Staying Able with Multiple Sclerosis

Multiple sclerosis treatment guide

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If you have been diagnosed with multiple sclerosis (MS), do not be disheartened. Even without a cure, there are drug treatments and other therapies that allow MS patients to continue living normal lives.

What is multiple sclerosis?

MS is a neurological disorder, meaning it affects the nervous system.

Researchers and doctors do not know the exact cause of MS. It is possible that a variety of factors - including genetics and infections - are involved in the development of MS.

Most experts maintain that MS is an autoimmune disease in which your body's immune system mistakenly attacks its own healthy tissues and cells. These attacks lead to inflammation of the central nervous system (brain and spinal cord), which can damage the protective layer that covers your nerves.

This nerve damage can cause problems with the communication between your brain and the rest of your body. Some MS patients may eventually lose the ability to talk or walk. Other patients may experience very few symptoms. The severity of the disease depends heavily on the level of nerve damage.

Symptoms of MS are different from person to person, depending on where the damaged nerves are located. Some of the more common signs and symptoms of MS include:

  • numbness or tingling in the arms, legs, face, or any other part of the body
  • trouble walking
  • speech problems
  • coordination problems
  • painful muscle spasms
  • eye pain
  • total or near-total loss of vision
  • reduced attention span
  • memory loss
  • dizziness
  • fatigue, which is often worse in the late afternoon

Most patients experience symptoms of MS in episodes, followed by periods without symptoms. This form of MS is called relapsing-remitting MS, and it is especially common in the beginning stages of the disease.

At the moment, there is no clear way to prevent or cure MS. However, MS patients have quite a few therapies to choose from. Some of these therapies are designed to treat symptoms, while others can alter the course of the disease itself.

Before starting any MS treatments, make sure to talk with your doctor to find what is the right course of action for you.

What are the medications used in the treatment of multiple sclerosis?

Without a cure, patients and doctors must find ways to keep the damage caused by MS to a minimum.

There are three main strategies involved in the treatment of MS: treating attacks, changing the course of the disease, and treating symptoms.

Treating attacks

The majority of MS patients have the relapsing-remitting form of the disease. This means they will experience periods without symptoms followed by episodes of acute symptoms that will last for at least 24 hours.

These episodes, or attacks, are commonly treated with steroids. These drugs reduce the inflammation that occurs during an attack.

Doctors prescribe steroids to reduce the intensity and length of an attack, and to cut down on any irreversible damage caused by the attack.

Some examples of steroids - which are known more formally as corticosteroids - used in the treatment of MS include:

  • Deltasone (prednisone)
  • Liquid Pred (prednisone)
  • Medicorten (prednisone)
  • Orasone (prednisone)
  • Intravenous methylprednisolone (an injected form of the drug Medrol)

As steroids can cause long-term side effects like high blood pressure and an increased risk of infection, doctors usually prescribe a high-dose, short-term treatment plan.

Steroids have no long-term effect on the progression of MS. As such, the benefits of long-term steroid use do not outweigh the risks of other health problems.

Changing the course of the disease

While some patients may have very mild symptoms and require little treatment, other patients need strong drug treatment to save them from irreversible damage to their nerves and bodies.

Over time, MS can take a huge toll on your central nervous system. As the disease progresses, the nerves in your brain and spinal cord can become permanently damaged.

In order to prevent this permanent damage, doctors commonly prescribe one of eight FDA-approved drugs for the long-term treatment of MS.

These drugs include:

Avonex, Betaseron, Extavia, and Rebif are part of a class of drugs known as beta interferons. These drugs slow down the rate at which MS gets worse over time. As interferons can cause side effects like liver damage, patients taking these drugs should get frequent blood tests to keep an eye on the health of their liver.

Doctors prescribe Copaxone because it seems to block the immune system's attack on myelin - the protective layer that covers the nerves. This drug is taken through injection under the skin. Some patients have reported side effects including shortness of breath and flushing.

Gilenya is a drug taken orally. It prevents permanent nerve damage by trapping immune cells in lymph nodes. In other words, Gilenya works by reducing the activity of the immune cells that attack your body's healthy myelin.

After taking your first dose of Gilenya, you may experience a slower heartbeat. For this reason, you should have your heart monitored for six hours after taking the drug for the first time. Other side effects of Gilenya include high blood pressure and blurred vision.

Tysabri works similarly to Gilenya. It keeps harmful immune cells from making contact with your central nervous system. Tysabri does not allow immune cells to move from your bloodstream to your brain and spinal cord.

Doctors can be hesitant to prescribe Tysabri because it increases the risk of a deadly brain infection called progressive multifocal leukoencephalopathy. Typically, doctors prescribe Tysabri only if other treatments have failed or caused serious side effects.

Novantrone is a drug that suppresses the activity of the immune system. While the drug may prevent nerve damage, it can also hurt your heart and possibly lead to leukemia. For these reasons, Novantrone is only prescribed in the most severe cases of advanced MS.

Treating symptoms

There are a variety of symptoms associated with MS. Some of these symptoms - such as muscle stiffness and bowel control problems - are directly caused by nerve damage. Other symptoms - such as depression - are the byproducts of living with a debilitating disease.

Regardless of a symptom's source, MS patients need to seek treatment. Such treatment often involves medications.

Muscle relaxants are used to treat muscle spasms and stiffness. Examples of muscle relaxants prescribed to MS patients include:

  • Lioresal (balcofen)
  • Zanaflex (tiznidine)

Fatigue is another problem among many patients suffering from MS. Symmetrel (amantadine) is used to reduce fatigue.

A whole variety of other drugs are used to treat the many symptoms of MS. Some patients may need medications for depression, while others may need drugs to control pain. Some patients even may need drugs that address bladder and bowel control problems.

What natural therapies are used in the treatment of multiple sclerosis?

When it comes to MS, natural treatments mainly address symptoms, rather than the disease itself. That is, there are no natural treatments known to alter the course of the disease. Instead, natural treatments can improve mobility, pain, and overall quality of life.

Physical therapy and exercise

While exercise will not save you from nerve damage, it can keep you healthy and strong enough to complete those daily tasks that become hard for many people with MS. Physical activity and exercise can build strength and muscle tone, improve balance and coordination, and reduce depression.

MS patients can benefit from a variety of exercises, including stretching, aerobic exercise, and muscle strengthening.

Working with a physical therapist, you can find the types of exercises that work best for your specific symptoms. Your physical therapist can also help you figure out the best way to use devices such as canes or crutches.

Occupational therapy

Over time, MS can make it difficult to complete daily tasks that were once simple. You may find it hard to dress yourself or cook a meal.

Occupational therapists can help you learn how to adapt to these tasks in your home and workplace. They can guide you through the use of assistive devices you may need in your bathroom, bedroom, and kitchen. They can also assess and treat memory and thinking problems.

Speech and language therapy

MS can lead to problems with speech and communication. Speech and language therapists can run you through exercises to improve your ability to pronounce words and communicate. They can also show you exercises to fix problems with swallowing.

Diet

Your diet is key to maintaining a strong immune system. As the immune system is a central player in MS, it is important to eat a healthy, well-balanced diet.

Cooling down

Heat has been shown to make symptoms worse in people with MS. While these increased symptoms typically fade within a few hours, cooling techniques can help to lessen fatigue and increase stability.

Useful cooling techniques include:

  • cold baths, especially if your whole torso is submerged
  • the use of air conditioners in the summer
  • keeping the house slightly cool during winter
Stress relief

Stress can trigger symptoms of MS. In fact, stress may make your symptoms worse. That is why it is important to learn to relax.

A variety of activities can help you relax; it is only a matter of finding which one is most effective for you. Such activities include:

  • meditation
  • yoga
  • tai chi
  • biofeedback
  • massage
  • acupuncture

It is important to remember that there is limited research on the effects of these natural therapies. Until more research is done, it is hard to say which strategies are safest and most effective. However, many of these natural therapies are part of living a healthy life in general. Taking care of your body as a whole will likely help you in your battle with MS.

Working with your doctor, physical therapist, and other therapists, you can find the most beneficial combination of medical treatments and natural therapies that keep your symptoms at a minimum while slowing the progress of your disease.