Diagnosing and managing multiple sclerosis (MS) typically involves a team of doctors and healthcare professionals. They’ll work closely with you to determine if you have the disease and the best course of care.
Multiple sclerosis (MS) can cause many different symptoms, which can range from vision problems to weakness to pins-and-needles sensations.
Read on to learn which doctors and healthcare professionals are part of the diagnosis process and can help treat it.
A variety of symptoms can indicate MS, such as fatigue, muscle weakness, vision problems, speech issues, and tremors. But these symptoms can also be associated with other conditions.
If you have any unusual or new symptoms, consider seeing a doctor or primary care physician (PCP) first. After the doctor conducts a physical exam and asks about your medical history, they may refer you to a neurologist.
A neurologist is a doctor who specializes in diseases of the nervous system. You’ll find neurologists in:
- private practices
- community-based MS centers
- academic settings
- general clinical settings
A neurologist is involved in testing, diagnosis, treatment, and symptom management.
Information to have handy
The National Multiple Sclerosis Society suggests it’s a good idea to write down a few things before your appointment. The neurologist will ask many questions to help them make an accurate diagnosis. Having the answers ready will help with the process.
Some questions you may be asked may cover your symptoms (such as how long you’ve had them and their severity), your family medical history, and any other conditions you might have.
Questions to ask
You should also consider writing down questions you’d like the doctor to answer for you. Some things you might want to ask about include your testing, treatment options, and your outlook if you do receive a diagnosis.
Based on your conversation with a neurologist and the information you provide, they may choose to do a physical examination. According to the MS Society UK, they’ll evaluate any changes or difficulties with your eyes, reflexes, coordination, speech, balance, or sensation.
After this, they may refer you to receive the following tests to confirm a diagnosis:
- MRI: This test lets the doctor identify any lesions in your brain and spinal cord.
- Visual evoked potential (VEP) test: This test looks at how long it takes your brain to process information coming from your eyes, ears, or skin.
- Spinal tap: This test looks for certain antibodies, proteins, or inflammatory cells in your spinal fluid.
- Blood tests: These tests let the doctor rule out other conditions.
Between 40% and 65% of people living with MS experience cognitive difficulties. It can cause difficulties with memory, focus, information processing, and problem-solving.
Most cognitive issues related to MS look similar and unlike other types of neurological problems. If you don’t already have a diagnosis, a neuropsychologist may be able to identify the symptoms and refer you for further testing.
After receiving a diagnosis, they can help you manage your mental function. They can also teach you to exercise to help maintain and improve mental function.
A clinical nurse specialist, nurse practitioner, or registered nurse might be involved in your care. These professionals have advanced training.
They can help you in many areas, such as adjusting to the diagnosis you received, counseling, helping take medications, monitoring side effects, and giving infusions of disease-modifying drugs.
A social worker is trained to assist you in identifying and accessing things such as support groups, community services, and other helpful programs. They can also assist you in navigating health payer benefits, getting disability accommodations, or getting unemployment benefits.
Social workers are also trained to identify issues in terms of how MS is affecting your life and those around you and provide counseling, emotional support, and crisis intervention.
Many people living with MS experience mood disorders such as depression or anxiety. Research also shows that getting psychiatric care may help reduce the severity of MS progression.
A psychologist or psychiatrist can diagnose and treat issues related to mental health, such as depression, which is common in MS.
Interventions can include specialized testing and ongoing counseling and support for you and your family. A psychiatrist can also prescribe medications such as antidepressants.
A physiatrist is a doctor who specializes in rehabilitation medicine. They can design a treatment plan to help you function at the highest level possible. This may include assistive devices such as a cane for walking, a splint to support a limp hand or foot, or a wheelchair for getting around.
It can also include designing movements to help strengthen and prevent muscle contractures or stiffness. They can also prescribe medication. The goal is to give you the highest possible quality of life.
Unlike physiatrists, physical therapists (PTs) can’t prescribe medications. They do treat problems that involve balance, coordination, strength, and mobility. PTs assess for things such as muscle strength, tone, and range of motion. They also look at your gait and balance.
PTs help you find the balance between exercise and fatigue by working with you to strengthen your muscles, teaching you to use rehabilitation equipment and mobility devices, and helping you stay fit.
They can be helpful in times when your symptoms subside in order to maintain your health and during relapses in order to help reduce discomfort.
As your disease progresses, your physical needs will change, and a PT can help you determine what you need.
An occupational therapist (OT) will help you stay productive, safe, and independent in your home and work environments.
Treatment may involve modifications of your space, such as in your bathroom, on your stairs, or in your car. They can also help you develop strategies to simplify jobs and conserve your energy.
A dietitian or nutritionist will help you maintain a balanced diet. There’s no diet specific to MS, but eating a balanced diet will help you stay healthy.
Some dieticians are specifically trained to work with people living MS. They
A dietitian can also help determine what foods are safe to eat if you have swallowing problems, based on recommendations from a speech-language pathologist (SLP). This can be soft foods, for example.
They can also monitor you over time to make sure you’re getting all the necessary nutrients and aren’t showing symptoms of any other metabolic conditions.
An SLP can help identify any impact on your speech and if you have problems with things such as:
In the case of swallowing problems, an SLP
If you have speech difficulties, they can help by connecting you with technology that can help with speech production so that you can continue to communicate effectively.
Should I see a rheumatologist or neurologist?
Rheumatologists specialize in diseases or conditions such as arthritis. Since MS affects the brain, a neurologist is better equipped to identify the symptoms. But a person experiencing symptoms such as fatigue or any other symptom that’s not specific to any one condition may see a rheumatologist as part of their search for a diagnosis.
What kind of doctor can diagnose MS?
The primary type of doctor who can diagnose MS is a neurologist. But a PCP and a number of other specialists may be able to recognize some of the symptoms. If you’re concerned, you can start with a PCP and see if they want to refer you to a neurologist.
Where do I find doctors in my area specialized to treat or diagnose MS?
You can look on the website of the National Multiple Sclerosis Society to find health professionals in your area. Medical insurance companies usually also provide a database of practitioners in their network.
If you’re having symptoms and are concerned about MS, you can start by seeing a PCP.
They’ll then usually refer you to a neurologist for diagnosis if they cannot rule out MS based on your examination. If you’re living with the disease, various doctors and healthcare professionals can help you manage the symptoms.