What is multiple sclerosis?

Multiple sclerosis (MS) is a disease that affects the central nervous system—the brain and spinal cord. It also affects the nerves to the eyes. Symptoms vary from person to person. It can cause problems with muscle strength, vision, balance, mood, and thinking. And it may cause fatigue, pain, muscle spasms, and numbness and tingling.

Your nerve cells have a protective covering called myelin. Without myelin, the brain and spinal cord can't communicate with the nerves in the rest of your body. MS causes areas in the brain and spinal cord to get inflamed. It slowly damages the myelin and nerves in patches. These patches of damage are called lesions.

MS tends to get worse over time. But usually this happens slowly. It's hard to predict how MS will affect you. MS is different for each person. Some people's lives won't change much when they have MS. They may function well for a long time. But others may lose the ability to walk or do everyday tasks as the disease gets worse.

There is no cure for MS. But medicines and other treatments might help slow its progression and treat your symptoms.

MS symptoms vary from person to person. They may come and go over time. MS can cause problems with muscle strength, vision, balance, mood, and thinking. It may cause fatigue, pain, muscle spasms, and numbness and tingling. It may also cause bowel and bladder problems. As MS progresses, symptoms may get worse.

Different medicines are used to treat MS. Some may slow its progression and help prevent attacks (relapses). Some treat attacks. Others help treat the symptoms. Other treatments may include physical, occupational, speech, or cognitive therapy to help you function better. Counseling and exercise may also help.

General care

• Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Use a cane, walker, or scooter if your doctor suggests it.
• Keep doing your normal activities as much as you can.
• Try to stay active mentally. Read or do things like crossword puzzles if you enjoy doing them.
• Keep cool. For many people, MS symptoms get worse when they are even a little bit hotter. This could be from the weather, a hot shower, exercise, or a fever. Cooling vests, neck wraps, cool cloths, air conditioning and cool showers after exercise can help. So can avoiding hot tubs and saunas.
• Seek connections. Spend time with friends, family, and others. Joining a support group for people with MS may help.
• Tell your doctor if you feel sad, depressed, or hopeless. Also tell your doctor if you have lost interest in things you usually enjoy. Medicine and counseling can help.
• If you smoke, try to quit. Smoking may increase problems caused by MS. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Try to cut down on stress. Calm yourself or release tension by doing an activity you enjoy, such as reading a book, listening to music, or gardening.

Diet and exercise

• Talk to your doctor about your diet and any supplements you take.
• Tell your doctor if you're having problems chewing or swallowing. Your doctor or a speech therapist may recommend changes to your diet to help make it easier to swallow. You may need to avoid certain foods or liquids. You also may need to change the thickness of foods or liquids in your diet.
• If you get full quickly or get tired easily when you eat, try eating smaller meals more often. You can also try a liquid meal replacement such as Ensure or Boost.
• Get exercise and physical activity on most days. Exercise can be safe even if your symptoms are severe. A physical therapist can help you find the best way to be active. Physical activity and exercise can reduce many of the symptoms of MS. Exercise might also reduce attacks (relapses).
• Ask your doctor about taking vitamin D. The doctor may suggest taking it and can suggest a dose. Low vitamin D levels may be linked to MS.

Experts don't know why MS happens to some people but not others. The disease runs in families, so there may be a genetic link. MS is more common in people who grew up in regions that are farther away from the equator. Low vitamin D levels may also be linked to MS. Certain infections and smoking may also play a role in MS.

Many complementary and alternative medicine (CAM) treatments have been proposed for people who have MS. Research hasn't shown all of the proposed CAM treatments to be effective or safe for people who have MS. But some treatments may help relieve certain symptoms of MS. For example, some forms of marijuana may help with muscle stiffness (spasticity) and pain.

A person with MS may benefit from safe CAM treatments along with standard medical treatment. For example, some people use acupuncture, massage therapy, mindfulness, or yoga to help with some of their symptoms.

Talk to your doctor if you're interested in trying any of these treatments.

The exact cause isn't known, but most experts think that MS is an autoimmune disease. In MS, the immune system attacks the protective covering of the nerve cells (myelin) in parts of the brain and spinal cord. Areas of the brain and spinal cord get inflamed. Over time, the myelin and nerves are damaged.

Multiple sclerosis (MS) is a disease that affects the central nervous system—the brain and spinal cord. It can cause problems with muscle strength, vision, balance, mood, sensation, and thinking. MS tends to get worse over time. But usually this happens slowly. Medicines and other treatments might help slow its progression and treat symptoms.

MS can cause cognitive problems. These may include trouble with:

• Memory, especially short-term memory.
• Problem solving.
• Keeping attention on a mental task.
• Finding the right words to express yourself.
• Grasping ideas quickly.

These problems can occur early in the course of the disease. And they may get worse with time. These problems can also be a side effect of medicines you're taking for other MS symptoms. Or they could be made worse by other symptoms of MS, like depression, fatigue, pain, and sleep problems.

MS can also cause mental health problems. Someone who has MS may:

• Have depression.
• Have thoughts of suicide.
• Have anxiety.
• Feel sad, worried, or angry.
• Feel lonely or be isolated.
• Laugh or cry suddenly for no reason, even if something isn't funny or sad.

Medicines and counseling can help treat problems caused by MS. Joining a support group for people with MS can also be an option. Talk to your doctor if you need help.

People with MS are more likely to die by suicide. Emergency help is available 24 hours a day, 7 days a week. If you or someone you know talks about suicide, self-harm, a mental-health crisis, a substance-use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Call 1-800-273-TALK (1-800-273-8255).
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

Therapy is used to help improve specific skills that are lost or damaged due to MS. MS can cause problems with muscle control and strength, vision, and balance. It can also affect your thinking. Your therapy needs may change over time as your symptoms change.

There are many types of therapy that can help you function better when you have MS. They include:

Physical therapy

This therapy uses exercise of all types to help you stay as independent as possible. Your therapist will help you find which exercises are best for you. Exercise and physical activity are good for all people who have MS. And it's still important even as the disease gets worse.

Exercises will:

• Stretch and strengthen muscles.
• Get your heart and lungs working harder.
• Help you with your balance and ability to move.

You'll also learn how to cool off between exercises, since heat can make symptoms worse.

Occupational therapy

This therapy teaches you how to be as independent as possible.

You can learn how to use equipment or aids to help you with your daily life. This includes aids that help you eat, get dressed, bathe, and do other tasks.

You can also learn how to save energy while you do those tasks. And you can learn how to do them while using a cane, a walker, or a wheelchair.

Speech therapy

MS can affect the nerves that help you to talk and swallow. With therapy, you may be able to:

• Reduce long pauses or slurring.
• Reduce the nasal sound that can happen when your face muscles get too relaxed.
• Improve your speech patterns and the way you pronounce words.
• Learn other ways to communicate, such as with a phone or alphabet cards.
• Learn what foods and eating habits can help if it's hard to swallow.

Cognitive retraining

"Cognitive" is a word that refers to your brain's ability to do things like remember, solve problems, and make decisions. MS can make these things harder.

Therapy can often retrain your brain to find other ways to do these tasks. For example, you may learn to rely on other ways to remember and stay organized, like using a computer, a cell phone, a notebook, or a filing system.