Multiple Sclerosis (MS) is an autoimmune disorder that affects the central nervous system, especially the brain and spinal cord. As MS progresses, your nerves may become damaged and your quality of life may decrease as a result. There are several different ways that your MS can be treated, but the type of treatment will depend on how progressed your MS is and what your symptoms are. There is no cure for MS, but learning how to treat the symptoms of MS can slow down the disease’s advancement and help improve your quality of life.
Corticosteroids can help reduce inflammation of the nerves, the primary site of MS effects. Common corticosteroids that are prescribed by an MS specialist for for MS include prednisone (usually taken orally) and methylprednisolone (usually administered intravenously). Though often effective, corticosteroids carry numerous unpleasant side effects, including insomnia, elevated blood pressure, mood swings/irritability, and fluid retention in the body.
Undergo plasma exchange.
Plasma exchange, also known as plasmapheresis, helps many MS patients during a period of MS attacks. During plasmapheresis, plasma is drawn and the blood cells mixed with albumin (a protein solution) before being returned to the body.
Plasma exchange is primarily used in patients with new symptoms, severe symptoms, or symptoms that have not responded to other treatment methods like steroids.
Plasma exchange may be performed when you are under the care of an MS specialist.
Try physical therapy.
Many people experiencing an MS attack/flare up suffer from symptoms like blurred vision or exceptionally spastic muscles. One way to help reduce the issues related to muscle control and regain control of your limbs is through physical therapy, though some experts recommend using physical therapy exercises in conjunction with a course of corticosteroids for maximum effectiveness.
Take muscle relaxants.
Many people suffering from MS experience painful muscle stiffness and/or muscle spasms. This may target any part of the body but seems to be most prevalent in the legs. Taking muscle relaxants can help reduce spasms and ease the pain associated with muscle stiffness.
Commonly-prescribed muscle relaxants for MS patients include baclofen (Lioresal) and tizanidine (Zanaflex).
Manage bladder/bowel problems.
A common symptom of MS as the disease weakens the nerves and muscles is the loss of bladder and bowel control. How you manage these symptoms will vary, depending on the severity and advancement of your MS. To help manage bladder and bowel problems, your doctor may advise you to:
Stay on schedule – a daily schedule can be extremely helpful for bowel problems. But it can also be helpful for managing urinary problems. By staying on a regular schedule and “training” your bladder to prolong the need to urinate until the next scheduled bathroom break, you may be able to increase your ability to control your excretory needs.
Do Kegel exercises – Kegel exercises strengthen the muscles in your pelvis, which can help improve bladder control. To start out doing Kegel exercises, you’ll need to squeeze/tense the muscles you use to control the flow of urine. Hold the squeeze for three seconds, then release. Repeat the process 10 to 15 times per session, and try to practice at least three times each day. As you strengthen your muscles, add one additional second each week until you’re able to tense the muscles for 10 seconds at a time.
Take medication for your bladder – there are a number of medications that can help control the muscles which may be contributing to your bladder problems. Common medications for bladder problems include Darifenacin (Enablex), Fesoterodine (Toviaz), Imipramine (Tofranil), and Oxybutynin (Ditropan).
Eat more fiber – Adding fiber to your diet, in conjunction with drinking more fluids, may help manage some bowel problems. Try eating whole grain breads, cereals, and fresh fruits and vegetables, or ask your doctor about taking a fiber supplement.
Use stool softeners – if you experience frequent constipation, talk to your doctor about taking a stool softener to help facilitate bowel movements.
Talk to your doctor about any over-the-counter medications you’re considering, especially if you experience diarrhea.
Get more physical activity.
Though the symptoms of MS may limit your ability to engage in physical activity, some patients find that physical activity can help improve physical and mental wellbeing. Common activities include exercise, yoga, and meditation.
Try medical cannabis.
You may find some relief of your muscle spasms and pain by trying cannabis, if you live in a place that permits its medical use. The American Academy of Neurology recognizes that medical cannabis, when smoked or taken orally (extracts as well as synthetic cannabinoids), can help patients suffering from a number of MS symptoms. However, marijuana is not for everyone. Talk to your doctor about the potential benefits and risks of using marijuana.
In the United States, 23 states and the District of Columbia have passed laws that allow patients with qualifying conditions to legally purchase or grow, possess, and use medical marijuana.
The use of medical marijuana is also permitted in Canada.
Find out if your state, province, or country permits the use of medical marijuana by searching for medical cannabis laws in your region. If you live in a place that permits the medical use of marijuana and you believe that it may help with your MS symptoms, talk to your doctor about the benefits and side effects of medical marijuana.
Take beta interferons.
Beta interferons are frequently prescribed and monitored by an MS specialist to manage relapsing forms of MS. These medications are injected intravenously and have been proven to reduce both the frequency and the severity of MS relapses. Liver damage is a possible side effect of using beta interferons, so it’s important to have regular blood tests performed by your doctor to monitor your liver enzymes for damage.
Common beta interferons include interferon beta-1a (such as Avonex and Rebif) and interferon beta-1b (like Betaseron and Extavia).
Try glatiramer acetate.
This medication must be prescribed and monitored by an MS specialist. It is administered intravenously and it can help control the body’s immune system attack on the body’s myelin nerve sheaths. This protein may help reduce the number of relapses a patient experiences, and may delay or even prevent permanent disability.
Copaxone is a commonly-prescribed glatiramer acetate medication.
Use dimethyl fumarate.
Dimethyl fumarate is an oral medication prescribed and monitored by an MS specialist that can help reduce MS relapses. It is typically taken twice a day. Side effects may include diarrhea, flushing, nausea, and a lowered white blood cell count.
Tecfidera is a commonly-prescribed dimethyl fumarate.
This medication that is also prescribed and monitored by an MS specialist can help reduce the frequency of relapses by preventing your immune system from attacking the nerves in your brain and/or spinal cord. Taking fingolimod may also delay or even prevent permanent disability.
Fingolimod is typically taken orally, once each day.
Taking fingolimod may slow your heart rate and cause high blood pressure or blurred vision. Your doctor will monitor your heart rate for at least six hours after administering your first dose of fingolimod.
Teriflunomide is prescribed and monitored by an MS specialist. This medication is taken orally, once each day, to prevent or reduce MS relapses. Teriflunomide can have numerous side effects of varying degrees of severity, including liver damage and hair loss. Teriflunomide should not be taken by women who are pregnant or who may become pregnant, or by the male partner of a woman who may become pregnant, as it can cause severe damage to a developing fetus.
Natalizumab may help prevent immune cells from traveling to the brain and spinal cord, thereby reducing the chances of nerve damage at these sites. It is often effective at treating relapsing forms of MS, though it may also increase the risk of experiencing a viral infection in the brain. Talk to your doctor about the benefits and potential risks of natalizumab.
A prescription and monitoring by an MS specialist is required.
Alemtuzumab works by targeting a protein that is located on the surface of immune cells in your body. It also depletes your body’s white blood cell count, which may reduce the chances of nerve damage, but it also carries risks. Some patients have an increased risk of infections and autoimmune complications due to the reduced white blood cell count.
Alemtuzumab is prescribed and monitored by an MS specialist, administered over five consecutive days, then followed up with another three days of drug infusions one year after the initial treatment.
Mitoxantrone is an immunosuppressant that may help treat severe and advanced-stage MS. However, its use is typically limited due to the risk of heart damage and blood cancer. Talk to your doctor about the benefits and potential risks of using mitoxantrone.
This drug also requires a prescription and monitoring by an MS specialist.