Multiple sclerosis (MS) is a terrible disease, often progressing to the point where a person can no longer walk or take care of themselves. It can consume a person’s life, transforming them from an active person into a wheelchair invalid.
But what exactly is MS? How does it work? What causes it? And how can it be treated? You probably know someone with the disease and yet don’t even know how they contracted it.
Never fear. In this post, we’re going to give you a simple how, what, and why for MS. We’re going to walk through the source of the disease, the symptoms, and how it can be treated.
At the end of the post, we’ll look at some exciting developments in the research that can give hope to those suffering.
What Is Multiple Sclerosis?
Multiple sclerosis is a devastating disease that affects around 400,000 people in the United States. The ratio of women to men with MS is 2:1, and if you have a parent or sibling with MS, there’s a 1-3% chance of developing it.
The disease is caused by the immune system attacking the myelin, which is a protective sheath covering nerves and fibers throughout the body. As this occurs, communication problems begin developing between the brain and the rest of the body. As time passes, the nerves can deteriorate and become irreversibly damaged.
For a simple explanation of MS, check out this short video:
As Healthline notes:
Researchers still aren’t certain what causes MS. One leading hypothesis is that it’s a genetic predisposition combined with an environmental or viral factor. People with other autoimmune diseases, especially type 1 diabetes, thyroid disease, or inflammatory bowel disease, are at a slightly increased risk of developing MS. Researchers are also studying the relationship between MS and infections such as Epstein-Barr, herpes, and varicella-zoster, among others.
While symptoms of the disease tend to vary on a patient by patient basis, early symptoms often include:
- Blurred or double vision
- Thinking problems
- Clumsiness or a lack of coordination
- Loss of balance
- Weakness in an arm or leg
- And others
Right now, there is no cure for the disease, there are only ways to manage it. Fortunately, there are ways to slow the disease, with some exciting new research on the horizon.
What Are The Standard Treatments?
Although treatments will vary for each case, standard treatments typically fall into three categories:
- Treatments for attacks
- Treatments to slow the progression of the disease
- Treatments for symptoms
Treatments For Attacks
Corticosteroids, like prednisone and methylprednisolone, can be used to minimize and reduce nerve inflammation.
A plasma exchange, where your blood plasma is removed, separated from the blood cells, mixed with a protein solution (albumin), and then injected back into your body can also be used to treat attacks. This method of treatment is typically used with severe attacks that fail to respond to steroids.
Treatments To Slow The Progression
To understand these treatments, you need to know the difference between primary-progressive MS and relapse-remitting MS.
- Primary-progressive MS features a constant and worsening progression of the disease with no clear relapses.
- Relapse-remitting MS features flare ups and then relapses. During the relapses, the body begins to recover.
There is only one FDA-approved disease-modifying therapy for primary-progressive MS: ocrelizumab (also known as Ocrevus).
However, there are a number of treatments for relapse-remitting MS.
- Beta interferons. Injected under the skin or directly into muscles, these drugs can lessen the frequency and intensity of relapses. Side effects include: flu-like symptoms and reactions at the injection site. Liver damage is also a possibility, making it essential to monitor the liver enzymes.
- Ocrelizumab (Ocrevus). As mentioned above, this drug is the only FDA approved drug for treating primary-progressive MS. It can also be used to treat relapse-remitting MS, and is typically given through intravenous infusion. Side effects include: injection site irritation, low blood pressure, fever, nausea and more.
- Glatiramer acetate (Copaxone). By blocking the your immune system’s attack on your myelin, this drug can slow the overall progression of relapse-remitting MS. It is injected beneath the skin. Side effects include: irritation at the injection site.
- Dimethyl fumarate (Tecfidera). Taken twice daily, this oral medication helps minimize the number of relapses. Side effects include: flushing, diarrhea, lowered white blood cell count, and nausea.
- Teriflunomide (Aubagio). Taken once daily, this medication also helps reduce the overall relapse rate. Side effects include: hair loss, liver damage, and others. It should be noted that this drug shouldn’t be taken by women who are pregnant or may become pregnant since it can damage the fetus.
- Natalizumab (Tysabri). Designed to block the movement of harmful immune cells from your bloodstream to your brain and spinal cord, this drug is often a first treatment for those with severe MS.
There are numerous other treatments which can be used to slow relapse-remitting MS. Prior to beginning a treatment, you should research your options and the potential side-effects. You should also ask your doctor any and all questions since each treatment has it’s own unique benefits and risks.
Treatments For Symptoms
In addition to treating the various causes of MS, there are a number of ways to treat the often debilitating symptoms that come with the disease.
- Physical therapy. A therapist can teach stretching and strengthening exercises, as well as give suggestions for how to more easily perform daily tasks. Therapy can also help with the leg weakness and gait issues that often accompany MS.
- Medications for various symptoms. A doctor can prescribe medications to help minimize fatigue, depression, pain, sexual dysfunction, and the many other symptoms that are painfully common with MS.
- Muscle relaxers. MS patients often experience uncomfortable, even painful stiffness and spasms. Doctors may prescribe muscle relaxers like tizanidine or baclofen.
In addition to the medical treatments listed above, there are a number of medical treatments that may or may not help with both the symptoms and progression of MS.
- Regular physical exercise can strengthen the muscles which often grow weak with MS.
- Cranberry juice or supplements can minimize and treat urinary tract infections, which often afflict women who have the disease.
- Calcium and vitamin can counteract osteoporosis, which is when the bones become weak and brittle. Studies also indicate that it may play a role in slowing the disease.
- Acupuncture can relieve some of the ongoing pain and muscle stiffness.
- Meditation can minimize stress and stiffness, both of which are common side-effects of MS.
- Yoga is beneficial for stretching tight muscles and putting the body in a relaxed state.
Talk to your doctor before taking any herbal supplements since some of them can either interfere with medications or make certain symptoms worse.
The Future Of Treatment
There are some exciting developments in terms of treating MS. A recent, albeit small, study published in The Lancet suggests that aggressive chemotherapy followed by a stem cell transplant can massively reduce the progression of the disease.
As the BBC notes:
One existing treatment is for the immune system to be suppressed with chemotherapy and then stem cells are introduced to the patient’s bloodstream – this procedure is known as an autologous haematopoietic stem cell transplant (HSCT).
But in this study, Canadian researchers went further – not just suppressing the immune system, but destroying it altogether.
It is then rebuilt with stem cells harvested from the patient’s own blood which are at such an early stage, they have not developed the flaws that trigger MS.
The authors said that among the survivors, over a period of up to 13 years, there were no relapses and no new detectable disease activity.
All the patients who took part in the trial had a “poor prognosis” and had previously undergone standard immunosuppressive therapy which had not controlled the MS – which affects around two million people worldwide.
While this is a significant development, it should be noted that this is also an extreme treatment. One of the patients in the study even died, so there are certainly some large risks associated with this treatment.
However, for those with a poor prognosis and little success treating their illness, this could be a lifesaver.
There are also numerous drugs in development that may have the potential to slow the various facets of the disease.
Until there is a cure for MS, patients will continue to do their best to manage the disease. Though this may be frustrating, there is good reason to think that drugs and treatments will continue to improve until a cure is finally discovered.
Until that day, MS sufferers will continue to live out the words of Barbara De Angelis:
We don’t develop courage by being happy every day. We develop it by surviving difficult times and challenging adversity.