Treatments for Managing Symptoms

Symptom management is a major focus of treating multiple sclerosis (MS). There are many different options based on the symptoms a person has and how severe they are. Prescription and over-the-counter drugs are often used. Physical therapy, occupational therapy, and assistive devicesmay also be helpful. Some people with MS may choose to use complementary and integrative health (CIH) options, as well.^1-3

Controlling MS disease activity

There is currently no cure for MS. However, there are drugs that decrease MS disease activity, slow down MS disability, and, in some cases, prevent MS disability. These drugs are called disease-modifying therapies (DMTs). They can help reduce how severe relapses are and how often they occur. DMTs are a key part of the strategy to reduce the number of MS symptoms a person develops over time.^1-3

The goal of DMTs is to reduce damage to the protective layer surrounding the nerves. This layer, called the myelin sheath, is damaged in those with MS. This damage can lead to neurodegeneration of the affected nerve cells.^1-3

There are a variety of DMTs used to treat MS. Some are taken by mouth. Others are infused into a vein (IV) or injected under the skin. You and your doctor will work together to determine what DMT might be right in your situation. Common examples of DMTs include:^2-4

• Glatiramer acetate
• Natalizumab
• Ocrelizumab
• Fingolimod
• Dimethyl fumarate
• Interferon beta
• Teriflunomide

Treating relapses

Relapses are a sudden attack of neurologic symptoms that are the result of new inflammatory MS lesions in the brain or spinal cord. Relapses can cause new symptoms to appear or previous symptoms to worsen. The symptoms of the MS attack depend on where the lesion is located. Relapses can vary from person to person and from one attack to the next. They can be mild or severe and present with one symptom or many at the same time.^1,3,5

During a relapse, people may take high doses of steroid drugs (corticosteroids) to treat their symptoms until they lessen. Symptoms that linger beyond the relapse period may need additional symptom management.^1,3,5

Treatment of MS symptoms

The range of potential MS symptoms is wide. The symptoms that arise also vary from person to person. What symptoms a person has depends on which areas of the nervous system MS has affected in them. In many cases, prescription or over-the-counter drugs can help manage these symptoms. These drugs might include:^1,6,7

• Corticosteroids
• Anticonvulsants
• Antidepressants
• Antihistamines
• Benzodiazepines
• Muscle relaxants
• Anti-nausea medicines
• Anti-inflammatory drugs

Common issues that may require drugs or other treatment include:^1,6,7

• Abnormal sensation (paresthesias)
• Pain
• Muscle spasms
• Difficulty walking or maintaining balance while walking
• Bladder and bowel issues
• Cognitive issues (problems with memory, attention, or planning)
• Fatigue
• Emotional distress and depression
• Trouble sleeping
• Sexual dysfunction
• Vision issues
• Trouble speaking, swallowing, or breathing
• Tremors
• Seizures

This is not a full list of all potential MS-related issues. If you notice a new or worsening symptom, talk with your doctor. They can help determine whether a new symptom is due to your MS or another condition. Together, you can create a plan that helps manage your symptoms in the best way for you.³

Physical and occupational therapy

Physical therapists (PTs) and occupational therapists (OTs) are important members of the MS care team. PTs and OTs work with other members of your team to help you manage your symptoms. These other team members may include speech-language pathologists (SLPs) and cognitive specialists (neuropsychologists). The makeup of your team will depend on what symptoms you are having and what support you need.^2,3,8

Your goals in physical and occupational therapy might include:^1-3,8

• Learning more about your MS symptoms and potential treatment options
• Understanding ways to avoid future complications of the disease
• Developing an exercise program that works for you, including stretching and strengthening exercises
• Learning how to use helpful assistive devices like walkers or canes
• Practicing or improving everyday tasks like bathing, dressing, cooking, and driving
• Staying as independent as possible

Each person’s plan will be tailored to their individual goals and symptoms.

Mental and emotional health support

Living with a chronic health issue like MS can be challenging emotionally as well as physically. It is common for people with MS to experience intense stress, anxiety, or depression. In some cases, these can be managed with antidepressant or anti-anxiety medicines. Counseling also can be helpful, whether on its own or in combination with medicine.^3,6,9

Support groups are another way to find comfort and guidance. Some of these groups meet regularly in person. Some are held online and on your own time. If you are feeling overwhelmed emotionally, talk with your doctor. They can help you find a support option that works for you.^3,6,9

Complementary and integrative health (CIH)

Complementary treatment options can be used alongside traditional medical treatments to help keep symptoms at bay. CIH treatments take a whole-body (holistic) approach to improving and maintaining health. Some common examples of CIH methods used by people with MS are:^10,11

• Yoga
• Meditation
• Massage
• Dietary supplements
• Herbal medicine
• Acupuncture

Before starting a new CIH method, talk with your healthcare team. Some, like yoga or meditation, pose few risks. But others, like supplements and herbs, can have side effects or affect the way prescription drugs work.^10,11

Many treatment plans include both prescription drugs and CIH options. You and your healthcare team can determine what is best in your case and make any treatment changes safely.¹¹