Management of Your Multiple Sclerosis

Welcome to the Patient Facing Content Template. This has been made by students from the University of Northampton.

Original Editor - User Name Top Contributors - Katherine McBeth, Memoona Awan and Kim Jackson

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This information is not intended to replace your healthcare professional. Please make sure you seek medical advice if you are experiencing any symptoms.

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What is Multiple Sclerosis?

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system in which the myelin sheath surrounding the axons of the brain and spinal cord becomes damaged, resulting in demyelination and scarring. When this occurs it may slow down or stop the transmission of nerve impulses.

Multiple sclerosis (MS) affects everyone differently because symptoms vary so much from person to person. In addition, there are four different types of MS.

Causes

The specific cause of multiple sclerosis is unknown. The most widely accepted theory is that multiple sclerosis is an autoimmune disease that preferentially destroys the CNS while the peripheral nervous system is spared.
Your immune system mistakenly attacks the nerves in your brain and spinal cord.
Possible causes
Immunologic factor
Environmental factor
Genetic factor
Infectious factor
Gut microbiome factor

Prevention

Quit smoking
Get adequate sun exposure and supplement with vitamin D
Eat a healthy diet low in saturated fat, and supplement with flaxseed oil
Keep your stress levels down and exercise regularly

Symptoms

Multiple Sclerosis will present with varying symptoms depending upon the location of the nerves being affected. Symptoms usually appear suddenly and rapidly over minutes or hours, but in rare cases, the symptoms may be insidious and take several weeks to months to develop.

Central - Fatigue, Cognitive impairment, Depression, Unstable mood
Visual - Blurred vision, involuntary eye movements, double vision
Speech - Difficulty pronouncing and producing sound
Throat - Difficulty swallowing
Musculoskeletal - Spasms, Weakness, involuntary movements when walking
Sensation - Pain, numbness, Burning/prickling sensation (usually hands, arms, legs & feet)
Bowel - Incontinence, diarrhoea or constipation
Urinary - Incontinence, frequency or retention

Diagnosis

As MS is complex, diagnosis is not straightforward to diagnose.

Tests for MS could include blood tests and magnetic resonance imaging (MRI). It is also important to rule out any other potential diagnosis, such as Lyme disease and vitamin B12 deficiency.

Management

An Occupational therapist can carry out an in-home assessment & suggest adaptations that could help you day-to-day, with things like washing, dressing & moving around your home. Relationship counselling or a sex therapist can help with changes in the dynamics of relationships and reduced interest in sex or difficulty reaching orgasm. Your doctor may prescribe different medications to help with your symptoms. For example, Gabapentin can be used to treat muscle spasms and stiffness. Additionally, Amantadine can be used to help with fatigue. A speech and language therapist can help you overcome difficulties with speech and swallowing.

Assessment scales

Expanded disability status scale is used to assess and evaluate disability in Multiple sclerosis.

Exercises

Exercise is key to a healthy life in general. It can help to reduce the risk of life-threatening diseases including but not limited to cardiovascular diseases, obesity & Type-II diabetes. When you have MS it is even more important to keep moving. NHS England recommends 150 mins of exercise each week. Exercising can also help improve mood, fatigue and balance.

The best way to start exercising is to find something you enjoy. So do not be afraid to try something new. You could also try doing an activity with a friend or family member for support.

This page will give you some exercises you can do to get moving and improve some of your symptoms. You can increase the intensity over time to challenge yourself. For example, you could add a weight or increase the number of sets or repetitions.

Lie on your back, with your knees bent up. Place the palms of your hand flat on the floor. till your hips back and push through your feet to lift your hips and back off the floor. (10 repetitions, 3 times)

Start in a tabletop position, with knees and hands on the floor. gently contract your abdominal muscles. Then raise one arm in front of you and the opposite leg behind you. (10 repetitions, 3 times)

Start with your thumb close to the opposite knee. diagonally raise your hand above your head so that it ends on the same side as the hand you are using. finishing with the thumb pointing upwards. Then slowly lower back down to the starting position. (10 repetitions, 3 times)

Sit comfortably on a chair and make sure your feet are hip-width apart. lean forward bring your weight onto your feet, and squeeze your bottom to stand up. Slowly lower back to sitting. make sure you do not drop your chin and keep looking forward. (10 repetitions, 3 times)

hold a weight in your hand (this could be a can of beans), and bend your elbow so that your hand moves towards your chest. Then slowly lower your hand back to the starting position. your elbow should remain by your side throughout the movement. (10 repetitions, 3 times)

Self-Management

It is important to make sure you are getting enough sleep. Make sure you have a regular sleep pattern. Avoid screen time 1 hour before bed. Avoid caffeine 8 hours before bed. Make sure you do not go to bed hungry or thirsty. Finally, make sure your room is dark and the are no viable clocks.

Fatigue is improved by healthy sleeping patterns, exercising and planning your days and weeks so that your tasks are not all to be done on the same day.

There is currently little evidence that a specific diet for MS can help. However, maintaining a healthy balanced diet improves overall wellbeing.

Stop Smoking, research suggests smoking can make your MS worse. You can get support from your doctor to do this.

More Information and Support

For more information on Multiple Sclerosis click here.

If you would like more information on the stages of Multiple Sclerosis click here.

MS Society

For UK guidance on adult exercise guidelines click here.

NHS Guidelines for MS