Multiple Sclerosis Education and Awareness

Articles

Mar 1

A disease called multiple sclerosis (MS) affects the central nervous system which is comprised of your brain and spinal cord. MS can be a slow progression of disability due to damage to the nerves in your brain or spinal cord. Nerves are protected by myelin, which forms a sheath around their fibers. MS creates an immune response and targets these protective coverings on the nerves. The result is a disruption of communication between these nerves, your whole body, and your brain. This damage can continue to worsen and create a permanent problem or disability in the body. At times, symptoms of MS present themselves ways that are incredibly disruptive to an individual’s daily routine and overall independence. In addition to the physical repercussions of this disease, the effects can also take a toll on an individual’s mental and emotional health.

Symptoms of MS

Due to the nature of the disease, symptoms of MS range very widely from one person to the next. Depending on the severity of damage to the nerves and progression of the disease, a person may experience more severe or less severe symptoms. There are some common symptoms associated with nerve damage such as numbness in an area of the body or limbs or tremors throughout the body along with a disfunction in body coordination. Other areas of the body may be affected, such as the eyes through vision loss or blurred vision, speech issues such as slurring or enunciation, overall fatigue or issues with other bodily functions.

Causes of MS

Much like other chronic diseases, healthcare professionals are unsure of the exact cause of MS. Although research continues to present new ideas and information, there are some indications that may be related to the development or triggering of MS in individuals. Those who have contracted specific infections or diseases in the past, such as the virus Epstein-Barr, might be more likely to develop MS at some point in life. Vitamin D is another indicator, as individuals who have lower exposure to the sun in certain regions are more likely to develop MS. As with other autoimmune diseases, MS is related to a lack of proper immune function.

Types of MS

The International Advisory Committee on Clinical Trials of Ms in 2013 defined four different potential courses that people with MS may have, though that comes with a disclaimer that there’s not been a proven way to predict the track of how multiple sclerosis will affect each person. The four different types are clinically isolated syndrome (CIS), primary progressive MS (PPMS), secondary progressive MS (SPMS), and relapsing-remitting MS (RRMS). Knowing and identifying the type of MS you or a loved one is living with can help you develop an understanding of the care and treatment that is specific to you.

Clinically Isolated Syndrome (CIS)

CIS refers to the symptoms caused by the first onset episode where demyelination (loss of myelin) happens in the central nervous system. It is classified as CIS when the episode occurs for a full 24 hours. Myelin is the coating of lipids and proteins around your nerves in both the central nervous system and peripheral nervous system. The only nerves affected by MS are in the central nervous system. Myelin helps your nerves to function properly within these systems.

CIS can be either monofocal or multifocal. In a monofocal CIS episode, a singular neurological sign occurs such as a lesion or pain or tingling in an area affected by the loss of myelin. In multifocal multiple neurological responses occur meaning the body is being impacted in several areas during the episode.

CIS doesn’t necessarily result in the individual having MS in the future but it can and should be taken seriously. It is highly suggested that the person having this episode go on to have an MRI scan to scan the brain for any lesions and this can help to infer the likelihood of going on to develop MS.

Primary progressive MS (PPMS)

PPMS is categorized as less functioning of the person's neurological functioning. PPMS can be defined as either active or inactive as well as with progression or without progression to explain how the relapse or new activity in the nerves that are taking place.

MRIs or neurological examinations are highly recommended as the most effective way to monitor the patient’s MS activity in their brain. Based on the results of this MRI your doctor can diagnose which type of treatment will be beneficial based on the level of activity you are currently exhibiting. If you have low activity they may suggest disease modification therapy to help reduce the risk of relapse and if it is active your physician will suggest different types of rehabilitation to care for your specific symptoms.

PPMS also attacks the myelin in the central nervous system but has less inflammation-causing fewer lesions on the brain overall making it harder to detect with an MRI. PPMS is usually diagnosed during the 40s or 50s and men and women are diagnosed about equally.

Relapsing-remitting MS (RRMS)

RRMS is the most common form of MS. 85% of people diagnosed with MS are actually diagnosed with RRMS. This is when there are definitive attacks happening on the person's nervous system causing active relapses and lesions in the brain and spinal cord. This is where flare-ups occur and then are followed by remission of the disease where symptoms disappear entirely or there may be some symptoms that still linger. While in remission there shouldn’t be any sign of progression though.

People with RRMS are usually diagnosed at younger ages, between their 20s and 30s, it can even occur in childhood. In RRMS women are affected two to three times more than men.

Some of the symptoms related to RRMS are:

Numbness
Fatigue
Problems with Cognition
Stiffness
Vision Issues
Problems with mobility

Secondary progressive MS (SPMS)

SPMS has often been seen following the course of RRMS in many individuals. It is usually the second phase of the disease for most people. In SPMS a worsening of the neurological functioning can be followed and a similar model to the other forms of MS where there are active and inactive moments. Within SPMS occasional relapses may occur. SPMS is seen in older individuals since this is a progressive diagnosis. Studies show that 50 percent of those with RRMS will evolve to SPMS within 10 years and 90 percent within 25 years.

Late-Onset MS

Fewer people over the age of 50 are diagnosed with MS. Symptoms of late-onset MS are often misdiagnosed as symptoms of aging because healthcare providers are more familiar with what the disease looks like for younger patients.

Some of the symptoms of MS that are often overlooked are cognitive impairment, fatigue, balance and vision problems, etc.

Even MRIs may not provide conclusive evidence of MS in folks over the age of 50 because they can be interpreted as other vascular diseases that are common for older folks. MS can resemble a stroke, dementia, Parkinson's disease, and many others from a brain scan perspective.

Late-onset MS progresses faster in older individuals. Physical disability and loss of motor functions are found to happen more rapidly. Both RRMS and PPMS are found in late-onset MS diagnoses. A study was done by a research journal titled Plos One found evidence that people with late-onset MS reached a higher level of disability faster than those of younger populations. The average time found was around 6.5 years versus the 12.8 years found in others. Men have also been found to progress faster than women.

Living with MS

While nerve damage can be permanent, MS is a disease that can have remission and relapse cycles. An individual might experience a prolonged time with no symptoms but could start to recognize symptoms again later in life. Symptoms of MS can also worsen or improve over the course of months or years.

Diagnosis

A diagnosis of MS typically comes after your healthcare professional has ruled out other causes of symptoms and performed an MRI to measure brain imaging indications. Because the symptoms of MS can vary so greatly, healthcare professionals can sometimes have difficulty identifying MS as the cause of their symptoms.

Treatment

Because there is no direct treatment for MS, early detection is key to enabling individuals to manage symptoms and slow progression. Some individuals with MS do not present any severe symptoms and therefore simply must monitor any new or progressing symptoms throughout their life.

Diet & Nutrition

People within western countries have been found to have MS more than those in other countries proving that diet and environmental factors can have a key role in your health and wellness.

Being mindful of your diet can help manage MS flare-ups and control its progression through the body. It is recommended that for MS patients a diet consisting of high antioxidants, fiber, calcium, vitamin D, and a wide variety of other vitamins and supplements can be beneficial to help with symptoms.

A diet high in fruits and vegetables, grains, fish, nuts, specific meats, eggs, dairy, probiotics, and herbs of all sorts should be helpful to those with MS. Folks with MS may have a higher risk of celiac and should get tested to know if they have this intolerance as it could cause more inflammation that could be harmful to those with MS.

Activity & Exercise

MS causes fatigue and muscle stiffness so differing levels of activity throughout the week can help to provide relief and less tension in the body overall. Going for walks regularly even if just for short distances can really help get your circulation flowing. Walking on the treadmill is also beneficial.

Stretching prepares you for any exercise but also helps to relieve stiffness which is a symptom of MS. Stretching all muscles or doing something like yoga daily can bring great relief.

Other physical activities that have been found to be helpful for folks with MS are swimming and general strength training exercises. Swimming works every part of your muscle and it’s much easier to stretch in the water. Strength training and building muscle is helpful to help with muscle fatigue can be more detrimental over time.

Physical Therapy

Physical mobility is the most common issue for individuals with nerve damage. Treatment for mobility usually involves physical therapy to address ways to gain strength and regain mobility throughout the body. Other management strategies may be employed in conjunction with physical therapy to ensure an individual gets plenty of rest, has proper nutrition, and manages stress appropriately.

Occupational Therapy

Changes to an individual’s abilities can bring about a need for changes in their routine or natural environment. Occupational therapists often work with individuals with MS as they adjust to a new way of living independently. As they progress through therapeutic intervention to manage physical symptoms, individuals with MS can work with an occupational therapist to manage their daily tasks such as doing laundry, cleaning, grooming, managing medications, or adjusting to assistive equipment.

Speech Therapy

It is common for individuals diagnosed with MS to experience issues with speech, voice, and swallowing. Damage to nerves that are associated with speaking can cause individuals to slur their words or have trouble pronouncing words with the correct articulation. Controlling the volume of a person’s voice can also be a symptom caused by MS. Speech-language pathologists work with patients with MS to develop better articulation of words in speaking by targeting and strengthening specific muscles in the face or mouth. For difficulty swallowing (or dysphagia), speech-language pathologists may require an individual to change their position when eating or drinking, alter or limit the consistency of food, or even recommend a feeding tube to ensure proper nutrition is achieved.

Although MS is related to developed disabilities or negative effects on cognitive function, many individuals with MS are able to lead an independent, fulfilling life. The best step that a person can take after experiencing the onset of MS and diagnosis is to begin to develop a long-term treatment plan for managing the disease. It is very common for individuals to experience changes to their mental health either due to their difficulty adjusting or the nerve damage itself. Depression is common in individuals with new diagnoses or potential disabilities that they feel may alter their life significantly. It is important that individuals with MS seek the appropriate treatment for not only their physical symptoms but their emotional symptoms as well. Mental health and physical health are inextricably tied and may affect each other. Managing symptoms of MS with the help of therapists can help individuals achieve maximum independence and continue to feel fulfilled and productive throughout the course of their lives.

If you or a loved one have been recently diagnosed with MS and are looking to begin treatment through physical, occupational, or speech therapy, work with the trusted, professional team at Tilton’s Therapy to help you begin your treatment plan. We work with individuals of all ages in Northern Nevada, Southern Nevada, Oregon, and Hawaii.