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Multiple Sclerosis: Treatment with Physical Therapy

Multiple sclerosis (MS) is a progressive neurologic disease that damages the nerves. This damage often leads to serious symptoms, such as the following:

  • numbness and tingling
  • weakness
  • muscle pain
  • vision problems

In some people, MS can be aggressive and advance quickly. In other people, it can be mild and progress at a much slower pace, with long periods of inactivity.

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In any case, physical therapy (PT) can be an important part of treatment for people with MS. Read on to learn what PT can do to help you manage your MS.

Why PT can be helpful with MS

PT for MS involves exercises to strengthen your muscles and improve your gait (how you walk) and your balance and coordination. It also involves stretches to help you maintain mobility and prevent muscle spasms. PT can also include training on how to use mobility aids like a cane, walker, or wheelchair.

PT can be helpful even in the earliest stages of MS. It can help you:

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  • learn how to support and cope with your changing body
  • avoid exacerbating symptoms
  • develop strength and stamina
  • regain abilities after a disease relapse

A discussion with a physical therapist can help you understand how your body will change as the disease progresses. Getting PT can help you prepare for these changes and help you maintain or improve a healthy lifestyle.

Physical therapy at different MS stages

PT may be helpful at various stages of your condition, and for different types of MS.

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At diagnosis

At the time of your MS diagnosis, it’s important to meet with a physical therapist for a baseline evaluation. This exam allows the therapist to see what your body is capable of now so they can compare that with your future abilities. You can also discuss your physical limitations and understand what levels of exercise and physical activity are appropriate for you.

After the initial exam, you may not need to continue seeing a physical therapist. But, you’ll likely want to continue with PT if you have an aggressive, rapidly progressing type of MS.

During a relapse

A relapse — also called a flare or exacerbation — is a period of time when symptoms of MS are more frequent or severe. During this period, you may have greater difficulty with everyday tasks that include:

  • working
  • cooking
  • walking
  • bathing

Your physical therapist will know how the relapse is affecting you by conducting a physical exam and comparing it with your baseline evaluation. After a relapse you should meet with your physical therapist to resume PT. Therapy after a relapse may help you regain some of the strength you might have lost during the relapse.

For progressive multiple sclerosis

If you have primary progressive MS, you don’t experience relapses. Instead, your disease is on a gradual, constant decline.

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If you’re diagnosed with this type of MS, ask your doctor to refer you to a physical therapist right away. It’s crucial to your health and well-being that you start PT as soon as you can. PT can teach you how to compensate for the changes you’ll experience. You may also need to learn how to use a mobility aid, such as a standing device or wheelchair.

Read more: Treatment for PPMS »

For advanced multiple sclerosis

People with advanced MS have severe MS symptoms. In most cases, people with advanced MS are nonambulatory. This means they cannot walk or get around without help from another person or a motorized device. Also, people at this stage have an increased risk of developing other health conditions such as osteoporosis or epilepsy.

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People with advanced MS can still benefit from PT. For instance, PT can help you learn to sit properly, develop upper body strength, and maintain the ability to use mobility aids.

Where you’ll have physical therapy

Physical therapy can be done in several locations that include:

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  • your home
  • an outpatient facility
  • an MS treatment center

PT for MS may be different based on where it’s provided. In some cases, the stage of the disease determines where you should have your PT. In other cases, you may be able to select the option that works best for you.

Inpatient PT

You’ll receive Inpatient care while you’re staying at a healthcare facility. PT conducted in an inpatient facility is often done in a hospital, MS treatment center, or long-term care facility.

Most people who require inpatient PT have experienced a fall or some type of injury due to MS. People with advanced-stage MS may also be living in an assisted-living center, and PT may be required as part of treatment.

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Outpatient PT

Outpatient care takes place in a doctor’s office, physical therapy office, or therapy center. People who have outpatient PT come to the venue for therapy and leave afterward.

Outpatient PT can be a good choice for people who are recovering from a relapse or learning to handle the physical changes MS causes.

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Home care

With home care, a physical therapist will come to your home to provide PT. People in all stages of MS can use home care.

This type of therapy may be especially useful for people who’ve been recently diagnosed with MS and are learning to deal with slight changes in their physical abilities. Home care can also be good for people who have late-stage MS and are nonambulatory.

Making your treatment plan

If you have MS, talk with your doctor about your course of treatment. If you would like to begin working with a physical therapist, ask your doctor for a referral.

MS is different for everyone, and some people may respond well to certain exercises while others won’t. Be honest with your doctor and your therapist about your symptoms and how you’re feeling so that they can create a PT program that’s right for you.

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