How is multiple sclerosis (MS) treated?
There is currently no cure for multiple sclerosis. A combination of medicines, physical, speech and occupational therapies may help you cope with and relieve your symptoms, slow the progress of the disease and maintain a good quality of life.
How can medicines help?
Some medicines for MS can help relieve symptoms and treat specific problems. Other medicines can affect the long-term outcomes of the disease.
Some people who have mild symptoms choose not to take certain medicines because of the risks associated with them and the possibility of serious side effects. Your doctor will talk to you about the risks and benefits of taking medicines to treat MS.
What symptoms of MS can medicines treat?
Specific medicines can treat some of the common symptoms of MS. These include:
- Bladder problems: tolterodine, oxybutynin
- Constipation: stool softener, laxative
- Depression: venlafaxine, paroxetine
- Erectile dysfunction: tadalafil, alprostadil
- Pain: phenytoin, gabapentin
- Muscle stiffness and spasms (spasticity): dantrolene, baclofen
- Urinary problems: desmopressin, methenamine, phenazopyridine
What about steroids?
During flare-ups, affected nerve areas can become inflamed. You may have pain and loss of function in parts of your body. Steroids reduce inflammation, so that you can return to normal function sooner. Some examples of steroids given for MS include prednisone (taken by mouth) and methylprednisolone (given as a shot). Steroids are usually taken for a short period of time to help with symptoms. They do not treat the long-term outcomes of MS.
What medicines treat the long-term effects of MS?
Interferons are a group of natural proteins made by human cells. Interferons seem to slow the worsening of symptoms of MS over time. These kinds of medicine are usually given as an injection (a shot). Some examples of interferons used to treat MS include IFN Beta-1a and IFN Beta-1b. Interferons may cause serious liver damage as a side effect. Other side effects include flu-like symptoms and depression.
Glatiramer acetates are thought to block the cells that damage myelin, the substance that surrounds and protects your nerve cells. People taking this drug usually experience fewer relapses and fewer new nerve cell lesions. The medicine is given as a shot (injected with a needle) once a day. Side effects may include hives or pain at the injection site, heart palpitations and shortness of breath.
What other medicines are used to treat MS?
Natalizumab and mitoxantrone are 2 other kinds of medicine that treat more serious or advanced multiple sclerosis.
People who have tried other drugs first and have not had good results may try natalizumab. However, natalizumab can have serious side effects, and it should not be used in combination with other disease-modifying drugs. One of the known side effects is an increased risk of a fatal brain infection.
Mitoxantrone is sometimes used by people whose relapsing-remitting MS has worsened or changed to progressive MS, in which symptoms get steadily worse. Side effects include lowered resistance to infection, and increased risk of blood and heart disease.
How can other therapies help?
Different therapies can be helpful for some people who have MS. Some of the common ones are listed below.
Physical Therapy (PT) can help with walking, strength, balance, posture, fatigue and pain. PT can include stretching and strengthening exercises, and training to use mobility aids like canes, scooters or wheelchairs. Your physical therapist can also help you adapt your exercise routine to accommodate your symptoms or flare-ups.
Occupational Therapy (OT). The goal of OT is to help improve your level of independence and safety at home and at work. Your therapist can show you how to use tools to help in daily tasks. Your therapist can also recommend changes to your physical living or working space to make your tasks easier. Your therapist may help you continue to pursue activities or hobbies that you enjoy.
Speech Therapy. MS can cause problems with the control of the muscles used for talking and swallowing. A speech therapist can help you learn to communicate as clearly as possible, and also teach you to practice safe swallowing.
How can I keep myself as healthy as possible?
Living with MS may require you to make some lifestyle changes. These changes can help keep you as strong and healthy as possible. Below are some tips that may help.
Nutrition. Eat a nutritious, well-balanced diet that is low in fat and high in fiber. A healthy diet will keep your immune system strong, and give you the best chance of good health.
Physical Activity. Continue to exercise if your doctor says it is okay. Exercise can help you improve muscle tone and strength, balance and coordination. Stretching exercises can help with stiffness and mobility. Exercise can also help lift your mood.
Rest. It is important to get enough exercise, but it is also important to get plenty of rest. MS causes fatigue, so pay attention to your needs. You may have to make accommodations in your work or family schedule to include time for rest.
Temperature. Some people who have MS aren’t bothered by heat, but be careful using hot tubs or saunas, and taking hot baths or showers. Too much heat can lead to extreme muscle weakness. If heat bothers you, find ways to cool down. A cool bath or air conditioning may help.
Support. Get support from friends, family, your community, a support group, your doctor or other health care professionals. Encouragement and reassurance from others will help you better cope with the challenges of living with MS. Try to maintain as normal a life as you can, and continue to do the things you enjoy.
Written by familydoctor.org editorial staff