Treatment for Managing Symptoms

Symptom management is a major focus of treatment in multiple sclerosis (MS), encompassing a variety of approaches. Therapeutic options include prescription and over-the-counter medications, physical and occupational therapy, assistive devices, complementary and alternative medicine, self-help strategies, and a number of other specialized interventions to address specific symptoms and challenges posed by MS.

Prescription and over-the-counter medications

Several types of medication are used to help alleviate and manage symptoms associated with MS. The main categories of medication include:

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

Drugs to treat bladder problems and erectile dysfunction are also sometimes necessary.

Physical and occupational therapy

If you have MS, physical and occupational therapists are important members of your care team, especially as the disease progresses and symptoms begin to affect your ability to engage in normal daily activities. Physical therapists specialize in:

• Educating you about the physical symptoms of MS and options to alleviate these symptoms and avoid complications
• Developing and tailoring an exercise program that helps you address specific symptoms and challenges
• Use of assistive devices, such as mobility aids and equipment for the home and office, that can help you adapt to your disabilities and continue to function independently

An occupational therapist is specially trained to help you maintain and improve everyday skills, including dressing, bathing, preparing meals, and driving, with the goals of preserving the ability to live independently and improve quality of life.

Assistive devices and technologies

Assistive technologies play an important role in helping people with MS live with symptoms including:

• Spasticity
• Muscular/skeletal problems
• Weakness and fatigue
• Balance problems
• Vision problems
• Speech and language difficulties
• Cognitive impairments

Examples of assistive devices commonly used by people with MS include braces to lend support and steadiness if balance or weakness are problems, mobility aids, such as canes, walkers, and electric scooters, and clocks and wrist watches with large print for people with vision problems.

An online resource for labor-saving assistive technologies and ideas and gadgets for making everyday activities easier, from staying mobile to preparing meals, is Independent Living Aids.

Natural remedies, complementary and alternative medicine

Natural remedies, and complementary and alternative medicine, encompass a wide variety of treatments and approaches, including:

• Dietary supplements
• Herbal medicine
• Acupuncture
• Homeopathy
• Massage
• Mind-body approaches such as yoga, hypnosis, and meditation

Many of these treatments or approaches may not be offered by your physician. Nor have many been rigorously evaluated for effectiveness in the same manner as prescription medications. However, these approaches may provide important benefits to the patient with MS. For instance, acupuncture, meditation, massage, and biofeedback can be useful to many people for relief of MS-related pain syndromes.

Self-help strategies

Self-help strategies are essential in helping you compensate for common MS symptoms. For instance, fatigue and weakness can make energy a precious resource when you have MS. Therefore, you can learn to save energy by organizing home and workspace to make common tasks go more efficiently.

In the kitchen, laying out ingredients and organizing cooking utensils can make meal preparation go more smoothly and take less energy. Getting certain workplace accommodations, such as a parking space near an office entrance or arranging a flex time work schedule, can help you get the most out of your limited daily energy supply.

Specialized interventions

A number of specialized therapies and interventions are available to help manage MS symptoms. For instance, if you have sleep problems you can work with a sleep specialist to determine the cause of the problem and choose appropriate interventions. Urologists offer a number of treatment options, including urinary catheterization and instruction in dietary and fluid management, as well as special medications, to address bladder problems.

Similarly, a vision specialist may recommend eye patching for double vision and use of prisms or other special corrective devices for other vision symptoms. Other specialties that may be useful in addressing MS symptoms include psychotherapy and counseling, sexual therapy, speech/language pathology, cognitive rehabilitation, and neuropsychology.

Before beginning treatment for MS, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.