Multiple Sclerosis

What is multiple sclerosis (MS)?

Multiple sclerosis, often called MS, is a disease that affects the central nervous system—the brain and spinal cord. It can cause problems with muscle control and strength, vision, balance, feeling, and thinking.

Your nerve cells have a protective covering called myelin. Without myelin, the brain and spinal cord can't communicate with the nerves in the rest of the body. MS gradually destroys myelin in patches throughout the brain and spinal cord. These patches of damage are called lesions. They cause muscle weakness and other symptoms.

MS is different for each person. You may go through life with only minor problems. Or you may become seriously disabled. Most people are somewhere in between.


What are the symptoms of multiple sclerosis (MS)?

The symptoms of MS vary from person to person. Which symptoms you have will depend on which parts of your brain or spinal cord are damaged. Over time, symptoms may come and go, or they may be long-lasting. Certain things like being hot or having an infection may cause symptoms to get worse for a short time. As MS progresses, symptoms may get worse.

Common symptoms

  • Feeling very tired (fatigue).
  • Muscle symptoms. These include weakness, stiffness, and spasms. You may be clumsy or have a tremor. These problems may make it hard to hold on to things or walk. Over time, a cane or wheelchair may be needed.
  • Visual symptoms. These include blurry vision, eye pain, blindness, and double vision. Optic neuritis—a sudden loss of vision that's often painful—may be a first symptom of MS.
  • Sensory symptoms. These include numbness and tingling, feelings of pins-and-needles, and coldness. They may occur in a limb or on your face or body. You may also feel a band of tightness around the trunk of your body.
  • Pain. This may include headaches, nerve pain, and pain from muscle spasms.
  • Bladder symptoms. These may include a need to urinate often. Or you may not be able to control or empty your bladder. You may wake up at night to urinate.
  • Constipation and other bowel symptoms. You may have a hard time passing stool (constipation). Or you may lose control of your bowels.
  • Sexual problems. You may be less interested in having sex. Or you may have pain during sex or have problems getting an erection.
  • Cognitive problems. You may have trouble focusing. You may forget things. Or you may have trouble thinking quickly or solving problems.
  • Mental health symptoms. You may feel depressed or anxious.
  • Sleep problems.
  • Vertigo and balance problems. You may feel dizzy or unsteady.


What causes multiple sclerosis (MS)?

The exact cause isn't known, but most experts think that MS is an autoimmune disease. In MS, the immune system attacks the protective covering of the nerve cells (myelin) in parts of the brain and spinal cord. Areas of the brain and spinal cord get inflamed. Over time, the myelin and nerves are damaged.




How is multiple sclerosis (MS) treated?

Your treatment will depend on what type of MS you have, your choices about medicines, and your symptoms. There is no cure for MS. But there are medicines and other treatments that might help.

Different medicines are used to treat MS. Some treat attacks (relapses). Others help prevent attacks and reduce brain lesions. They may slow the progression of the disease. Other medicines may be used to manage ongoing symptoms.

Physical therapy, occupational therapy, and speech therapy can help you manage some physical problems caused by MS. Cognitive therapy can help if you have trouble thinking clearly or remembering.

Regular exercise and physical activity can also help. They can reduce symptoms, and exercise might reduce MS attacks. Exercise is helpful for everyone who has MS, even if you have severe symptoms or can't do certain things. A physical therapist can help you find the best way for you to be active.

If you have diabetes, high blood pressure, or heart problems, managing these may help your MS.

Depression and anxiety are common with MS. If you have either of these, talk to your doctor. Medicines and counseling can help.

Some complementary medicine treatments may help relieve symptoms of MS. Talk to your doctor if you are interested in trying any of these treatments.

In some cases, surgery may be done if you have severe tremor (shakiness) that affects movement. Or it may be done to implant a catheter or pump in the lower spinal area to deliver a constant flow of medicine to help treat severe muscle stiffness (spasticity).


What happens when you have multiple sclerosis (MS)?

The course of MS depends on which type you have. Most people who have MS have attacks over many years. An attack is a period of time when there are new symptoms or when old symptoms get worse. An attack can last for days to weeks. Symptoms usually go away (remit) after an attack. Attacks are also called relapses, flares, or exacerbations.

In general, MS follows one of four courses:

  • Relapsing-remitting. Attacks come and go over time. The disease doesn't get worse between attacks.
  • Secondary progressive. The disease follows a relapsing-remitting course at first. Then it gets worse (progresses) over time, even without attacks.
  • Primary progressive. The disease gets worse from the start, with or without attacks.
  • Clinically isolated syndrome (CIS). This is an MS attack in a person not known to have MS. An MRI only shows damage from this attack. There are not old MS lesions on the MRI. These people may or may not go on to have MS.

It's hard to predict how MS will affect you. Some people may function well for a long time. But others may lose the ability to walk or do everyday tasks as the disease gets worse.


How can you care for yourself when you have multiple sclerosis (MS)?

General care

  • Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • Use a cane, walker, or scooter if your doctor suggests it.
  • Keep doing your normal activities as much as you can.
  • Try to stay active mentally. Read or do things like crossword puzzles if you enjoy doing them.
  • Keep cool. For many people, MS symptoms get worse when they are even a little bit hotter. This could be from the weather, a hot shower, exercise, or a fever. Cooling vests, neck wraps, cool cloths, air conditioning and cool showers after exercise can help. So can avoiding hot tubs and saunas.
  • Seek connections. Spend time with friends, family, and others. Joining a support group for people with MS may help.
  • Tell your doctor if you feel sad, depressed, or hopeless. Also tell your doctor if you have lost interest in things you usually enjoy. Medicine and counseling can help.
  • If you smoke, try to quit. Smoking may increase problems caused by MS. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Try to cut down on stress. Calm yourself or release tension by doing an activity you enjoy, such as reading a book, listening to music, or gardening.

Diet and exercise

  • Talk to your doctor about your diet and any supplements you take.
  • Tell your doctor if you're having problems chewing or swallowing. Your doctor or a speech therapist may recommend changes to your diet to help make it easier to swallow. You may need to avoid certain foods or liquids. You also may need to change the thickness of foods or liquids in your diet.
  • If you get full quickly or get tired easily when you eat, try eating smaller meals more often. You can also try a liquid meal replacement such as Ensure or Boost.
  • Get exercise and physical activity on most days. Exercise can be safe even if your symptoms are severe. A physical therapist can help you find the best way to be active. Physical activity and exercise can reduce many of the symptoms of MS. Exercise might also reduce attacks (relapses).
  • Ask your doctor about taking vitamin D. The doctor may suggest taking it and can suggest a dose. Low vitamin D levels may be linked to MS.

Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.

Related Stories