Multiple sclerosis, or MS, is a long-lasting disease that can affect your brain, spinal cord, and the optic nerves in your eyes. It can cause problems with vision, balance, muscle control, cognitive issues and other symptoms.The effects are often different for everyone who has the disease. Some people have mild symptoms and don’t need treatment. Others will have trouble getting around and doing daily tasks.
MS happens when your immune system attacks a fatty material called myelin, which wraps around your nerve fibers to protect them. Without this outer shell, your nerves become damaged. Scar tissue may form.
The damage means your brain can’t send signals through your body correctly. Your nerves also don’t work as they should to help you move and feel. As a result, you may have symptoms like:
- Trouble walking
- Feeling tired
- Muscle weakness or spasms
- Blurred or double vision
- Numbness and tingling
- Sexual problems
- Poor bladder or bowel control
- Problems focusing or remembering
The first symptoms often start between ages 20 and 40. Most people with MS have attacks, also called relapses, when the condition gets noticeably worse. They’re usually followed by times of recovery when symptoms improve. For other people, the disease continues to get worse over time.
In recent years, scientists have found many new treatments that can often help prevent relapses and slow the disease’s effects.
What Causes MS?
Doctors don’t know for sure what causes MS, but there are many things that seem to make the disease more likely. There are many theories floating around out there. People with certain genes may have higher chances of getting it or if you grew up in your childhood years in colder climates.
Some people may get MS after they’ve had a viral infection — like the Epstein-Barr virus or the human herpesvirus 6 — that makes their immune system stop working normally. The infection may trigger the disease or cause relapses. Scientists are studying the link between viruses and MS, but they don’t have a clear answer yet.
Some studies suggest that vitamin D, which you can get from sunlight, may strengthen your immune system and protect you from MS. Some people with higher chances of getting the disease who move to sunnier regions seem to lower their risk.
There are three main types of MS. They vary in their symptoms, disease course, and how they are treated.
Relapsing-remitting MS: About 85 to 90 percent of people with MS are first diagnosed with this form. During relapses, you’ll experience neurological symptoms and functionality will decline. During remissions, symptoms may disappear or just become milder. Remission may last weeks or months.
Secondary-progressive MS: Some people with relapsing-remitting MS eventually develop secondary-progressive MS. It has a more progressive disease course in which symptoms become chronic and irreversible.
Primary-progressive MS: Symptoms slowly, but steadily get worse over time. Relapses don’t occur, and the rate of worsening varies greatly. This is a less common type, accounting for about ten percent of cases. It tends to affect the spinal cord more than the brain.
The less common types (or secondary) MS are Benign and Malignant or Fulminant MS.
In the central nervous system of a healthy person, nerve cells in the brain and spinal cord rapidly send signals to each other and to the rest of the body. But in a person with MS, this signaling is impaired due to damage to the myelin. Nerve impulses are either slow or not transmitted at all, and that causes a vast array of symptoms.
Which MS symptoms each person with MS experiences is unique to them, but some are more common than others because the disease tends to affect certain locations within the central nervous system.
Fatigue is one of the most common symptoms of MS, occurring in about 80 percent of people. It can significantly interfere with a person’s ability to function at home and work, and is one of the primary causes of early departure from the workforce. Fatigue may be the most prominent symptom in a person who otherwise has minimal activity limitations.
The cause of MS fatigue is currently unknown. Ongoing studies seek an objective test that can be used as a marker for fatigue, and for precise ways to measure it. Some people with MS say that family members, friends, co-workers or employers sometimes misinterpret their fatigue and think they are depressed or just not trying hard enough.
Other common symptoms of MS include:
- Abnormal sensations (e.g.., numbness and tingling, itching, tightness, burning)
- Muscle weakness
- Cognitive problems
In people who experience remission, symptoms might go away entirely. In others, they may become milder. Some people, however, have no periods of improvement.
Diagnosing MS can be difficult at times, and it’s especially hard to confirm it based on symptoms alone given that they can come and go and be rather nebulous. A medical history, physical examination, tests such as blood tests and magnetic resonance imaging (MRI) of your brain and/or spinal cord are usually needed to determine if you do, in fact, have MS.
If you’re having new symptoms that could point to MS, see your doctor. He or she will likely refer you to a neurologist if the disease is suspected.
You’ve got a lot of treatment options for combatting MS. Disease-Modifying-Drugs (DMD) include:
- Injectable drugs such as Avonex, Betaseron, Rebif, and Plegridy
- Pills such as Gilenya (fingolimod), Tecfidera (dimethyl fumarate), and Aubagio (teriflunomide), Mayzent® (Siponimod)
- Infusions such as Lemtrada (alemtuzumab), Novantrone (mitoxantrone), Tysabri (natalizumab), and Ocrevus (ocrelizumab)
Most of them are for relapsing types of the disease, but evolving research on treatments for progressive MS are improving that picture. Ocrevus is the first FDA-approved treatment for both relapsing and primary-progressive MS.
Being diagnosed with any chronic condition is scary. You’ve probably been forced to make changes to your life and to accept the impact of MS on your body and your quality of life.
- Learn all you can: Knowledge is power, and it can give you some control over the unpredictable nature of this condition.
- Prepare for doctor’s visits: It’s a good idea to devise a list of questions prior to your appointment and/or bring someone along with you, so you’re sure to get the answers that you need.
- Commit to treatment: It’s important for your peace of mind and MS care to establish an open, trusting relationship with your healthcare team. Ask them about proper ways to communicate and what constitutes an emergency. Stick to your medications, and wellness plan with your Wellness Coach. Communicate all concerns, like negative side effects, to your team of professionals.
- Consider changes: Healthy lifestyle habits like stress management, a healthy diet, regular exercise (that especially encourages balance and flexibility), connecting mind+body+spirit, smoking cessation, and sleep hygiene are beneficial with MS and for good overall health.
- Give your brain a workout: Research suggests that brain training can improve your mental function with MS. Reading, playing games, doing puzzles, or actively trying to learn new skills can help keep your brain sharp.
In Health & Wellness
Jen Martin | The MS Wellness Coach