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MULTIPLE SCLEROSIS: 1st of 2 columns on MS

Mar 3, 2009

Dr. Paul MackareyJudging by my email inquiries on this topic, it is fairly safe to say that most readers of this column either directly or indirectly know of someone who has Multiple Sclerosis (MS). MS has been a part of my life as a physical therapist, friend, and relative of some very incredible people and their families, affected by this disease. According to the National Multiple Sclerosis Society, MS affects approximately 400,000 people in the United States. MS is second only to trauma as the most common cause of neurological disability for those in early to middle adulthood. MS is almost three times as common in women. MS is very uncommon before adolescence or after 50. However, the risk increases from teen years to age 50.

What is MS?

Multiple sclerosis is considered to be an autoimmune disease. The immune system of the body does not work properly when it fails to attack and protect the body against substances foreign to the body such as bacteria. Instead, the system allows the body to attack normal tissues and create diseases such as MS, rheumatoid arthritis and lupus. In MS, the immune system attacks the brain and spinal cord of the central nervous system. Each nerve has an outer covering of a fatty material (myelin) for insulation to improve the transmission and conductivity of impulses or messages to and from the brain. The damage to the myelin of the nervous system interrupts the ability of messages to travel to and from the brain, through the spinal cord and to other areas of the body such as the muscles in the arms and legs. Due to this “short circuiting” the brain becomes unable to send or receive messages. In multiple sclerosis, scar tissue or plaques (sclerosis) replaces the fatty myelin in “multiple” areas. This is also called demyelination.


The symptoms associated with MS vary greatly from person to person. The amount, frequency and speed of the demyelination process vary greatly and are directly related to the loss of strength and function in daily activities. Some people are independent and ambulatory with mild and infrequent episodes of weakness and disability and live a relatively normal life. Others suffer from frequent and aggressive episodes that significantly weaken and disable. Some common symptoms in the early stages include: muscle weakness, loss of coordination, blurred vision, pain in the eyes, double vision. Some common symptoms as the disease progresses are: muscle stiffness with muscle spasms, pain, difficulty controlling urination, difficulty thinking clearly.


The diagnosis of MS can be very difficulty in the early stages because the symptoms are often vague and temporary. Also, MS symptoms are very similar to other neurological problems. A neurologist will run several tests to rule out other possible problems. However, an MRI showing demyelination of the nerves is a primary confirmation.


Treatment for MS depends upon many factors and requires consultation with your physician. Some medications can control the frequency and severity of MS symptoms such as pain, weakness, and spasticity. Also, some drugs can slow the progression of certain types of MS. Additional treatments for MS include: diet, exercise, physical therapy, support groups, and counseling for the MS patient and their family. Part II of Multiple Sclerosis will discuss these options in further detail.

Visit your doctor regularly and listen to your body.