Treatments for specific MS signs and symptoms

Multiple sclerosis can result in a variety of symptoms that are often treated individually by doctors. Individual treatments are explained in the section that follows:  

Fatigue

Fatigue is a common symptom associated with MS.

People who suffer from fatigue as a result of MS are often prescribed a drug known as amantadine, however, this treatment may have a somewhat limited effect. It is likely that the individual’s doctor will also give him or her some advice on how to best manage fatigue through sticking to a healthy diet for increased energy, exercising appropriately while taking the limitations that MS may be causing into account, getting enough sleep and practising techniques that aid in conserving energy. Medications that aggravate the symptoms of fatigue should be avoided, these include some painkillers.

There are courses that MS sufferers can attend to learn coping techniques for fatigue. One method of learning how to deal with fatigue is known as CBT (cognitive behavioural therapy). CBT is a form of talk therapy which allows the patient to learn how to manage their issues and change the way they behave and act. CBT is commonly used to assist with mental health conditions such as anxiety and depression, however, some people with MS find this technique to be helpful as depression is often associated with MS-induced fatigue.

Visual problems

Visual issues that are related to MS (multiple sclerosis) tend to improve without treatment within a number of weeks, therefore, most patients do not need to seek treatment. However, should visual issues be extremely severe, then steroids are often prescribed to aid in speeding up recovery.

If the MS sufferer has any issues with involuntary eye movements, then gabapentin is typically prescribed. Some patients suffering from double vision may need to see an eye specialist known as an ophthalmologist.

Muscle stiffness and spasms

Muscle stiffness and spasms, known as spasticity, are often improved through physiotherapy. Spasticity refers to a condition wherein specific muscles are continuously contracted. This contraction of the muscles results in a tightness or stiffness of the muscles and can interfere with a person’s normal movement, gait and even their speech. Spasticity is often associated with MS as it is caused by the damage done to the area of the brain and spinal cord that controls voluntary movements.

Should spasticity be severe, then the affected person may be given a medication to help in relaxing their muscles. Some of these medications include:

• Baclofen
• Gabapentin
• Tizanidine
• Clonazepam
• Dantrolene
• Diazepam

The above-listed medications do come with some side effects which include:

• Weakness
• Dizziness
• Nausea
• Diarrhoea

It is advised that patients discuss medication options with their designated medical professional/s.

Mobility problems

Issues regarding mobility are commonly caused by muscle spasticity and spasms, as previously mentioned. However, mobility issues are sometimes a result of dizziness, balance or muscle weakness.

If an MS patient suffers from issues with mobility, then they may benefit from:

• Using a supervised program for specific exercises designed by a physiotherapist
• Performing specialised exercises known as vestibular rehabilitation (VRT) to aid in improving issues with balance, as these exercises help in stabilising gait and gaze
• Using medication for tremors and dizziness
• Using mobility aids such as a wheelchair (this is not always necessary), walker or a walking stick
• Implementing home adaptations such as railings, grips or stair lifts

Neuropathic pain

The term neuropathic refers to an abnormal and often degenerative state of the nerves or nervous system often resulting in pain. With multiple sclerosis, nerve pain is a result of the damage done to the patient’s nerves and is usually reported as being stabbing and sharp, however, it is also able to present as a burning sensation or severe skin sensitivity.

Neuropathic pain is normally treated through medication such as carbamazepine, amitriptyline (this medication is actually an antidepressant that is used to treat depression, however, recently it is used increasingly by specialists across disciplines to treat pain) or gabapentin.

Musculoskeletal pain

For patients living with MS, strains and stresses on the body and joints occur as a result of the disease.

Ms sufferers who experience musculoskeletal pain may benefit from seeing a physiotherapist who will be able to assist with pain management through specifically designed exercise techniques and even seating positions.

Should pain be severe, the individual may be given painkillers. Specialists may also recommend the use of a specialised device that will stimulate the nerves. This small device (roughly the size of a small radio) is known as a TENS (transcutaneous electrical nerve stimulation) machine and uses low-voltage electric currents that help relieve pain.

Issues with learning, thinking and memory (i.e. cognitive problems)

If suffers person suffering from MS experiences any issues with memory and thinking (cognition), then a doctor is likely to fully explain and record any treatments given so that the patient can understand their condition and the prescribed treatment plan clearly.

It is likely that the patient will also be referred to a clinical psychologist in order for their cognitive issues to be assessed and to find effective ways of managing these problems. 

Emotional problems

Should an MS sufferer experience any emotional outbursts, these include crying or laughing with no logical reason as to why, then they will be assessed by a clinical psychologist or other mental health professional such as a psychiatrist. The patient may then be treated with medications such as antidepressants.

Patients who have MS and suffer from depression can also be treated with therapy such as CBT (cognitive behavioural therapy).

If the affected individual feels worried or anxious, they may be prescribed benzodiazepines. These are a kind of tranquiliser that aid in calming one down.

Sexual issues

Men who have multiple sclerosis will often find it difficult to obtain or maintain an erection, this is known as erectile dysfunction. Men with this issue are likely to be prescribed medication that will help in temporarily increasing the blood flow to the penis, one popular drug is known as Viagra (sildenafil). These types of drugs can be prescribed by a general practitioner.

Men with erectile issues may also benefit from attending sessions with a sex therapist or a relationship counsellor. These specialists can help both men and women who have MS and are suffering from issues of reduced sex drive, also known as lowered libido or who suffer from difficulties in reaching orgasm.

Bladder problems

There are a number of medications available for patients suffering from an overactive bladder or individuals who need to urinate frequently to the point that their sleep is interrupted due to MS.

Should the patient find it difficult to empty their bladder completely, then they may benefit from the advice of a physiotherapist or continence nurse. Hand-held external stimulators are also available and may help in emptying the bladder.

In some cases, a catheter may be used to aid in emptying the bladder. In rarer cases, individuals may need a catheter long-term in order for their bladder to empty safely. A catheter aids in draining urine from the patient’s urinary bladder through the use of a thin, flexible, hollow tube that is inserted through the urethra and into the bladder to allow for urine to effectively drain out.

A urologist (a doctor who specialises in the treatment or study of disorders and the function of the urinary system) or a continence adviser may also be able to offer the patient specialist treatment and additional advice on dealing with the issue. Some treatments include bladder exercise, electrical treatment or botulinum toxin injections to aid in the functioning of the bladder muscles.

Botulinum toxin injections help to ease the stiffness in the muscles and allow for the bladder to be effectively emptied, thereby easing incontinence (a lack of control over urination or defecation).

Bowel problems

Patients with MS often suffer from constipation, this can be treated through effectively changing diet and incorporating more fibre into food intake or by taking laxatives.

Should constipation be more severe, then this can be treated with suppositories. This medication is inserted into the anus in tablet form or administered through an enema.  An enema involves the patient being given a liquid medication which is squirted into the rectum, reaching and rinsing the large bowel, softening the stools and flushing them out.

In some cases of bowel incontinence, the sufferer may be treated with medications that prevent diarrhoea or through performing pelvic floor exercises to strengthen their rectal muscles. When these muscles are strengthened, the individual can often release stools more easily. 

Swallowing and speech difficulties

A speech and language therapist will be able to help a person affected by MS to find different ways in overcoming issues with swallowing and speech should they arise. These specialists will advise the individual on foods that are easier to swallow and exercises that allow them to strengthen the muscles needed for swallowing and speech.

Should swallowing issues progress and become more severe, then some patients may need a feeding tube to ensure that they receive proper nutrition, this is inserted through the skin into the stomach.

Alternative medicine

A number of people suffering from multiple sclerosis use a number of complementary or alternative treatments to assist in managing symptoms such as muscle pain and fatigue.

Some alternative forms of medicine include meditation, massage, yoga, a healthy diet, acupuncture, breathing and relaxation techniques and exercises. These techniques aid in boosting the patient’s overall physical and mental well-being, however, studies to support the effectiveness of these in the treatment of MS are limited.

Some individuals use herbal medications such as cannabis or Ginkgo biloba to help in easing their symptoms, however, these treatments are not scientifically supported or recommended by most healthcare professionals as they have the potential to result in a number of adverse side effects.

Specialised diet for MS (multiple sclerosis)

Some patients may find it beneficial to see a dietician to help them to design a healthy eating plan with the right vitamins and nutrients to potentially aid in the management of MS symptoms and overall well-being.

These diets typically exclude or limit transited fats, refined grains, sugar, sodium, gluten and some saturated fats.

Fruits, vegetables, flaxseeds, turmeric, ginger and Omega-3 fatty acids (found in fish) have been known to have anti-inflammatory properties and aid in coping with some symptoms of MS.

Further research is needed to fully explore the benefits of eating well and the effect this has on multiple sclerosis (if any), however, eating a healthy diet has been known to help in overall physical and mental health for those with or without MS.

Exercise and MS (multiple sclerosis)

There are a number of benefits to exercise, particularly in individuals with MS who battle to perform certain physical activities. When patients have a low level of activity, their risks of cancer, diabetes, mental decline, depression, heart disease and weight gain are increased.

Some studies have shown that exercise has a behaviourally beneficial effect on patients and aids in managing a number of the symptomatic and functional consequences associated with multiple sclerosis.

Studies show that regular exercise can aid in improving:

• Muscle strength
• Fitness
• Mood
• Mobility
• Overall sense of well-being

If an exercise routine is designed for those with MS, it will need to take into account the sufferer’s limitations and capabilities. The program may also need to be changed and adjusted accordingly to the progression of the individual’s symptoms.

Along with healthy and proper nutrition, incorporating a daily exercise program into daily life will aid in dealing with and even suppressing the progression of a number of symptoms.

The different types of exercise for MS (multiple sclerosis)

A physical therapist who has a thorough understanding of the variety of symptoms associated with multiple sclerosis, as well as the challenges that the sufferer faces in their daily life, will be able to design an effective exercise program and instruct the patient on how to perform the different exercises.

A number of individuals with MS will benefit from:

• Weight (strength) training
• Cycling
• Gardening
• Walking
• Calisthenics (gymnastic exercises that help in achieving grace of movement and fitness)

It is advised that the patient speaks to their doctor or specialist before partaking in any fitness regimen.