MS can cause a range of symptoms that can be treated individually. Treatments for some of the main symptoms are outlined below.
Many people with MS experience fatigue.
For fatigue caused by MS, you may be prescribed amantadine, although this medication may only have a limited effect. You should also be given general advice on ways to manage fatigue, such as exercise, keeping healthy sleep patterns, energy-saving techniques and avoiding medications that can worsen fatigue (including some painkillers).
Specialist fatigue management courses or therapy, such as cognitive behavioural therapy (CBT), can also help some people with MS cope with their fatigue.
MS-related visual problems will often improve on their own, usually within a few weeks, so you may not need any treatment. If your symptoms are particularly severe, you may be prescribed steroids to help speed up recovery.
If you have problems with involuntary eye movements, medication such as gabapentin can sometimes help. Some people with double vision need help from ophthalmologists (eye specialists).
Muscle spasms and stiffness
Muscle spasms and stiffness (spasticity) can be improved with physiotherapy. Techniques such as stretching exercises can help if your movement is restricted.
If your muscle spasms are more severe, you may be prescribed a medicine that can relax your muscles. This will usually be either baclofen or gabapentin, although there are alternative medicines, such as tizanidine, diazepam, clonazepam and dantrolene.
These medicines all have side effects, such as dizziness, weakness, nausea and diarrhoea, so discuss which of these would be best for you with your specialist MS nurse or GP.
Mobility problems are often the result of muscle spasms and spasticity (see above), but they can also be caused by muscle weakness, or problems with balance or dizziness.
If you have problems with mobility, you might benefit from:
- an exercise programme supervised by a physiotherapist
- special exercises called vestibular rehabilitation, if you have problems with balance
- medication for dizziness or tremors
- mobility aids, such as a walking stick, or occasionally a wheelchair
- home adaptations such as stair lifts or railings
An occupational therapist can carry out an assessment of your home and suggest adaptations that may be of help.
Neuropathic pain is caused by damage to your nerves and is usually sharp and stabbing. It can also occur in the form of extreme skin sensitivity, or a burning sensation.
This type of pain can be treated using the medicines gabapentin or carbamazepine, or with a medication called amitriptyline. This is an older type of antidepressant, but these days it's mainly used for pain control.
Living with MS can cause stresses and strains to the muscles and joints in your body.
A physiotherapist may be able to help with this pain by suggesting exercise techniques or better seating positions.
If your pain is more severe, you may be prescribed painkillers. Alternatively, you may have a device that stimulates your nerves, called as a transcutaneous electrical nerve stimulation (TENS) machine.
Problems with thinking, learning and memory
If you experience problems with thinking and memory, any treatment you receive will be fully explained and recorded, so that it's clear to you.
You should be referred to a clinical psychologist, who will assess your problems and suggest ways to manage them.
If you experience emotional outbursts, such as laughing or crying for no apparent reason, you should be assessed by a specialist such as a clinical psychologist. They may suggest treatment with an antidepressant.
People with MS who have depression can also be treated with antidepressants or therapy, such as CBT.
If you often feel anxious or worried, you may be prescribed antidepressants or benzodiazepines, which are a type of tranquilliser that have a calming effect.
Men with MS who find it hard to obtain or maintain an erection (erectile dysfunction) may be prescribed medication to temporarily increase the blood flow to the penis, such as sildenafil (Viagra). This is provided by the NHS if you have MS.
Relationship counselling or seeing a sex therapist may also help both men and women with MS who are having problems with reduced interest in sex or difficulty reaching orgasm.
Various medications are available if you have an overactive bladder or need to pee frequently during the night.
If you find it difficult to empty your bladder, advice from a continence nurse or physiotherapist can help. Hand-held external stimulators can also help some people to start peeing or to empty the bladder.
Occasionally, a catheter can be used to empty the bladder when needed. In rare cases, people with MS may need a long-term catheter to keep the bladder emptying safely.
You may be referred to a continence adviser or urologist, who can offer specialist treatment and advice, such as botulinim toxin injections, bladder exercises or electrical treatment for your bladder muscles. Read more about treating urinary incontinence.
It may be possible to treat mild to moderate constipation by changing your diet or taking laxatives.
More severe constipation may need to be treated with suppositories, which are inserted into your bottom, or an enema. An enema involves having a liquid medication rinsed through your bottom and large bowel, which softens and flushes out your stools.
Bowel incontinence can sometimes be treated with anti-diarrhoea medication or by doing pelvic floor exercises to strengthen your rectal muscles.
Speech and swallowing difficulties
A speech and language therapist can help you find ways to overcome problems with speech and swallowing.
For example, they can offer advice about foods that are easy to swallow and they can recommend exercises to strengthen the muscles used in speech and swallowing.
If swallowing problems become very severe, some people need to be fed using a tube, which is fitted into the stomach through the skin.
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