There is no cure for multiple sclerosis (MS), so treating it mainly focuses on slowing down the progression of the disease, while managing symptoms. Disease progression and symptoms range greatly from person to person, so work with your doctor to develop a treatment plan that is right for you.
Disease-modifying medicines can reduce the frequency and severity of relapses. They also can control the growth of lesions and reduce symptoms. There are currently several drugs approved by the Food and Drug Administration for modifying MS.
The injectable medications currently approved are:
- interferon beta-1a (Avonex, Rebif)
- interferon beta-1b (Betaseron, Extavia)
- glatiramer acetate (Copaxone)
- pegylated interferon beta-1a (Plegridy)
There are three therapies that must be given by infusion at a licensed clinic:
- natalizumab (Tysabri)
- mitoxantrone (Novantrone)
- alemtuzumab (Lemtrada)
There are also three oral treatments you take as a pill:
- teriflunomide (Aubagio)
- fingolimod (Gilenya)
- dimethyl fumarate (Tecfidera)
Medications to Treat Relapses
Experiencing a relapse is discouraging, so ending it as quickly as possible benefits both the body and the mind. Inflammation is a key feature of MS relapses, and it can lead to many of the secondary symptoms. Corticosteroids are often used to ease inflammation and reduce the severity of attacks. Corticosteroids used to treat MS include methylprednisolone (intravenous) and prednisone (oral). ACTH (H.P. Acthar Gel) may be prescribed if corticosteroids did not provide relief, or if intravenous treatments can’t be used.
Medications for Physical Symptoms
Muscle relaxants are often suggested for people with MS. That's because relaxing muscles helps with the very common MS symptoms of pain, spasms, and fatigue. Relieving those symptoms can also help with depression. Drugs for muscle stiffness include:
- baclofen (Lioresal)
- cyclobenzaprine (Flexeril)
- diazepam (Valium)
- tizanidine (Zanaflex)
Drugs used to treat fatigue may include amantadine hydrochloride (Symmetrel) and modafinil (Provigil). Fluoxetine (Prozac) is also often prescribed, since it helps combat both fatigue and depression.
There are more than a dozen prescription medications for bladder problems (like incontinence) related to MS. The most efficient medicines for constipation and bowel symptoms associated with MS seem to be over-the-counter stool softeners.
Physical Therapy and Exercise
Fatigue plays a big role in the life of people with MS. When you’re tired, you just don’t feel like exercising. Unfortunately, the less exercise you get, the more tired you feel. That’s why physical therapy (PT) and exercise need to be carefully tailored to MS patients. Things like keeping session times short and increasing exercise over time are important factors.
When should an MS patient seek out PT? Certainly during a relapse that has produced a change in functions like walking, coordination, strength, or energy. The goal of PT during relapse is to return to a prior level of function, if possible.
A PT program addressing disease progression may consist of professional services along with self-care activities such as a home exercise program, aqua-therapy, or a personal fitness program at a gym or health club. Getting out of the house to exercise can also help address the depression and social isolation that plagues MS patients.
Constant movement and activity is absolutely critical to fighting MS. As you build and modify your MS exercise routine, make sure you include basic stretches you can do sitting or from bed. When you feel comfortable with those exercises, add more demanding exercises like walking, water exercise, or dancing. Anything you can do with others, especially exercise you really enjoy, will help.
Managing Emotion in the Midst of Change
People with MS are faced with a constantly changing illness. This creates a painfully difficult emotional state. You might feel depression, grief, emotional instability, and anger — perhaps all in the same day.
Keeping cool when you have MS calls for creative solutions. Antidepressants very often are helpful, but they are also usually not enough. And while talk therapy with a licensed practitioner is a very good idea, you may need help from someone who has a more personal understanding of MS. Look to your local MS Society for education, counseling references, and support groups. Find people who know that you are more than your disease and keep a positive outlook. We don’t have a cure yet, but thousands are working every day to improve the quality of life for MS patients.