. A neurologist is a specialist in MS and serves as the leader of the team. The neurologist makes the MS diagnosis and suggests treatment options for the patient.
The course and symptoms of MS vary from person to person, and therefore the treatment will be unique for each patient.
Other members of an MS treatment team may include:
- nutritionist or registered dietician
- occupational therapist
- physical therapist
- primary health care provider
- speech pathologist
- social worker
- bladder specialist
Health care professionals use medications to treat and manage MS symptoms. There are many FDA-approved MS treatment medications. These medications, also called disease-modifying therapies (DMTs), come in oral, injectable, and infusion forms. The National Multiple Sclerosis Society lists the following medications:
A person can take oral medications in tablet form. These include:
- dimethyl fumarate
- diroximel fumarate
- monomethyl fumarate
A person can inject the following medications for MS:
- glatiramer acetate
Doctors will administer this type of therapy via an injection into a person’s vein. It includes:
Some healthcare providers may use medications approved for other diseases to treat MS. This is referred to as off-label use.
A physical therapist (PT) teaches individuals special exercises along with training them in the use of mobility aids such as canes, crutches, scooters, and wheelchairs.
Physical therapy helps a person be safe and independent in their mobility and walking.
A physical therapist may suggest:
- eye or head movements
- distorting or eliminating visual input
- changing or moving weight-bearing surfaces
- strengthening or stretching exercises
Occupational therapy involves helping people with MS be safe and productive in their personal care, leisure activities, and workplace. Occupational therapists may recommend canes, shower support bars, and other assistive devices.
Occupational therapists also help a person modify their activities and movements to adapt to their changing body. Activity modifications may include:
- sliding objects rather than lifting them
- using a shoehorn or switching to velcro shoes
- changing posture when eating
- using heavier eating utensils
- using a smart pen for note-taking
- using chair cushions to raise seating level
A speech-language pathologist (SLP) evaluates and treats problems with speech and swallowing. Treatment consists of individualized strategies to help a person with their communication, eating, and swallowing as necessary. Some strategies may include:
- neck, shoulder, and mouth exercises to improve muscle strength, movement and coordination
- dietary changes to aid easier swallowing
- communication assistance with letter boards or text-to-talk devices and other smart-phone apps
People with MS can develop problems with failing to store urine or failing to empty their bladder. These symptoms can lead to urinary incontinence, skin breakdown, and infections.
Behavioral strategies can help train the bladder and limit complications, such as:
Health care professionals also treat MS bladder symptoms with medications such as Botox or Bactrim.
Adopting a healthy lifestyle can help a person manage their MS symptoms. Examples of healthy routine changes include:
- maintaining a regular exercise routine to help with muscle spasms, balance, and depression
- taking regular rest periods to help with fatigue
- practicing good sleep hygiene to improve an overall sense of well-being
- eating a diet rich in nutrients and fiber and low in highly processed foods to lower the risk of MS health complications such as constipation or cardiovascular disease
- consuming adequate
vitamin Dthrough sun exposure, foods, or supplements, which may help lessen MS relapse rates
- seeking counseling or mental health support to learn healthy coping strategies
- practicing stress management
- giving up smoking, which can mitigate disease progression
- limiting alcohol intake to help lessen balance problems, urinary urgency, and depression
The following medications and therapies may help a person experiencing these other symptoms of MS:
- Constipation: Medications such as Dulcolax or mineral oil may help relieve constipation. Including more fiber in the diets may also help keep stools loose.
- Dizziness: Taking meclizine may help relieve dizziness and vertigo.
- Fatigue: Doctors may recommend medications such as Adderall to combat fatigue and improve alertness. A person can also try establishing a regular bedtime routine and avoiding stimulants before sleeping.
- Itching: If a person with MS experiences itchiness, a doctor may recommend hydroxyzine.
- Sexual problems: Cialis can help males maintain an erection. People with MS may also wish to discuss the emotional side of sex with a therapist to come to terms with the changes the condition may have caused them.
- Spasticity: Medications such as Botox or Baclofen may help ease spasticity in people with MS.
- Tremors: A doctor may prescribe clonazepam to help ease tremors.
- Depression: A diagnosis of MS can be an extremely stressful experience. A doctor may advise certain medications, such as Celexa or Cymbalta, to improve a person’s mood. However, a person can also join a support group, or explore mental health resources available to them.
Alternative treatments will not cure or reverse the course of MS. However, they may offer some relief from symptoms like pain.
Some of these alternative treatments may include:
The specific area of the CNS that is inflamed or scarred causes a person’s symptoms. Because each individual’s MS activity in the brain is unique to them, symptoms can range from mild to severe and can come and go or change over time.
MS may include any combination of these symptoms:
|optic nerve inflammation||headache||change in frequency||weakness||sadness or depression||itching|
|blurred vision||numbness or tingling feelings||hesitancy||spasticity||mood swings||hearing loss|
|dancing eyes (nystagmus)||off balance||frequent nighttime urination||falls||crying||loss of bowel control|
|double vision||brain fog or trouble with thinking||loss of bladder control||pain||irritability||hard stools|
|low vision||memory loss||unable to empty bladder||difficulty walking||stress||fatigue|
|blind spots||tremors||infections||difficulty swallowing||anxiety||malaise|
|eye pain||seizures||kidney stones||breathing and speech difficulties||grief||sexual difficulties|
MS is the result of an abnormal immune system response within the central nervous system. The actual cause of MS is unknown. Possible contributing factors in developing the disease include:
- Genetic predisposition: MS is not a hereditary disease. However, the risk of getting MS is higher in relatives of a person with the disease than in the general population.
- Smoking: Smoking increases a person’s risk of developing MS and is associated with more severe disease and more rapid disease progression.
- Geographic location: MS is more common in people who live in places where there is a lack of sun exposure resulting in low vitamin D levels.
- Infections: Certain germs, such as the Epstein-Barr virus, may act as potential triggers for MS.
Multiple sclerosis is an inflammatory and neurodegenerative disease of the CNS. There is no cure for MS.
According to the National Multiple Sclerosis Society, combining disease-modifying therapies (DMTs), symptom management, and a healthy lifestyle is the best treatment plan for managing MS.
Some people may not choose treatment. It is important that a person weigh possible side effects against their quality of life. A doctor can help a person decide which treatment is right for them.