Multiple sclerosis (MS) is a neurodegenerative and inflammatory immune condition that causes problems throughout the body. It’s caused by a breakdown of the protective cover (myelin sheath) around the nerves. This makes it hard for the brain to communicate to the rest of the body.
The exact cause of MS is still unknown, but doctors do understand the long-term effects and symptoms of MS. Read on to learn more about the effects of MS on your body.
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What we do know is that it affects the nervous system and gradually impacts the whole body. The body’s immune cells attack healthy nerve tissue over time, affecting the body’s internal systems to respond healthily.
Primary versus secondary MS symptoms
Most of the problems described above are primary symptoms associated with MS. This means that they’re directly caused by the nerve damage resulting from attacks to the myelin sheath. Some primary symptoms can be treated directly by trying to slow the nerve damage and prevent MS attacks.
However, once nerve damage exists, secondary symptoms can arise. Secondary MS symptoms are common complications of primary MS symptoms. Examples include UTIs that result from weak bladder muscles, or a loss of muscle tone that results from an inability to walk.
Secondary symptoms can often be treated effectively, but treating the source of the problem can prevent them altogether. As the disease progresses, MS will inevitably cause some secondary symptoms. Secondary symptoms can often be well-managed with medication, physical adaptation, therapy, and creativity.
When someone has MS, their body’s immune system slowly attacks its own myelin sheath, which is composed of the cells that surround and protect the nervous system including the spinal cord and brain. When these cells are damaged, the nerves are exposed and the brain has difficulty sending signals to the rest of the body.
The disconnection between the brain and the organs, muscles, tissues, and cells served by the damaged nerves causes symptoms such as:
Depression and other changes in the brain can be a direct result of MS or an indirect result from the difficulty of coping with the condition.
In rare or advanced cases, nerve damage can cause tremors, seizures, and cognitive problems that closely resemble other neurodegenerative conditions such as dementia.
Vision and hearing loss
Vision problems are often the first sign of MS for many people. Double vision, blurriness, pain, and problems seeing contrast can begin suddenly and affect one or both eyes. In many cases, vision problems are temporary or self-limiting, and likely result from nerve inflammation or fatigue of the eye muscles.
Although some people with MS experience permanent vision problems, most cases are mild and can be effectively treated with steroids and other short-term treatments.
Rarely, people with MS may experience hearing loss or deafness caused by damage to the brainstem. These types of hearing problems usually resolve on their own, but can be permanent in some cases.
Speaking, swallowing, and breathing
According to the National MS Society (NMSS), up to 40 percent of people with MS have speech problems. These include:
- poor articulation
- volume control issues
Such effects often occur during relapses or times of fatigue. Other speech problems can include changes in voice pitch or quality, nasality, and hoarseness or breathiness.
Speech problems can be caused by breathing difficulties that are brought on by weak or damaged nerves that control muscles in the chest. Difficulty controlling the muscles involved in breathing can begin early in the disease and worsen as MS progresses. This is a dangerous yet rare complication of MS that often can be improved through work with a respiratory therapist.
Swallowing problems are less common than speech difficulties, but can be far more serious. They may occur when nerve damage weakens muscles and hinders the body’s ability to control the muscles involved in swallowing. When proper swallowing is disrupted, food or drink can be inhaled into the lungs and increase your risk for infections, such as pneumonia.
Coughing and choking when eating and drinking can be signs of swallowing problems and should be evaluated immediately. Speech or language therapists can often help with trouble speaking and swallowing.
Muscle weakness and balance issues
Many people with MS experience effects to their limbs. Damage to the myelin sheath often results in pain, tingling, and numbness of the arms and legs. Problems with hand-eye coordination, muscle weakness, balance, and gait may occur when the brain has trouble sending signals to the nerves and muscles.
These effects may start slowly and then worsen as nerve damage progresses. Many people with MS first feel “pins and needles” and have difficulty with coordination or fine motor skills. Over time, limb control and ease of walking may become disrupted. In these cases, canes, wheelchairs, and other assistive technologies can aid in muscle control and strength.
People with MS are at higher risk of developing osteoporosis due to common MS treatments (steroids) and inactivity. Weakened bones can make individuals with MS susceptible to fractures and breaks. Although conditions like osteoporosis can be prevented or slowed through physical activity, diet, or supplementation, weak bones can make MS balance and coordination problems even riskier.
A growing body of evidence suggests that vitamin D deficiencies may play an important role in the development of MS. Although its exact impact on individuals with MS isn’t yet well understood, vitamin D is vital to skeletal health and immune system health.
MS is thought to be an immune-mediated disease. This means that the body’s immune system attacks healthy nerve tissue, which causes nerve damage throughout the entire body. Immune system activity seems to result in the inflammation responsible for many MS symptoms. Some symptoms may flare up during an episode of immune system activity and then resolve when the episode or “attack” ends.
Some research is investigating whether suppressing the immune system with medication will slow the progress of MS. Other therapies try to target particular immune cells to prevent them from attacking the nerves. However, drugs that suppress the immune system may make people more vulnerable to infection.
Some nutrient deficiencies may affect immune health and worsen MS symptoms. However, most MS physicians only recommend special diets when a specific nutrient deficiency is present. One common recommendation is a vitamin D supplement — this also helps prevent osteoporosis.
Problems with bladder and bowel functions commonly occur in MS. Such issues can include:
- loss of bowel control
In some cases, diet and physical therapy or self-care strategies can reduce the impact of these problems on daily life. Other times, medications or more intense intervention may be necessary.
The use of a catheter may occasionally be necessary. This is because nerve damage affects how much urine those with MS can comfortably hold in the bladder. This can result in spastic bladder infections, urinary tract infections (UTIs), or kidney infections. These problems can make urination painful and very frequent, even overnight or when there’s little urine in the bladder.
Most people can effectively manage bladder and bowel problems and avoid complications. However, serious infections or hygiene problems may arise if these problems are left untreated or unmanaged. Discuss any bladder or bowel issues and treatment options with your doctor.
MS doesn’t directly impact the reproductive system or fertility. In fact, many women find that pregnancy offers a nice reprieve from MS symptoms. However, the NMSS reports that 2-4 out of 10 women will experience a relapse during the postpartum period.
However, sexual dysfunction, such as difficulty experiencing arousal or orgasm, is common in people with MS. This can be caused by nerve damage or by MS-related emotional problems such as depression or low self-esteem.
Fatigue, pain, and other MS symptoms can make sexual intimacy awkward or unappealing. However, in many cases, sexual problems can be addressed successfully through medication, over-the-counter aids (such as lubricant), or a bit of advanced planning.
Circulatory system problems are rarely caused by MS, although weak chest muscles can lead to shallow breathing and low oxygen supply. However, lack of activity due to depression, difficulty using muscles, and a preoccupation with treating other problems may prevent people with MS from focusing on the risk of cardiovascular disease.
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Treating MS from head to toe
While there’s no cure for multiple sclerosis, a wide variety of medications, herbal remedies, and dietary supplements may help alleviate symptoms. Treatment can also modify the disease by preventing its progression and overall effects on your body.
MS affects everyone differently. Each person experiences a unique set of symptoms and responds to treatments individually. Therefore, you and your doctors should customize your treatment regimen to address your MS symptoms specifically and alter it as the disease progresses or relapses. A carefully designed treatment plan can help make MS more manageable.