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Multiple sclerosis, or MS, is a lifelong condition that affects the spinal cord and brain. There is a wide range of symptoms that arise from this disorder, including issues with vision, balance, leg and arm movements, among many others. It can sometimes lead to severe disability.
MS is two to three times more common in women than in men. The latest statistics from the government indicate that more than 105,000 people are currently living with multiple sclerosis in the UK. And, according to the NHS, diagnosis of the condition usually occurs in people in their 20s and 30s.
What is Multiple Sclerosis?
Multiple sclerosis is not an inherited condition. A recent study suggested that although the disorder can occur more than once in a family, there is only approximately a 1.5% chance of someone developing MS if their parents have it.
Research by the MS Society highlighted that there is not a single gene that causes the condition, but probably more than over 200 genes that may contribute to the chances of developing it.
The MS Society also said that genes are only a sample of the causes of MS. Environmental factors also play a part. Statistics show that people who live further away from the equator are more likely to develop MS than individuals in locations that get lots of sunshine. This implies that low levels of vitamin D could be a factor in developing the condition.
There is also some evidence that infections could trigger the disorder. Epstein Barr virus has one of the most commonly known links to triggering MS. However, getting this virus does not mean you will develop MS.
Lifestyle factors have also been identified in studies as factors that may cause MS. Smokers, for example, have a higher risk of developing it. This could be due to the way chemicals in the cigarette smoke disrupt the immune system. There is also an increased risk of developing the disorder as a passive smoker.
Other research studies have indicated that obesity can play a role in MS, too. The link to being overweight in childhood is a prevalent factor.
There are several ways that obesity may contribute to the development of MS, including immune system overactivity and inflammation of the body. There is also a suggestion that overweight people have less vitamin D, among other factors.
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Everyone experiences different symptoms with MS. However, two distinct types have been identified – relapsing-remitting MS and primary progressive MS.
Over 80% of people diagnosed with multiple sclerosis have this type. Relapsing-remitting disorders see people experience episodes of symptoms, which usually worsen, or display new signs. They can worsen over days, or weeks, and then can appear to improve in a comparable period.
Relapsing-remitting MS episodes can come on at any time and usually without notice. It has been suggested that these experiences are related to periods of stress, or illness. Some people may receive treatment during this time, while others do not. It can depend on the discomfort caused by new, or worsening symptoms.
The period in between relapses is known as remission. In this time, the symptoms experienced in the relapse might disappear altogether and not return for several years. Remission can also last several months, or years. However, it is common for some symptoms to return time-after-time.
For people living with relapsing-remitting MS, it can develop into a secondary progressive disorder. This typically occurs after several decades, and the symptoms get worse over time. With a secondary progressive condition, there will be fewer, or no relapses.
Studies have suggested that around 50% of people with this type of MS will go on to develop the progressive condition within 15 to 20 years of being diagnosed. There is also a risk of developing the secondary condition the longer someone has MS.
While many people have episodes of symptoms, individuals with primary progressive MS develop the condition and experience worsening issues from the start. There are generally no periods of remission for sufferers and symptoms will gradually get worse over time. However, while some people do see aspects of stabilisation in the condition at intervals, for others, they do not go away.
Multiple sclerosis can cause different symptoms for different people. Not everyone will experience the same issues. However, there are some common areas that the condition affects.
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MS sufferers may experience problems with balance. It could be something as subtle as being wobbly on your feet to more extreme issues such as totally losing balance and falling over. The damage caused to the myelin in the body causes the messages and processing aspect of balance to be disturbed. In some cases, people living with MS may have vertigo and feel nauseous. Another element of this also includes blocked messages to muscles in the body that aid movement. In this case, muscles do not respond appropriately to the messages sent from the brain, so reaction time is slower.
Muscle Stiffness and Spasms
This symptom is often described as ‘spasticity’ in MS sufferers. Many people suffer from stiffness and spasms throughout their lifetime. However, for people living with this condition, it can cause prolonged pain and discomfort.
Both balance and muscle stiffness are caused by information being disrupted by damaged myelin.
Tremors and Shaking
Some people experience muscle tremors, or shaking. There are varying degrees of each one, and some will experience slight tremors that are barely noticeable to the eye. However, others will have noticeable shaking that makes everyday things, such as drinking and eating, more challenging.
Studies have indicated that between 25% and 60% of people with MS experience these symptoms in some way. The most common type of tremor is called an intention tremor. This is when someone tries to reach for an object, and the shaking gets worse the closer they get to it.
Another common issue for people with MS is speech difficulties. This can be different for everyone, and sometimes the problem occurs for a few minutes, or can last for more extended periods. It is also something that is reported to appear more frequently in relapsing-remitting MS. However, many people find the changes are mild and manageable and do not hinder communication.
Invisible Symptoms of MS
While there are some obvious physical signs of MS, there are several invisible symptoms that can make diagnosis more challenging. These include:
Fatigue and Tiredness
This is one of the most common elements in people living with multiple sclerosis. However, it’s not just a case of feeling a little tired. Fatigue is overwhelming tiredness that does not improve with getting a good night’s sleep.
There are often several signs of fatigue, including:
- Difficulties with balance and experiencing dizziness
- Feeling tired even after getting “quality” sleep
- Exhaustion after doing very little activity
- Arms and hands may feel heavy.
Much like the other symptoms, sufferers will experience varying degrees of fatigue throughout their lifetime. There are also the psychological factors of fatigue that can impact someone living with MS.
Pain and Discomfort
Pain can be attributed to other symptoms, such as muscle stiffness and spasms. While for others, it could feel like a tingly, or numb sensation, in their limbs. There is also something called the ‘MS Hug’, which is described as tightness in the chest area.
Pain can be caused by direct issues, such as nerve damage, or a contribution of factors from symptoms caused by the condition. Every person has different experiences, and these can occur in short, or prolonged periods.
Another invisible issue is related to bladder function. Two common issues are caused due to a disruption in the messages getting through to the bladder – when to store, or when to empty. This can lead to incontinence issues in severe cases.
Similar to bladder problems, some people living with multiple sclerosis may experience bowel issues. Research has suggested that 7 in 10 people with MS will have bowel problems, and this can be either constipation, or incontinence, or sometimes both.
Eyes and Sight
Another common issue is with the eyes. Typical problems are reported with eye movement and vision. Individuals with MS may find their eyes do not move fluidly, and in some cases, they may not align. This can cause double vision and involuntary movements.
A disorder called optic neuritis is often associated with MS. However, not everyone who has this condition will go on to develop multiple sclerosis. It is caused by inflammation of the optic nerve and disrupts the signals that are transferred from the brain to the eyes.
While issues with oral health are not attributed directly to the underlying causes of MS, the symptoms experienced from the disorder can be attributed to changes in oral hygiene. These include shortening brushing sessions due to difficulties gripping the toothbrush, or even feeling exhausted undertaking this task. Other aspects, such as tremors, reduced coordination and pain, could contribute to a lack of oral health.
The MS Society reported that around a third of people with MS would experience some changes in this area. Like many other symptoms, individuals will have variations in severity. However, it can make eating uncomfortable, and in extreme cases, will need careful monitoring to ensure choking does not occur. There are some signs that could identify a problem with swallowing, including:
- Changes in speech
- Mouth creating too much saliva
- Coughing, or food going down the wrong way
- Food sticking to the back of the throat.
Effects On Memory and Thinking
Multiple sclerosis can affect cognitive function, which includes thinking and memory processing. As the myelin in the body is damaged, several aspects can be affected, including:
- Learning and memory
- Problem-solving skills
- Mental processing speed
- Attention span
- Finding the right word.
Symptoms can vary greatly, but any element of the above can impact significantly on a person’s lifestyle.
One of the most prominent aspects is the effect MS has on confidence when around other people. This can severely impact both the emotional and mental well-being of someone living with multiple sclerosis.
Many people find it challenging to explain their symptoms. It is also sometimes hard to diagnose, as people often perceive they will be labelled. Some frequent psychological changes that may occur include:
- Lack of confidence
Although there are a variety of signs of MS, there is no exact pattern when the symptoms may appear, or at what time in someone’s life they may start. In some cases, a person may also experience something entirely different from the typical signs. However, a common early indicator can be problems with vision. The reason for this is that it is one of the more apparent symptoms even if there are others present. Some individuals may not recognise any changes at first, as they are subtle and could be attributed to other more common ailments.
It is a good idea to see your doctor if you have any of the typical symptoms of MS. However, it is important not to assume these issues are solely due to the condition, as many of the signs mentioned above can be caused by other disorders.
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Depending on the symptoms, there are a variety of suitable treatments available. Some involve prescribed medication to relieve pain and physical signs. While others offer lifestyle management solutions that can help ease everyday issues and help people lead a full life.
While there is no cure for MS, there are ways to adapt your lifestyle that assists in managing the condition.
Some of the everyday lifestyle aspects include:
Healthy living and self-care – leading a healthy lifestyle can help to ease some symptoms and also reduce the risk of other health issues. Eating a balanced diet, drinking plenty of water, and exercising regularly will assist in improving your physical health and mental well-being.
Research has also shown that exercise can help with specific elements associated with multiple sclerosis, such as reducing fatigue, improving mobility, and strengthening bladder function.
The psychological factors that come with an MS diagnosis can have an impact on the individual and the people around them. Coming to terms with a long-term condition is understandably challenging, and this can mean it is difficult to talk to others.
The symptoms of MS can also make individuals feel self-conscious and uncomfortable in social situations. In these cases, communication and honesty are vital. Letting people know what they can do to assist is also helpful. Counselling and support services are also available to assist families coming to terms with a diagnosis.
Research has suggested that an MS diagnosis shouldn’t affect the ability to get pregnant. However, some treatments and drugs can impact fertility. It is also reported that someone living with relapsing-remitting MS experiences fewer relapses during pregnancy. In contrast, though, they can be more frequent after giving birth. The NHS recommends discussing health implications with a medical professional.
Working with MS
As most people will receive a diagnosis at an age when they are working, it can be challenging to know what steps to take. The MS Society offers excellent advice on dealing with decisions surrounding work, including taking time to make the right choices for your situation. The process can be overwhelming. However, adaptions can be made to continue with your career until you feel unable to work.
Several things can also help you within the work environment, including access to support for adjustments potentially to your job, or working environment. This makes up part of the Equality Act, and your employer may be able to apply for funding to support you. Several factors can be adapted to accommodate your diagnosis, including:
- Flexible hours
- Frequent breaks
- Working from home
- Rest areas.
There is also a range of additional support services, including the government-funded Access To Work scheme.
Treatments for Multiple Sclerosis
A variety of treatments are available, which can help to manage symptoms and lifestyle, including physiotherapy. If someone is experiencing mobility issues, physiotherapy may be an option.
This treatment helps to improve the fluidity and movement of muscles. There are specialist neuro-physiotherapists that specialise in nerve problems like MS. This treatment can target specific areas and also be used for other symptoms, such as bladder and pain problems.
Cognitive Behavioural Therapy (CBT)
This treatment offers a type of talking therapy to reduce depression and anxiety. It identifies how we think and feel and how this might shape the actions we take. Working with a CBT therapist also gives an individual the ability to implement coping strategies and face the disorder in a positive way.
Some symptoms may be treated with medication. This is typically used for pain and discomfort, and areas such as involuntary movements.
Alternative Approaches to Treatment
Alongside medical treatments, some people try alternative methods of self-care and holistic approaches to ease symptoms. Exercise has been identified as a method of managing the condition.
Activities such as yoga, Pilates, and Tai Chi is said to be helpful, as they take a gentle approach to fitness and strength training. Other practices, such as massage and aromatherapy, may also help with aspects such as stress, anxiety, and depression.
There are several other treatments including Disease-Modifying Therapies and Haematopoietic Stem Cell Transplantation (HSCT).
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Once diagnosed, support is available via the NHS. This will offer guidance in many aspects, such as where help can be found, benefits available to MS sufferers, and tips for people caring for someone with MS.
As symptoms progress, adaptions at home and work may be required. Different types of aid can be incorporated into a living space. For example, easy-access showers and toilet aids make personal care more manageable. Getting around the house can also be challenging, so there are mobility aids and ramps that can be installed in the home.
If multiple sclerosis has been diagnosed, it will need to be reported to the DVLA and the car insurance company. In most cases, people with MS can continue to drive. Still, details may need to be communicated about the severity of the condition.
MS Charity Support
There are charities that are dedicated to the support of people with multiple sclerosis. They also carry out vital research into the condition. They can also help with advice and assistance in managing health after diagnosis. The two leading MS charities in the UK are MS Society and MS Trust.
One of the most significant lifestyle areas that can affect people living with MS is money. In some cases, the inability to work may mean less income coming into the household.
There are several benefits which someone with MS may be entitled to, including Employment and Support Allowance, Disability Allowance, or Personal Independence Payment for anyone under the age of 64. For individuals looking after someone with MS, the Carer’s Allowance could also be an option.
For more information on money matters, the Money Advice Service is a handy resource.
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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.
Central nervous system – this system is made up of the spinal cord and brain. It controls all functions throughout the body
Cognitive function – these are the mental abilities people have, which include learning, reasoning, problem-solving, attention, memory and decision-making
Disease-Modifying Therapies (DMTs) – a range of treatments to help reduce MS relapses for people living with relapsing-remitting multiple sclerosis
Epstein Barr Virus – a common human virus, also known as the cause of glandular fever
Haematopoietic Stem Cell Transplantation (HSCT) – a type of intense chemotherapy treatment for people living with MS. It is used to reduce the damage caused to nerve fibres and regrows the immune system with stem cells
Immune system – the organs and processes of the body that help to fight infection and toxins
Myelin – a protective layer that covers nerve fibres, which enables smooth transmission of messages to the brain and body
Vertigo – the sensation that everything around you is spinning, or moving
Vitamin D – an important vitamin that helps to regulate the amount of phosphate and calcium in the body. It is needed for healthy bones and muscles