Many options are available for treating MS and its related symptoms. Your doctor can help create a tailored plan for you. Here’s what that may look like.
Unlike high blood pressure or diabetes, there are no instruments to measure your multiple sclerosis (MS) level. Your doctor finds out how you’re doing by asking questions, examining your strength and other functions, and possibly ordering an MRI.
“I ask a patient if they’ve had any new symptoms in the past year, if any symptoms have worsened, or is there anything they could do a year ago that they can’t do now,” said Dr. Saud Sadiq, director and chief research scientist at Tisch MS Research Center New York.
If the doctor sees no change in your mental status or muscle strength, they may also order an MRI, which helps determine whether they see new lesions on the brain, spinal cord, or if there’s evidence of disease progression. If there’s nothing new in your symptoms, examination, or MRI, then the treatment is working.
If you are not noticing any relief, you can explore alternative treatment options.
“But even patients who are doing well might need more aggressive treatment,” said Dr. Karen Blitz of Holy Name Medical Center.
“If the MRI is active, the patient should be treated more aggressively, no matter how they feel,” she said.
Blitz added, “Just like cancer, which is treated aggressively to prevent it from spreading, MS can be a very bad disease and aggressive treatment prevents further deterioration. Often, patients are told they have a mild form of the disease and they can watch and wait; but the earlier MS is treated, the better patients do.”
Your doctor would typically treat each symptom individually. They use corticosteroids to shorten attacks. You can manage muscle spasticity or stiffness with stretching exercises and medications like tizanidine.
Dalfampridine (Ampyra) can help walking with speed by enhancing nerve signal conductions. Aerobic exercise and medication such as modafinil (Provigil) can help reduce fatigue, increase wakefulness and may also reduce fatigue due to MS.
Modafinil is prescribed off-label, meaning it is not approved specifically to relieve fatigue in MS, so some insurance companies will not pay for its use in MS.
Constipation is not uncommon and you can manage it with diet and fluid changes, suppositories, or medications. Burning or painful sensations may respond to a variety of medications, including amitriptyline (Elavil) and gabapentin (Neurontin).
Yes, if you are experiencing any reductions in function as a result of your MS. Physical therapy won’t change the course of your MS, but it may improve other factors such as fitness, mobility, sleep, energy, and focus, making you potentially more independent.
Importantly, it can help strengthen any muscles weakened by lack of use and improve balance as well.
Occupational therapy can also improve independence in daily living. If you’re having problems with eating, dressing, or grooming, occupational therapists can help with coordination and strength, and recommend equipment for your home or workplace to help with daily activities.
Additionally, speech therapy will help if you have problems speaking or swallowing. Cognitive rehabilitation may help improve memory, attention, and problem-solving, which may be due to the loss of myelin in the brain.
Yes. More research notes the benefits of exercise and other rehabilitation strategies in improving the quality of life, safety, and independence in people with MS. Exercise
“Exercise has a lot of benefits for MS, especially for management of fatigue,” said Dr. Gabriel Pardo, director of the Oklahoma Medical Research Foundation Multiple Sclerosis Center of Excellence.
“Patients think that working out will make them more tired, but the opposite is actually true. In addition, when patients have issues with muscle tone, spasticity, and ambulation (the ability to walk), exercise will keep muscles limber and preserve strength.”
Some people with MS are sensitive to heat, so using air conditioners, fans, or drinking cool beverages might help.
Lots of diets have been put forth for MS, but none have proven effective or necessary.
Your doctor should be able to give you a good indication of your outlook. There are different types of MS, some of which are more progressive than others.
Even if you have primary progressive multiple sclerosis (PPMS), which is expected to worsen over time, there is a lot your doctor can do to minimize it. Researching about the latest treatments can help you ask your doctor about them more.
None have adequate scientific evidence. The danger of using them is that people might stop using prescribed treatments, which can certainly worsen their MS.
But some people find that complementary therapies, such as acupuncture, hypnosis, massage, and meditation, help reduce stress, manage symptoms, and make them feel better.