While there’s no cure for multiple sclerosis (MS), there are many treatments available. These treatments mainly focus on slowing down the progression of the disease and managing symptoms.
Different people can have different types of MS. And disease progression and symptoms range greatly from person to person. For both reasons, each person’s treatment plan will be different. Read on to learn about the types of MS treatments available.
Disease-modifying medications can reduce the frequency and severity of MS episodes, or relapses. They also can control the growth of lesions (damage to nerve fibers) and reduce symptoms.
There are currently several drugs approved by the U.S. Food and Drug Administration (FDA) for modifying MS. They come as injectables, infusions, and oral treatments.
These four medications are given as injections:
- interferon beta-1a (Avonex, Rebif)
- interferon beta-1b (Betaseron, Extavia)
- glatiramer acetate (Copaxone, generic versions)
- pegylated interferon beta-1a (Plegridy)
These four therapies must be given by infusion at a licensed clinic:
- alemtuzumab (Lemtrada)
- mitoxantrone (Novantrone)
- natalizumab (Tysabri)
- ocrelizumab (Ocrevus)
These three treatments you take by mouth as pills:
- teriflunomide (Aubagio)
- fingolimod (Gilenya)
- dimethyl fumarate (Tecfidera)
Ending a relapse as quickly as possible benefits both the body and the mind. That’s where relapse treatments come in.
Inflammation is a key feature of MS relapses. It can lead to many other symptoms of MS, such as:
Corticosteroids are often used to ease inflammation and reduce the severity of MS attacks.
Corticosteroids used to treat MS include methylprednisolone (intravenous) and prednisone (oral).
If corticosteroids don’t provide relief for relapses, or if intravenous treatments can’t be used, there are other treatments. These may include:
- ACTH (H.P. Acthar Gel): ACTH is an injection into your muscle or under your skin. It works by prompting the adrenal cortex gland to secrete the hormones cortisol, corticosterone, and aldosterone. These hormones reduce the level of inflammation in your body.
- Plasmapheresis: This processinvolves removing whole blood from your body and filtering it to remove antibodies that may be attacking your nervous system. The “cleansed” blood is then given back to you as a transfusion.
- Intravenous immunoglobulin (IVIG): This treatment is an injection that helps to boost your immune system. However, evidence of its benefits for MS relapses has been inconsistent in clinical studies.
While the drugs listed above help treat MS, a range of medications are available to treat the different physical symptoms that MS can cause.
Drugs for pain and other muscle problems
Muscle relaxants are often prescribed for people with MS. That's because relaxing muscles helps with common MS symptoms such as:
- muscle spasms
Relieving those symptoms can also help with depression, which can occur with MS.
Drugs for muscle stiffness include:
- baclofen (Lioresal)
- cyclobenzaprine (Flexeril)
- diazepam (Valium)
- tizanidine (Zanaflex)
Drugs for fatigue
Fatigue is a common symptom for people with MS. Drugs used to treat fatigue include modafinil (Provigil). They also include amantadine hydrochloride (Gocovri), which is used off-label for this purpose. Off-label use is when a drug that’s approved for one purpose is used for another.
Fluoxetine (Prozac) is also often prescribed since it helps combat both fatigue and depression.
Drugs for bladder and bowel problems
There are more than a dozen prescription medications for bladder problems (such as incontinence) related to MS. Talk to your doctor about which drugs might be best for you.
The most effective medications for constipation and bowel symptoms associated with MS seem to be over-the-counter stool softeners. If you have questions about these products, ask your pharmacist.
Constant movement and activity is critical to fighting MS. Exercise helps:
- improve muscle strength
- increase cardiovascular health
- improve mood
- improve cognitive function
However, people with MS often experience fatigue. And when you’re tired, you may not feel like exercising. But the less exercise you get, the more tired you’ll feel. That’s another reason why exercise, including physical therapy (PT), is so important. However, it needs to be carefully tailored to people with MS. Things such as keeping session times short and increasing exercise over time are important factors.
When to seek PT
Someone with MS should consider PT during a relapse that has produced a change in functions such as:
The goal of PT during relapse is to return to a prior level of function, if possible.
Benefits of PT
A professional PT program will help improve your strength and physical function. It may also include self-care activities such as:
- home exercise programs
- aqua therapy
- a personal fitness program at a gym or health club
Getting out of the house to exercise has the bonus of helping to address depression and social isolation that people with MS can experience.
Where to begin
A good way to start your MS exercise routine is to try basic stretches while you’re sitting or in bed. When you feel comfortable with those exercises, add more demanding exercises such as walking, water exercise, or dancing. As you get stronger and more comfortable exercising, you can modify and build on your exercise program.
Keep in mind that anything you can do with others, especially exercise you enjoy, can help.
If you have MS, physical symptoms aren’t the only things you have to deal with. You may face a constantly changing illness, which can make coping with your condition emotionally challenging. You might feel symptoms that include:
Two popular treatment options are medication and therapy. But while antidepressants can often help relieve symptoms, they may not be enough. And although talk therapy with a licensed practitioner is a good idea, you may need help from someone who has a more personal understanding of MS.
Your next step might be to find someone to talk to who understands what you’re going through. Look to your local MS Society for education, counseling references, and support groups. Talking with people who know what it means to have MS can provide you with coping strategies and remind you that you’re not the only one dealing with this condition.
Coping with MS isn’t easy, but treatment can make a big difference in how you feel, both physically and emotionally. Work with your doctor to develop a treatment plan that addresses your issues and can help improve your physical symptoms and emotional outlook.