Multiple sclerosis (MS) can affect many different parts of the body. Managing it typically involves a team of doctors and healthcare professionals. They will work closely with you to determine the best course of care. The MS team typically includes:
- primary care physician
- social worker
- physical therapist
- occupational therapist
- speech-language pathologist
- recreational therapist
If you are having any symptoms of MS, you will first see your family doctor or primary care physician. After an exam and medical history review, your doctor may refer you to a neurologist.
A neurologist is a physician who specializes in diseases of the nervous system. You will find neurologists in private practice, in community-based MS centers, in academic settings, and in general clinical settings. A neurologist will be involved in testing, diagnosis, treatment, and symptom management.
Before your appointment with a neurologist, it is a good idea to write down a few things.
Information to Have Handy
A neurologist will ask many questions. This will help to make an accurate diagnosis. Having the answers ready will help with the process. Some questions you will be asked include:
- What are your symptoms?
- When did they begin?
- Are they constant or do they come and go?
- What makes your symptoms worse?
- What makes them better?
- How severe are they?
- Does anyone in your family have MS?
- What other medical conditions do you have?
- What medications do you take?
Questions to Ask
In addition to having information ready, write down questions you would like the doctor to answer for you. Some things you might want to ask include:
- Do you think I have MS?
- How will we know for sure?
- Is there a test?
- What else might be causing my symptoms?
- Can this be treated?
- Will it go away?
- Is it going to get worse?
- What do you recommend?
A neuropsychologist will help you manage your mental function. MS can cause difficulties with memory, focus, information processing, and problem solving. A neuropsychologist might teach you exercises to help maintain and improve mental function.
A clinical nurse specialist, nurse practitioner, or registered nurse might be involved in your care. These professionals have advanced training and can help you in many areas including:
- adjusting to your diagnosis
- ongoing assessment and management of symptoms
- maintaining general good health
- giving medication
- monitoring side effects
- communicating with the healthcare team
A social worker is trained to assist you in identifying and accessing community services programs, resources, and entitlements. Social workers are also trained to provide counseling and emotional support, along with crisis intervention.
A psychologist can diagnose and treat issues related to mental health such as depression, which is common in MS. Interventions can include specialized testing and ongoing counseling and support for you and your family.
A physiatrist is a physician who specializes in rehabilitation medicine. A physiatrist will design a treatment plan to help you function at the highest level possible. This may include exercise and assistive devices as well as medication. The goal is to give you the highest possible quality of life.
Physical therapists (PTs) treat problems involving balance, coordination, strength, and mobility. A PT will help you strengthen muscles, teach the appropriate use of rehabilitation equipment and mobility devices, measure for and apply braces and other orthotic supports, and help you maintain a fitness-oriented lifestyle. Physical therapists help you find the balance between exercise and fatigue. The assessment by a PT includes muscle strength, range of motion, proprioception (the perception of your location in space—is the toe up or down, for example), muscle tone, gait, balance, transfers, and mobility.
An occupational therapist (OT) will help you stay productive, safe, and independent in your home and work environments. This may involve modifications of your space, such as bathrooms, kitchens, entrances, stairways, and cars. They can also help you develop strategies to simplify jobs and conserve energy.
A dietician or nutritionist will help you maintain a healthy diet. There is no diet specific to MS, but eating healthy will help you stay healthy. A dietician can teach you to prepare healthy meals that can help with weight management and reduce fatigue and constipation. A dietician can also help with any swallowing problems that an MS patient develops.
A speech-language pathologist (SLP) can help if you have problems with breathing, swallowing, speech, and cognition. In the case of swallowing problems, the SLP will work with the physical therapist and dietician to help you learn to eat safely. If you are having speech difficulties, the SLP will help you with speech production and clarity so that you can continue to communicate effectively.
A recreational therapist (RT) will help you find diverse activities appropriate to your level of function. This will help improve your quality of life. Activities such as swimming, yoga, tai chi, hippotherapy (horseback riding), meditation, and other fitness programs have been found beneficial in managing MS. Reading, computer use, board games, and other mind-stimulating programs are very important for recreation with others and for relaxation.