Managing the ongoing symptoms of MS is challenging but can improve the person's quality of life. The most common symptoms of MS are fatigue, problems with bowel movements and urination, weakness, and cognitive changes. Less common symptoms are pain, spasticity, depression, and, in severe cases, inability to walk.
Fatigue is the most common and often the most disabling symptom of MS. It may occur in several different forms:
- activity related fatigue
- fatigue due to deconditioning (not being in good shape)
- lassitude—also known as "MS fatigue"
Treatment of fatigue requires energy management, medications, rehabilitation, or a combination of all three programs. People can be referred to a physical or occupational therapist or a personal trainer to help them utilize energy conservation techniques. There are certain medications that can be prescribed to increase energy and can be prescribed by the MS clinician.
Bladder & Bowel Dysfunction
Bladder and bowel dysfunction can be an ongoing or intermittent problem in MS. Bladder frequency, waking up at night to void, and bladder accidents can be symptoms of this problem. Bowel dysfunction can result in constipation, bowel urgency, loss of control, and irregular bowel habits. Both problems should be discussed with the MS clinician and can be managed effectively. There are tests that can be performed to determine the source of the problem and there are medications and dietary changes that may improve function. The goal is to promote function without complications and to sustain a desired quality of life.
Weakness in multiple sclerosis can be related to an exacerbation or a flare-up or can be an ongoing problem. This is a difficult and challenging problem to manage if it is ongoing, as treatments are generally more effective if weakness is a transient problem. Ongoing problems with weakness can be addressed by rehabilitation and the appropriate use of assistive devices such as canes, walkers, motorized scooters and an ongoing program to promote fitness and wellness.
Cognitive changes related to MS can be obvious or very subtle. It is important to discuss them with your clinician and to have the deficits identified and treated. Newer rehabilitation services and the use of computer technology have been shown to be of great benefit to many people with MS.
Acute & Chronic Pain
Like symptoms of weakness, pain in MS can be acute or chronic. Acute pain can be managed with a combination of medications and rehabilitation services; chronic pain should be addressed by identifying potential triggering factors such as infection and can also be controlled by medications prescribed by the MS clinician.
MS spasticity can affect a person's mobility and comfort. Spasticity can be defined as spasms or stiffness and may involve pain and discomfort. Regular exercise and stretching can reduce stiffness and improve function but the addition of medications may also be necessary.
Both clinical depression and a similar less severe emotional distress are common in people with MS. About 50% experience depression at some time during their illness. Referrals for counseling or psychiatric therapy along with medications would be appropriate for this challenging symptom.