Living With Multiple Sclerosis: Diagnosis, Treatment and Ongoing Care
Medically Reviewed by Kelsey Powell, MS, Medical Sciences
Multiple sclerosis, also called MS, is an autoimmune disorder in which your body’s immune system attacks the protective sheath (called myelin) that insulates your nerves and helps control the transmission of nerve impulses. Because of the breakdown in myelin, the electrical impulses that travel along your nerves slow down, and this in turn slows down the communication between your brain and body. At the same time, nerve damage also occurs. Symptoms of MS can vary based on the extent of the nerve damage and the type of nerves affected.
As MS progresses, you may begin to lose your ability to see, walk, write or speak. According to the National Multiple Sclerosis Society, MS is the leading cause (with the exception of physical trauma) of neurological disability beginning in early to mid-adulthood. Most people are diagnosed between the ages of 20 and 50, and around 200 people are diagnosed with MS every week.
Overall, MS affects approximately 2.3 million people worldwide, including about 400,000 Americans. Currently there is no cure for MS. However, treatments can help reduce the flare-ups that happen, modify the course of the disease and improve symptoms.
Symptoms of and Risk Factors for Multiple Sclerosis
Typical first signs of MS include sensory numbness and tingling, which can occur in one or multiple limbs. If you experience a “pins and needles” sensation that lasts for an entire day or longer, make an appointment with your doctor to discuss this symptom.
Another common early symptom of MS is eye pain with vision problems, a condition known as optic neuritis. It almost always occurs in just one eye, and you may feel pain with movement or a change in your vision — it can seem as if you’re looking through a foggy lens.
Symptoms of MS vary between individuals and can change as the disease progresses. Episodes, or flares, can last for days, weeks or months. These episodes alternate with periods of reduced or no symptoms (remissions). MS symptoms include:
- Double or blurred vision
- Electric-shock sensations that occur with certain head movements
- Lack of coordination or an unsteady gait
- Partial or complete loss of vision, usually in one eye at a time and often with pain during eye movement (optic neuritis)
- Muscle stiffness
- Numbness, tingling or weakness in one or more limbs, which typically occurs on one side of your body at a time or the bottom half of your body
- Difficulty controlling urination
- Decreased attention span, poor judgment and memory loss
- Slurred speech
Typical MS attacks usually resolve within a couple of days or weeks, even without treatment. Therefore, it’s important to pay attention to all these possible symptoms and to seek medical help if you’re concerned. Early detection and treatment of MS can result in better long-term outcomes.
The exact cause of MS is currently unknown. It’s generally accepted that MS is an autoimmune disorder. Scientists believe that a host of factors may contribute to the onset of the disorder, including exposure to environmental toxins, genetics and childhood exposure to certain viruses or bacteria.
The following factors may increase your risk of developing MS:
- Age: Individuals are typically diagnosed with MS between the ages of 20 and 50 years.
- Sex: People assigned female at birth are two to three times more likely to develop MS.
- Family history: If one of your parents or siblings has been diagnosed with MS, you have a 1–3% chance of developing the disease.
- Infections: A variety of viruses have been linked to MS.
- Ethnic background: MS occurs in most ethinic groups. However, Caucasians, particularly those of Northern European descent, are at the highest risk of developing MS. People of Asian, African and Native American descent have the lowest risk levels.
- Environmental factors: Certain environmental factors, including low sun exposure and tobacco use, are linked to MS.
- Other autoimmune diseases: There’s a slightly increased risk for MS if you have other autoimmune diseases, including thyroid disease, rheumatoid arthritis, lupus, Type 1 diabetes or inflammatory bowel disease.
Diagnosing Multiple Sclerosis
To diagnose MS, your doctor must definitively conclude all of the following:
- You have damage in at least two separate areas of your central nervous system, such as your brain, spinal cord or optic nerves.
- The damage in these areas occurred at least one month apart.
- All other possible diagnoses have been ruled out.
Your doctor may utilize the following diagnostic tests to confirm MS:
- A blood test can help rule out some infectious or inflammatory diseases that have symptoms similar to MS.
- A spinal tap (lumbar puncture) is when a medical professional removes a small sample of cerebrospinal fluid from within your spinal canal for laboratory analysis. This procedure can help detect antibodies associated with MS and also help rule out viral infections and other conditions that cause symptoms similar to MS.
- MRI is an imaging technology that can detect the presence of MS lesions in different parts of your central nervous system.
- Evoked potential tests are recordings of your nervous system's electrical responses to the stimulation of specific sensory pathways. Visual evoked potentials are considered the most useful for confirming an MS diagnosis.
Treatment for Multiple Sclerosis
There’s currently no cure for MS. Treatment regimens typically focus on managing symptoms and attacks as well as slowing the progression of the disease.
MS treatment regimens include:
- Corticosteroids, which help decrease the nerve inflammation associated with MS attacks; these are the most common treatment, and side effects may include increased blood pressure, moodiness, fluid retention and weight gain
- Plasma exchange, which separates your blood cells from your plasma and mixes the cells with a protein solution that’s then transfused back into your bloodstream; this procedure is utilized to help alleviate severe symptoms of MS relapses in people who aren't responding to IV steroids
- Physical therapy
- Muscle relaxants
- Oral, injectable and infusion treatments to reduce the inflammatory reactions of MS
- Medications to combat fatigue, depression, pain, and bladder and/or bowel control problems
Treatments for MS depend on your symptoms and the course of the disease. MS can take on a progressive, steadily worsening course in some patients, and this is often harder to treat than relapsing forms of MS.
Most current therapies target one of three outcomes for MS: reducing the disease’s progression, managing relapses or treating symptoms. The medications currently approved to reduce the progression of the disease all aim to suppress your immune system and decrease inflammation. Controlling inflammation may reduce damage to the myelin sheath and to nerve fibers.
The medical community is striving to find a way to improve and repair the nerve damage MS causes rather than just slow it down, and these efforts appear promising. “A treatment that is both anti-inflammatory and neuroprotective will give us much greater hope for halting progression and even causing repair and improvement,” says neurologist Rhonda Voskuhl, MD, director of the UCLA Multiple Sclerosis Program. “That’s different from just slowing the decline; it’s actually trying to make things better.”
Some people choose to utilize natural treatment options because these alternatives can provide relief when used in conjunction with doctor-prescribed medications and other therapies. However, if you choose to try natural remedies, remember that they shouldn’t be substitutes for supervised care from your doctor — but they can supplement it. Use the following dos and don’ts as guidelines.
Do Talk to Your Doctor
Although many people think that natural remedies are safe, the truth is that any herb or supplement that’s powerful enough to treat your symptoms also has the potential to interfere with your other medications. It may simply render them ineffective, or it could cause a life-threatening interaction. Always discuss new treatments with your doctor before using them.
Don't Believe the Hype
Natural remedies are big business, and some unethical sellers claim that the right herb can cure MS. These companies are generally trying to make a quick profit and may provide inferior products. Even if the natural remedy does help your MS, you probably won't see the miracle benefits advertised. Be cautious, and do your research.
Do Consider Minor Changes
Although they require more effort than simply taking a supplement every morning, minor lifestyle changes can be one of the best natural treatments for MS symptoms. Eating a balanced, healthy diet and staying active may reduce your symptoms, and reducing your alcohol intake and quitting smoking have also been shown to be beneficial.
Do Exercise Your Body and Mind
Many symptoms of MS, such as fatigue and muscle spasticity, can make it hard for you to stay active. However, there’s evidence that a careful exercise program can slow down the progression of these symptoms. Yoga and tai chi are both commonly recommended for people with MS because they can improve both strength and flexibility. You can also modify them easily, so you can do them at almost any stage of the illness or any level of mobility.
Another benefit of these forms of exercise is that they encourage meditation as well. Regular meditation has been shown to reduce chronic pain and improve the quality of life for people experiencing a long-term illness. You can practice meditation at home while you’re sitting or lying down, which is helpful for those flare days when you can’t exercise.
If you’ve been diagnosed with MS, you could be eligible to participate in research to help treat, halt or eventually cure the disease. Volunteering to take part in a study or clinical trial may not only benefit you but also could open the door for improved treatment options for all people who live with this condition.