Multiple sclerosis (MS) is an abnormal response of the body’s immune system. Instead of the immune system protecting the body by attacking harmful microorganisms, the immune system attacks healthy nerves in the central nervous system (the brain and spinal cord). More specifically, the protective covering surrounding a nerve (myelin). This causes scaring on the nerves, or lesions.
Lesions on the nerves disrupt communication between the brain and the body.
This disruption in communication causes a variety of neurologic symptoms including the following:
- Vision problems
- Numbness and tingling in the hands and feet
- Pain and itching
- Gait disturbance
- Dizziness and vertigo
- Bowel and bladder problems
- Cognitive (thinking) problems
- Emotional changes
The type and severity of symptoms will vary among people with MS.
What are the types of MS?
Relapsing-Remitting Multiple Sclerosis
The most common type of MS is relapsing-remitting MS (RRMS) and usually effects people in there 20s-30s.
People who have RRMS will have times when symptoms “flare up” (relapse) followed by a period when there are little to no symptoms (remission).
Secondary Progressive Multiple Sclerosis
People with secondary progressive multiple sclerosis (SPMS) usually starts out as RRMS. RRMS turns into SPMS when relapses start to trend toward worsening of symptoms with little to no remission between relapses. This shift from RRMS to SPMS usually occurs 15-20 years after the initially diagnosis of MS.
Primary Progressive Multiple Sclerosis
Primary progressive multiple sclerosis (PPMS) accounts for 10-15% of the cases of multiple sclerosis. Weakness in the legs and difficulty walking are the most common symptoms initially. Symptoms progressively worsen over time. PPMS does not have any relapses or remissions.
What is the treatment for multiple sclerosis?
There is no cure of multiple sclerosis. Treatment usually focuses on speeding up recovery from a relapse and slowing down the progression of the disease and managing the symptoms.
Treatment for MS relapses (attacks)
Oral and/or intravenous steroids are prescribed to treat the inflammation around the nerves.
Plasmapheresis (also known as plasma exchange) is when the plasma portion of the blood is separated from the red blood cells. The red blood cells are then mixed with albumin and put back onto the body.
Treatment to slow the progression of the disease
For primary progressive multiple sclerosis, ocrelizumab (Ocreves) is the only FDA approved disease modifying therapy.
Treatment to Manage MS Symptoms
Physical therapy focus on stretching muscles that may become shortened due to spasticity, balance retraining, and gait (walking) training. A physical therapist can also prescribe the appropriate assistive device to improve your safety with walking and also be involved in prescribing appropriate braces to protect joints around weakened muscles and improve the overall quality of movement.
MS may also cause pain in the muscles and involuntary muscle contractions (spasticity). A doctor may prescribe muscle relaxants, for example, baclofen or Zanaflex.
Medication to manage fatigue:
Fatigue can be a major problem of the disease. A doctor may prescribe medication to help with this
Medication to increase walking speed:
There are some medications that claim to increase walking speed. Talk with your doctor to learn more about this.
Article you may be interested in:
One of many problems when the neurologic system is damaged are ankle contractures. A contracture is where the soft tissue structures surrounding a joint shorten causing loss of movement. What Causes a Contracture? There are several factors that can lead to an ankle...
Balance (also known as postural stability) is dramatically impacted when there is damage to the neurologic system and can increase the fear of falling. It is the one ability most of us (adult humans) take for granted……..until it is gone. Lack of postural stability...
It seems almost every other week there is some new study on the benefits of exercise and how it can help prevent conditions like diabetes, heart disease, and depression. But what about multiple sclerosis? The national MS society reports that 1 million people are...
Why do some people seem to “thrive” in the midst of life’s challenges? You know the type. Or maybe you don’t. To understand what I mean, you need to be a “people analyzer”. You see, I AM a “people analyzer”. I love to know what makes people tick. Especially when it...
Abnormal muscle synergies are one of the most common "movement problems" after a stroke or brain injury. What is an abnormal muscle synergy? A flexor synergy is when the hip, knee, and ankle all flex at the same time (visualize drawing your knee into your chest). An...
What should you expect to achieve in neurologic rehabilitation? My answer might confuse you, frustrate you, and hopefully challenge you to think differently. The most critical component of a successful outcome (in neurologic rehabilitation) is NOT based on the extent...
Balance training is a critical component for anyone with ataxia. This is due to the fact that ataxia negatively impacts the balance system and is one of the leading causes of disability. Ataxia is caused by damage to the cerebellum. The cerebellum plays a MAJOR role...
Circumduction is a “walking problem” that is characterized by the leg swinging out to the side. This is typically a compensatory strategy to prevent someone from catching the foot on the ground. Before we dive into what might be causing you to swing the leg around the...
Fatigue is a major problem with a variety of neurologic conditions. Feeling fatigued can be a HUGE barrier in your physical recovery and it can also dramatically impact your overall quality of life.That being said, managing fatigue might be the single most important...
Are you super eager to relearn to walk? Walking is a HUGE goal for anyone who has lost that ability. Walking means different things to different people. And quite honestly, has far less meaning until you have lost this fundamental skill. All that being said, it is...