Treatments

Although there is no cure for multiple sclerosis (MS), there are many effective ways of managing the disease. Treating MS primarily focuses on developing strategies to manage symptoms. Because symptoms range greatly from patient to patient, it is essential that you work with your doctor or healthcare provider to develop a treatment plan that is right for you.

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Doctor’s Whiteboard: Don’t Let MS Slow You Down (Video Transcript)

Multiple Sclerosis is a complicated and often misunderstood condition, and if you or a loved one is dealing MS, then you probably have a lot of unanswered questions about how this disease may impact your life.

MS affects the central nervous system, making it sometimes difficult for the brain to send and receive messages from the body. Some people may experience fatigue or dizziness while others may experience issues with eyesight or sensitivity. There are actually a vast number of symptoms associated with MS, and everyone’s experience is unique.

The most common form of MS is called “relapsing-remitting,” where the symptoms periodically come and go. But MS is a progressive disease, and the severity of symptoms often increase over time and can eventually affect a person’s ability to work, study, or be as active as they would like.

The good news is that doctors have more tools than ever to help treat MS. And along with treatment, changing your exercise habits and diet can help keep symptoms under control.

When MS flairs up, your doctor may prescribe medications to treat specific symptoms, such as pain or weakness. Your treatment may also include medications that target the underlying causes of MS. These treatments help prevent the disease from damaging nerves and can help many patients remain symptom-free for extended periods of time.

Regular exercise, such as indoor or outdoor cycling, yoga, and strength training, has been shown to help ease MS symptoms as well as combat fatigue and depression. Watching your diet and maintaining an optimal body weight are also important in promoting mobility and easing strain on muscles and joints.

The most important things you can do to take control of your MS are, first, sticking with your treatment plan and, second, not letting MS define you or get you down. Treating MS early, working with your doctor, and staying active are key to maintaining the best quality of life.

If you’re interested in knowing more about treating Multiple Sclerosis, take a look at the information we have here at Healthline or make an appointment with your doctor.

Disease Modification Drugs

There are currently a number of drugs approved by the Food and Drug Administration to help modify the course of relapsing MS. There are five injectable medications: Interferon B-1a (Avonex), Interferon B-1b (Betaseron), Glatiramer Acetate (Copaxone), Interferon beta-1b (Extavia), and Interferon B-1b (Rebif). There are also two infusion therapy (intravenous therapy) medications, Natalizumab (Tysabri) and Mitoxantrone (Novantrone), and three oral treatments, Teriflunomide (Aubagio), Fingolimod (Gilenya), and Dimethyl Fumarate (Tecfidera).

Learn seven tips for beating MS fatigue »

Treating Physical Symptoms

Drugs & Medications to Treat MS Symptoms

Inflammation is very typical of MS relapses, and it can lead to many of the secondary symptoms associated with MS. Corticosteroids are often used to ease inflammation and reduce the severity of attacks are one of the most common MS treatment options. Corticosteroids used to treat MS include:

  • dexamethasone (intravenous)
  • methylprednisolone (intravenous)
  • prednisone (oral)

Muscle relaxants are also very commonly administered to MS patients to ease suffering due to painful muscle stiffness or muscle spasms. Commonly prescribed drugs to treat spasticity include:

  • baclofen (Lioresal)
  • cyclobenzaprine (Flexeril)
  • diazepam (Valium)
  • tizanidine (Zanaflex)

Other drugs may be prescribed to reduce fatigue, treat depression, pain, bladder problems, bowel control issues, or any other symptoms associated with multiple sclerosis. Teriflunomide (Aubagio) is a newer drug that helps treat relapsing forms of MS.

Rehabilitation and Physical Therapy

The delivery of rehabilitation services can be done in many venues: at home, in outpatient facilities, in inpatient programs, in health clubs and gyms, and at MS treatment centers. The approach to MS rehabilitation, however, must be quite different from how an orthopedic patient with a fracture or a spinal cord-injured person receives care. The issue of fatigue affects the pace of rehabilitation. Many people with other diseases can tolerate two to four hours of rehabilitation. People with MS may have problems dealing with that type of schedule. It is very important to establish an appropriate exercise and conditioning program that will not allow fatigue to interfere with function. Teaching energy conservation and pacing early on becomes very valuable.

When is rehabilitation indicated in MS? Certainly, it is appropriate during an acute exacerbation that has produced a significant change in functions such as walking, coordination, strength, or stamina. Rehabilitation in the context of an acute attack usually is time-limited and goal-oriented—the aim is to return to a prior level of function. Rehabilitation also is indicated during disease progression, when one is gradually losing function and is no longer able to move and transfer safely or be as mobile as in the past. A program at that time may consist of professional services, along with self-care activities such as a home exercise program, aquatherapy, or a personal fitness program at a gymnasium or health club. Studies have indicated that a targeted rehabilitation program can improve not only the strength of weakened muscles but also MS-related fatigue, depression, and social isolation.

It is important to remember that the duration of rehabilitation services will depend not only on available personnel and facilities but also on third-party reimbursement (insurance coverage). Most insurance carriers require that rehabilitation prescriptions contain information about desired outcomes—goals of therapy and specific benchmarks (i.e., ambulation with a walker, ability to walk 50 feet, safe transfers, etc.). Once these goals have been achieved, rehabilitation usually is terminated, with potential for reassessment once additional rehabilitation goals can be identified.

Treating Emotional Change

Emotional changes related to multiple sclerosis may encompass a wide variety of phenomena. They may include depression, grieving, reactions to stress, emotional lability (unstable moods), affective release (also known as pseudobulbar affect), euphoria, and anger. People who are diagnosed with multiple sclerosis are faced with a dynamic rather than a static illness. Problems confronted on one day may change the next. The disease itself may wax and wane; symptoms may come and go; function can be altered by environmental factors and personal symptoms such as fatigue.

Managing change in multiple sclerosis calls for creative solutions within a flexible and accepting environment. There's a need for adaptation over time so that management becomes the goal rather than the cure. In acknowledging this, principles of care must change from those of the acute medical model to one that is individualized and ongoing throughout a person's lifetime. The aims of emotional support are to support the person in accordance with his or her life goals with the preservation of autonomy and maintenance of a role in the family and society at large. This requires maintenance of emotional stability and positive interpersonal relationships.

Strategies to assist people manage change throughout the spectrum of the disease consist of education, individual, group, and family counseling, support groups, and networks of peers. The nature of multiple sclerosis challenges the people affected by the disease to seek appropriate support services with understanding professionals who can develop and implement individualized, culturally sensitive, and dynamic programs to meet the needs of all those affected by the disease throughout a lifetime.