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 communication between the central nervous system (CNS), which is made up 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 may recommend several treatments to slow its progression, relieve symptoms, and improve the quality of life for those affected. Treatment is not always necessary and people may prefer to forego it due to the potential side effects of some medications.
Keep reading to learn more about the treatments and therapies available for MS.
Since there is no cure for MS, treatment will aim to:
- slow the progression of the disease
- manage the symptoms of MS
- treat relapses of MS, also called attacks
- improve and maintain a person’s daily functioning
Most people with MS have a team of healthcare professionals who take care of them. A neurologist is a specialist in MS and leads the team. The neurologist diagnoses MS and suggests treatment options for the patient.
The course and symptoms of MS vary from person to person and therefore treatment will be unique for each patient.
Other members of a MS treatment team may include:
- nutritionist or registered dietitian
- Occupational therapist
- primary health care provider
- Speech Therapist
- social worker
- bladder specialist
Medicines are used by healthcare professionals to treat and manage the symptoms of MS. There are many drugs for the treatment of MS approved by the FDA. These drugs, also called disease-modifying therapies (DMT), come in oral, injectable and infusion forms. The National Multiple Sclerosis Society lists the following drugs:
A person can take oral medication in the form of tablets. These include:
- dimethyl fumarate
- diroximel fumarate
- monomethyl fumarate
A person can inject the following medications for MS:
- glatiramer acetate
Doctors will give this type of therapy through an injection into a person’s vein. He understands:
Learn more about what these MS medications do and how they work here.
Some healthcare professionals may use drugs approved for other conditions to treat MS. This is called off-label use.
A physiotherapist (PT) teaches individuals special exercises and trains them in the use of mobility aids such as canes, crutches, scooters and wheelchairs.
Physiotherapy helps a person to be safe and independent in their mobility and walking.
A physiotherapist may suggest:
- eye or head movements
- distort or eliminate visual input
- change or relocate bearing surfaces
- strengthening or stretching exercises
Occupational therapy is about helping people with MS to be safe and productive in their personal care, at play, and at the 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 changes in their body. Activity changes may include:
- drag objects rather than lifting them
- use a shoehorn or switch to velcro shoes
- change posture while eating
- using heavier cookware
- use a smart pen to take notes
- use chair cushions to raise the level of the seats
Learn more about occupational therapy for MS here.
A speech therapist (speech therapist) assesses and treats speech and swallowing problems. Treatment consists of individualized strategies to help a person communicate, eat and swallow when necessary. Some strategies may include:
- neck, shoulder and mouth exercises to improve muscle strength, movement and coordination
- dietary changes to make swallowing easier
- communication aid with letter boards or text-to-speech devices and other smartphone applications
People with MS can develop problems by not storing urine or failing to empty their bladder. These symptoms can lead to urinary incontinence, skin damage and infections.
Behavioral strategies can help train the bladder and limit complications, such as:
Health care professionals also treat bladder symptoms with medications like Botox or Bactrim.
Living a healthy lifestyle can help a person manage their MS symptoms. Here are some examples of healthy routine changes:
- maintaining a regular exercise routine to help relieve muscle spasms, balance, and depression
- take regular rest periods to relieve fatigue
- practicing good sleep hygiene to improve a general feeling of well-being
- eating a diet high in nutrients and fiber and low in highly processed foods to reduce the risk of MS-related complications such as constipation or cardiovascular disease
- consume enough
Vitamin Dthrough exposure to the sun, foods, or supplements, which can help reduce the rates of relapse of MS
- seek mental health counseling or support to learn healthy coping strategies
- practice stress management
- quitting smoking, which may lessen the progression of the disease
- limiting alcohol consumption to help reduce balance problems, urinary urgency, and depression
The following medications and therapies can help a person with these other symptoms of MS:
- Constipation: Medicines such as Dulcolax or mineral oil can help relieve constipation. Including more fiber in the diet can also help keep stools soft.
- Dizziness: Taking meclizine can help relieve dizziness and lightheadedness.
- Tired: Doctors may recommend drugs such as Adderall to fight fatigue and improve alertness. A person can also try to establish a regular bedtime routine and avoid stimulants before sleeping.
- Itching: If a person with MS feels itchy, a doctor may recommend hydroxyzine.
- Sexual problems: Cialis can help men 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 disease may have caused them.
- Spasticity: Medicines such as Botox or Baclofen can help relieve spasticity in people with MS.
- Tremors: A doctor may prescribe clonazepam to help relieve tremors.
- Depression: A diagnosis of MS can be an extremely stressful experience. A doctor may advise certain medicines, such as Celexa or Cymbalta, to improve a person’s mood. However, a person can also join a support group or explore the mental health resources available to them.
Find out about the different types of mental health resources and how to access them here.
In addition to medication, many people with MS try some form of alternative treatment to manage their MS symptoms, especially chronic pain.
Alternative treatments will not cure or reverse the course of MS. However, they can offer some relief from symptoms like pain.
Pain patients consider pain to be one of their most aggravating symptoms, and it is associated with decreased quality of life and increased disability.
Some of these alternative treatments can include:
The specific area of the CNS that is inflamed or scarred causes a person’s symptoms. Since each individual’s brain activity is unique, symptoms can range from mild to severe and can come and go or change over time.
MS can include any combination of these symptoms:
MS is the result of an abnormal immune system response within the central nervous system. The real cause of MS is unknown. Factors that can contribute to the development of the disease include:
- Genetic predisposition: MS is not an inherited disease. However, the risk of contracting MS is higher in relatives of a person with the disease than in the general population.
- Smoking: Smoking increases the risk of developing MS and is associated with more serious disease and faster disease progression.
- Geographical position: MS is more common in people who live in places where there is a lack of sun exposure, which results in low levels of vitamin D.
- Infections: Certain germs, such as the Epstein-Barr virus, can 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 (DMT), symptom management, and a healthy lifestyle is the best treatment plan for managing MS.
Some people may not choose the treatment. It is important that a person weighs the possible side effects against their quality of life. A doctor can help a person decide which treatment is right for them.