Multiple sclerosis (MS) is a disease of the central nervous system (the brain and spinal cord). MS can be very different from one person to another. You may have mild symptoms, or you may have severe loss of coordination and muscle control. You may have symptoms for days or weeks, followed by periods of no symptoms for weeks or months. Or you may have symptoms that keep getting worse.
MS is more common in women. It is usually diagnosed in adults younger than age 50, although it can happen to young children and older adults.
What is the cause?
A fatty substance called myelin covers your nerves. It helps nerve messages move quickly between the brain and other parts of the body. When you have MS, some of the myelin and areas of the nerve are damaged. The damage makes it harder for the nerves to send signals to the body.
MS may be caused by a problem with the immune system. The immune system is your bodyâ€™s defense against infection. If you have MS, your body may attack your myelin. What makes this happen is not known.
What are the symptoms?
Symptoms may include:
Feeling very tired
Weakness, clumsiness, or trouble walking
Face, neck, back, joint, or muscle pain
Numbness or tingling
Blurred or double vision
Problems with urination, such as needing to urinate often and urgently, trouble starting to urinate, or leaking urine
Bowel problems, such as loss of control of bowels, constipation, or diarrhea
Depression and mood swings
Memory loss and trouble paying attention
Sexual problems, such as loss of interest in sex. Men may have trouble having an erection, and women may have vaginal dryness.
Usually the symptoms come and go. The times when you are having symptoms are called flares, relapses, or episodes. The flares may last a few days or weeks at a time. The times when you are not having symptoms are called remissions.
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:
MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the central nervous system. MRI can show areas of damaged myelin.
Nerve conduction studies, which use small wires that are taped to your skin to send mild electric signals and check how well your nerves work to carry signals to your muscles.
Lumbar puncture, also called a spinal tap, which uses a needle to get a sample of fluid from the area around your spinal cord
You may have more than 1 MRI over time. Several MRIs may show damage to nerves showing in different parts of the central nervous system at different times. This confirms the diagnosis of multiple sclerosis.
How is it treated?
MS cannot be cured, but treatment for MS can help:
Shorten flare-ups of symptoms
Lengthen the time between flare-ups
Prevent damage to the nerves
Prevent or lessen new symptoms
Treatment may include medicine, therapy, counseling, and self-help aids.
Your healthcare provider may prescribe medicines to:
Keep your immune system from attacking the myelin and prevent flare-ups of symptoms.
Help symptoms be less severe during a flare-up as well as shorten the time each flare lasts.
Control depression, tiredness, bowel or urinary problems, and muscle spasms.
Physical therapy, occupational therapy, and speech therapy
Physical therapy and occupational therapy help you use and strengthen your muscles. These types of therapy can make it easier for you to take care of yourself. You may learn how to use devices such as walkers or wheelchairs to help you get places or stay in certain positions. Braces can also help by supporting joints when your muscles are not very strong. You may learn to use tools to help with daily activities, such as jar openers, buttonhooks, or household items with large handles.
Speech therapy helps improve speaking, eating, chewing, and swallowing. Special techniques and devices, such as computers, can also help you communicate.
Counseling can help you cope with stress, frustration, depression, and other emotions.
You may also need walkers, wheelchairs, or other tools to help you get places, stay in certain positions, or do tasks such as getting dressed.
How can I take care of myself?
Learn what things may trigger some of your symptoms and try to avoid them. For example:
Infections may trigger flare-ups of MS or worsen the symptoms. Avoid being around people who are sick. Wash your hands often. Ask your healthcare provider what else you can do to help prevent infections.
Getting too hot can cause or worsen symptoms. It may cause extreme muscle weakness. Try to keep cool with air conditioning or fans. Swimming in a cool pool may be a good choice for exercise.
Take all medicines as directed by your provider or therapist. Itâ€™s very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or if the medicines don’t seem to be working.
If you have bladder or bowel problems, you can wear protective pads inside your clothing. It may help to go to the bathroom on schedule, rather than waiting until you feel an urge. Eat high-fiber foods to help you move your bowels without straining. Talk to your provider about other things that might help you.
A healthy lifestyle may help. Talk to your healthcare provider about your personal and family medical history and your lifestyle habits. This will help you know what you can do to lower your risk for complications of MS. For example:
Eat a healthy diet. Ask your provider about the benefits of talking to a dietician to learn what you need in a healthy diet.
Drink enough liquids each day to keep your urine light yellow in color.
Try to keep a healthy weight. If you are overweight, try to lose weight to decrease the stress on your weak muscles.
Stay fit with the right kind of exercise for you.
Learn ways to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example, take up a hobby, listen to music, watch movies, or take walks. Try deep breathing exercises when you feel stressed.
If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.
Try to get at least 7 to 9 hours of sleep each night. Plan your daily activities around your energy levels and learn ways to conserve your energy. Take rest breaks during the day.
Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:
How and when you will hear your test results
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-05-08 Last reviewed: 2014-09-30
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Multiple Sclerosis: References
Cortese, I., Chaudhry, V., So, Y. T., Cantor, F., Cornblath, D. R., & Rae-Grant, A. (2011). Evidence-based guideline update: Plasmapheresis in neurologic disorders Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 76(3), 294-300.
Lublin, F. D., et al. (2014). Defining the clinical course of multiple sclerosis: The 2013 revisions. Neurology, 10-1212.