Multiple sclerosis (MS) is an autoimmune condition that affects more than 2 million people worldwide. What causes MS is unknown, but scientists believe there may be a triggering event that brings on the disease in those who already have some genetic factors.
There’s no cure, but those living with MS typically have long, productive lives. Advances in treatment have helped make MS a more manageable condition. While MS may still cause challenges, being proactive about treatment can make a big difference.
MS can cause numerous symptoms that vary from person to person. Since symptoms are often mistaken for other illnesses or conditions, MS is hard to diagnose.
There’s no single test to diagnose MS. According to the National MS Society, doctors rely on evidence from a few sources. In order to definitively state that symptoms are the result of MS, doctors must:
- find evidence of damage in at least two areas of the central nervous system.
- find evidence that the damaged occurred at two different points in time.
The tools doctors use to diagnose MS are:
- a comprehensive medical history
- a neurologic exam
- an MRI scan
- an evoked potentials (EP) test
- a spinal fluid analysis
The MRI can confirm MS even if the individual has only had one incident of damage to, or attack on, the nervous system. Similarly, spinal fluid analysis may support an MS diagnosis even if it’s not clear there were attacks at two different points in time. The EP test measures the brain’s response to stimuli, which can show whether the nerve’s pathways are slowing.
Despite all of this evidence, a doctor may still have to perform additional tests to eliminate the possibility of other diseases. Typically these will be blood tests to rule out Lyme disease, AIDS, hereditary disorders, or collagen-vascular diseases.
MS is an unpredictable disease with no cure. No two people experience the same symptoms, progression, or response to treatment. This makes it difficult to predict the course of the disease. It’s important to remember that MS isn’t fatal and most people with MS have a normal life expectancy. Around two-thirds of people with MS remain able to walk, although some may need a cane or other aid to make walking easier because of fatigue or balance issues.
Approximately 85 percent of people with MS are diagnosed with relapsing-remitting MS (RRMS). This type of MS is characterized by mild symptoms and long periods of remission. Many people with this form of MS are able to live their lives with very little disruption or medical treatment.
Half of those with RRMS will eventually progress to secondary progressive MS. This progression often happens at least 10 years after an initial RRMS diagnosis.
Some symptoms of MS are more common than others. Symptoms of MS may also change over time, or from one relapse to another. Some possible symptoms of MS include:
- numbness or weakness, usually affecting one side of the body at a time
- balance and coordination issues
- pain and vision disturbance in one eye
- bladder control issues
- bowel problems
Even when the disease is under control, it’s possible to experience attacks, also called relapses or exacerbations. Medication can help limit the number and severity of attacks. People with MS can also experience extended periods of time with no relapses.
MS is a complex disease, so it’s best treated with a comprehensive plan. This plan can be broken down into three parts:
- Long-term treatment to modify the course of the disease by slowing progression.
- Management of relapses by limiting the frequency and severity of the attacks.
- Treatment of the symptoms associated with MS.
There are currently 15 disease-modifying therapies (DMTs) approved by the FDA for the treatment of relapsing forms of MS.
If you’ve recently received an MS diagnosis, your doctor will likely advise you to start one of these medications immediately. MS can cause several symptoms, ranging in severity. Your doctor will treat these individually using a combination of medications, physical therapy, and rehabilitation. You may be referred to other health professionals experienced in treating MS, such as physical or occupational therapists, nutritionists, or counselors.
If you’re newly diagnosed with MS, you may want to know more about whether the condition will interfere with your current lifestyle, such as your ability to stay active or pursue your career. Most people with MS are able to keep living productive lives. Here’s a closer look at how different areas of your lifestyle could be affected by an MS diagnosis:
Staying active is encouraged by MS experts. Several studies, starting with an academic study in 1996, have found that exercise is an important part of MS management. Along with the usual health benefits, such as a lower risk of cardiovascular disease, staying active can help you function better with MS.
Other benefits of exercise include:
- improved strength and endurance
- improved function
- increased energy
- improved anxiety and depression symptoms
- increased participation in social activities
- improved bladder and bowel function
If you receive an MS diagnosis and you’re having difficulty staying active, consider seeing a physical therapist. Physical therapy may help you gain the strength and stability you need to be active.
In order to manage symptoms and promote overall health, a well-balanced, healthy diet is recommended. There’s no special diet for people living with MS. However, a diet low in saturated fats and rich in omega-3 and omega-6 fatty acids may be beneficial.
Omega-3 is found in fish and flaxseed oil, while sunflower oil is a source of omega-6. The vitamin biotin may also offer some benefit, but the National MS Society notes that biotin may also interfere with lab tests and cause inaccurate results. It’s always important to discuss your dietary choices with your doctor.
Many people who live with MS can work and have full, active careers. According to a 2006 article in the BC Medical Journal, many people decide not to disclose their condition to their employers or colleagues if they have mild symptoms. This led the researchers to conclude that their daily lives were not adversely affected.
Work and career is often a complex issue for people living with MS. Symptoms may change over the course of one’s working life and people face diverse challenges depending on the nature of their work and the flexibility of their employers. The National MS Society has a step-by-step guide to inform people about their legal rights at work, and to help them make decisions about employment in the light of an MS diagnosis.
An occupational therapist can also help you make the appropriate modifications to make it easier to continue with your daily activities at work and home.
Most people living with MS have health insurance, which helps cover the cost of medical visits and prescription medications. However, a 2016 study published by the American Journal of Managed Care found that many people with MS still, on average, paid thousands of dollars out of pocket annually.
These costs were largely linked to the price of vital drugs which help people with MS to manage the condition. The National MS Society notes that rehabilitation, home, and car modifications also pose a significant financial burden. This can pose a major challenge to families, in particular if the person is making changes to their working life as the result of an MS diagnosis.
The National MS Society has resources to help people with MS plan their finances and get assistance for items like mobility aids.
Connecting with others who are living with MS can be a way to find support, inspiration, and information. The search-by-zip-code function on the National MS Society website can help anyone find local support groups. Other options to seek out resources include your nurse and doctor, who may have relationships with local organizations to support the MS community.
MS is a complex condition that affects individuals differently. People living with MS have access to more research, support, and treatment options than ever before. Reaching out and connecting with others is often the first step to taking control of your health.