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Break It Down: Multiple Sclerosis

Multiple sclerosis, or MS, is a condition that affects approximately 400,000 Americans. Thankfully, the majority of people with MS have the same life expectancy as persons without the condition. However, they can have a variety of manifestations that impact their quality of life.

MS is an autoimmune disorder that affects the central nervous system, including the brain, optic nerves, and spinal cord.

Multiple sclerosis causes an attack on myelin, a substance that enables signal transmission along the nerves. Scar tissue creates gaps in functional myelin. This affects how messages are transmitted within the brain or along the nerves.

This scarring, or sclerosis, can manifest in different ways, and these effects can change over time, so there may not be a constant pattern of symptoms with MS. The most common symptoms are numbness and tingling in hands and feet, vision problems, poor balance, limited mobility, lack of concentration, and slurred speech.

These symptoms often go through periods of relapse or remissions. Sometimes there aren’t typical outward signs of the disease, so MS is often called a “silent disease.”

Relapsing-remitting MS is a form of the condition characterized by defined periods of relapse and remission without progression. About 85 percent of all patients are initially diagnosed with this form of MS before beginning treatment.

While there is no cure for MS, recent advances have led to effective therapies that can help MS patients manage their symptoms. Disease-modifying drugs work to change your body’s immune response. These treatments are available as oral medications or injections, prescribed by a medical professional. Other medications that are sometimes recommended to MS patients to ease symptoms include muscle relaxants or corticosteroids, the latter to reduce inflammation.

Because MS can be a challenging disease physically and mentally, drug therapy is often supplemented by physical and emotional support from trained therapists.

The key to successfully treating MS involves working closely with your doctor and other specialists. Medications, therapy, and proper lifestyle choices can help ensure that MS remains only a part of your life, not the determining factor of how you should live it.

The uncertainty of what to expect can make your multiple sclerosis (MS) diagnosis feel even more overwhelming. Here are some guidelines for what to anticipate.

Prognosis

One of your first concerns following your MS diagnosis is likely your prognosis. MS is an unpredictable disease with no cure. No two people experience the same symptoms, progression, or response to treatment. This can make it difficult to predict how the course of your disease will play out, especially when you’re first diagnosed.

Still, MS isn’t fatal and most people with MS have a normal life expectancy. Also, around two-thirds of people with MS remain able to walk. Some may need a cane or other aid to make walking easier because of fatigue or balance issues.

Approximately 85 percent of patients are diagnosed with relapsing-remitting MS (RRMS), which can have mild symptoms and long periods of remission. Many people with this milder form of MS are able to go on living their lives with very little disruption or medical treatment. Half of those with RRMS will progress to secondary-progressive MS. This progression often happens at least ten years after an initial RRMS diagnosis.

Symptoms

It’s understandable to be worried about what symptoms your new diagnosis will bring. Although your doctor won’t be able to tell you exactly which symptoms you’ll experience, some tend to be more common than others, including:

  • numbness or weakness, usually affecting one side of the body at a time
  • tingling
  • spasticity
  • fatigue
  • balance and coordination issues
  • pain and vision disturbance in one eye
  • bladder control issues
  • bowel problems
  • dizziness

Even when your disease is under control, you’ll experience attacks, also called relapses or exacerbations. Medication can help limit the number of attacks and the severity.

Treatment Options

MS is a complex disease, so it’s best treated with a comprehensive plan. This plan can be broken down into three parts:

  1. Long-term treatment to modify the course of the disease by slowing progression.
  2. Management of relapses by limiting the frequency and severity of the attacks.
  3. Treatment of the symptoms associated with MS.

There are currently eleven disease-modifying therapies (DMTs) approved by the Food and Drug Administration for the treatment of relapsing forms of MS. You’ll likely be advised to start one of these medications immediately following your diagnosis.

MS can cause several symptoms, ranging in severity. Your doctor will treat these individually using a combination of medications, physical therapy, and rehabilitation. You may be referred to other health professionals experienced in treating MS, such as physical or occupational therapists, nutritionists, or counsellors.

Lifestyle

You may worry that your new diagnosis will interfere with your current lifestyle and your ability to stay active. Fortunately, most people with MS are able to keep living productive lives.

Staying active is encouraged by MS experts. Several studies have found that exercise is an important part of MS management. Along with the usual health benefits, such as a lower risk of cardiovascular disease, staying active can help you function better with MS.

Other benefits of exercise include:

  • improved strength and endurance
  • improved function
  • positivity
  • increased energy
  • improved anxiety and depression symptoms
  • increased participation in social activities
  • improved bladder and bowel function

Another aspect of your life that you’re probably wondering about is your career or job. Many people are able to continue working. According to a paper published in the BC Medical Journal, many people decide not to disclose their condition to their employers or colleagues. Many also report that their daily lives aren’t adversely affected.

MS-certified physical therapists and occupational therapists can help you maintain a lifestyle that you’re comfortable with. Physical therapists can help you come up with a plan to get fit and stay active. An occupational therapist can help you make the appropriate modifications to make it easier to continue with your daily activities at work and home.

You cannot know exactly what to expect with an MS diagnosis, but learning as much as possible about your new condition and all of your options will make things easier.