The roots of MS remain mysterious, but doctors see some surprising trends. It’s most common in regions far from the equator, including Scandinavia and other parts of Northern Europe. These areas get less sunlight, so some researchers believe that vitamin D (the “sunshine vitamin”) may be involved. Research suggests a possible link between vitamin D deficiency and autoimmune disorders, but studies are ongoing. Genetics appear to play a role, as well.
MS is at least twice as common in women as it is in men. While it can strike people of any race, Caucasians appear to be most at risk. The chances of developing the condition are highest between ages 20 and 50.
Tests are often used, along with a medical history and neurological exam, to diagnose MS and rule out other causes of symptoms. More than 90% of people with MS have scar tissue that shows up on an MRI scan. A spinal tap can check for abnormalities in the fluid that bathes the brain and spinal cord. Tests to look at the electrical activity of nerves can also help with diagnosis. Lab tests can help rule out other autoimmune conditions or infections such as HIV or Lyme disease.
MS is different in every person. Doctors usually see four forms:
Research suggests that the disease may be more active during the summer months. Heat and high humidity may also temporarily worsen symptoms. Very cold temperatures and sudden changes in temperature may aggravate symptoms, as well.
Treating MS: Medications
While there is no cure for MS, there are “disease-modifying drugs” that can reduce the frequency and severity of MS attacks. Use can result in less damage to the brain and spinal cord over time, slowing the progression of disability. When an attack does occur, high-dose corticosteroids can help cut it short. Many drugs are also available to manage troubling MS symptoms, such as muscle spasms, incontinence, and pain.
Treating MS: Pain Management
About half of people with MS develop some form of pain, either as a result of a short circuit in the nervous system or because of muscle spasms or strain. Doctors may prescribe antidepressants and anticonvulsant medications to ease nerve pain. Pain medicines and anti-spasm drugs may also be used. Muscle pain often responds well to massage and physical therapy. Be sure to discuss the options with your doctor if you find yourself in pain.
Treating MS: Physical Therapy
If MS affects balance, coordination, or muscle strength, you can learn to compensate. Physical therapy can help strengthen muscles, combat stiffness, and get around more easily. Occupational therapy can help retain coordination in your hands for dressing and writing. And if you’re having trouble speaking or swallowing, a speech therapist can help.
Complementary Therapies for MS
Many nontraditional therapies for MS have not been well studied. Some people say acupuncture relieves symptoms such as muscle spasms and pain, but research to confirm its value isn’t conclusive. Others have reported benefits from injections of bee venom, but a rigorous study, lasting 24 weeks, showed no improvements in disability, fatigue, or the number of MS attacks. It’s important to inform your doctor about any supplements, special diets, or other therapies you want to try.
MS and Pregnancy
Doctors generally agree that it’s safe for women with MS to get pregnant. Research suggests no increased risk of complications during pregnancy. In fact, many women have fewer MS symptoms during pregnancy. High levels of hormones and proteins may suppress the immune system, reducing the odds of a new attack. It’s best to talk with your doctors before pregnancy, as certain MS drugs should not be used while pregnant or nursing. In the early months after delivery, the odds for a relapse can rise.
Staying Mobile With MS
The vast majority of people with MS are able to continue walking, though many benefit from some type of assistive device. Orthotic shoe inserts or leg braces can help increase stability. When one leg is stronger than the other, a cane can help. People with significant problems with their legs may need to use a walker. And a wheelchair or scooter may be best for those who are very unsteady or tire easily.
Adapting Your Home for MS
Making a few changes around the home can help you manage daily activities on your own. Install grab bars inside and outside the shower or tub. Use a non-slip mat. Add an elevated seat and safety rails to the toilet. Lower one of your kitchen counters so you can reach it from a sitting position. And get rid of any throw rugs, which are a tripping hazard.
MS and Exercise
Exercise can ease stiffness, fatigue, and other symptoms of MS. But overdoing it could make things worse. It’s best to start slowly. Try exercising for 10 minutes at a time, then gradually working your way up to a longer session. Before you begin, check with your doctor about what type of activity and level of intensity would be most appropriate. A few possibilities include water aerobics, swimming, tai chi, and yoga.
Outlook for MS
Most people with MS live a normal or near-normal lifespan. While the condition may make it more difficult to get around or complete certain tasks, it doesn’t always lead to severe disability. Thanks to effective medications, rehab therapies, and assistive devices, many people with MS remain active, stay in their jobs, and continue to enjoy their families and favorite activities.
Medically Reviewed by Gabriela Pichardo, MD
This article does not provide medical advice.