MS FAQs

One of the biggest challenges of living with multiple sclerosis (MS) is the uncertainty you face every day. These frequently asked questions (FAQs) about MS may help to address some of these concerns. If you have additional questions, your healthcare professional is still your best source for information.

MS basics

Treating MS

MS basics

What is multiple sclerosis?

Multiple sclerosis is an autoimmune disease affecting the central nervous system. An autoimmune disease is one in which the immune system attacks the body.

Normally, the immune system defends the body against foreign invaders such as viruses or bacterial. Instead, in the case of MS, the body's immune system attacks the nerves.

How do the nerves in the brain work?

Your brain contains nerve cells called neurons. Each neuron is protected by a type of insulation called a myelin sheath. The myelin also helps the neurons do their job of helping electrical impulses travel to and from the brain.

How does multiple sclerosis affect the nerves?

In MS, the immune system attacks the myelin sheath, damaging it. There can be so much damage that the neuron itself is hurt or even broken. When this happens, the neuron cannot help electrical impulses travel where they are supposed to go. This produces the different symptoms of MS.

What are common multiple sclerosis symptoms?

Common multiple sclerosis symptoms include:

• Bladder and bowel problems
• Cognitive difficulties
• Depression
• Fatigue
• Muscle rigidity or stiffness
• Weakness or poor coordination
• Numbness and tingling
• Pain in arms and legs
• Visual disturbances

What causes multiple sclerosis?

The exact cause of MS is unknown. However, these factors may lead to its development: environmental elements (e.g., temperature), infectious agents (i.e., bacteria or virus), and/or genetic predisposition.

Who can get multiple sclerosis?

Anyone can get MS, although 2 to 3 times more women than men have MS. Most people with MS are of northern European descent and are diagnosed between the ages of 20 and 50.

How many people have multiple sclerosis?

Worldwide, about 2.5 million people have MS. And in the US, approximately 400,000 people have MS.

How many forms of multiple sclerosis are there?

There are 4 different forms of MS. They are:

• Relapsing-remitting
• Primary-progressive
• Secondary-progressive
• Progressive-relapsing

What form of multiple sclerosis is most common?

Relapsing-remitting is the most common. About 85% of people with MS are first diagnosed with this form.

People have sudden, clearly defined flare-ups (also known as relapses, attacks, or exacerbations). These flare-ups represent acute worsening of brain function. They are followed by a time of partial or complete recovery (remission).

What websites related to multiple sclerosis might be helpful to me?

Find more information about multiple sclerosis (MS) and available treatments by visiting the sites listed below.

MS ActiveSource^®
MS ActiveSource Multiple Sclerosis Resource
http://www.MSactivesource.com
MS ActiveSource is one of the largest MS resources on the Internet.

AVONEX^® (Interferon beta-1a)
Multiple Sclerosis Treatment
http://www.AVONEX.com
A site providing information on AVONEX^®, the leading treatment for multiple sclerosis worldwide.

National Multiple Sclerosis Society
http://www.nmss.org A national society with local chapters that promotes research and provides services, education and advocacy for people with multiple sclerosis and their families.

Treating MS

Why is multiple sclerosis treatment so important?

Multiple sclerosis is like an iceberg. The part that you see above the water is big.

• In MS, this would be relapses and other symptoms patients experience

But the part you can't see below the water is even bigger and can have an even greater effect.

• In MS, brain lesions can develop and permanent loss of brain tissue (atrophy) can occur whether or not a person is having relapses and symptoms

When should multiple sclerosis treatment be started?

You should start multiple sclerosis treatment as soon as possible. Many studies have shown that permanent nerve damage can happen during early relapses.

What multiple sclerosis treatments are available?

• Natalizumab (TYSABRI^®)
• Interferon beta 1-a (AVONEX^®, Rebif^®), interferon beta-1b (Betaseron^®, Extavia^®)*
• Glatiramer acetate (Copaxone^®)*
• Fingolimod (Gilenya^®)*
• Mitoxantrone (Novantrone^®)

*AVONEX is a registered trademark of Biogen Idec. All other trademarks are the property of their respective owners.

Should I switch from the multiple sclerosis therapy I'm taking now?

Only you can answer this question after carefully discussing with your doctor how well you're doing on your current therapy, and the potential side effects and risks of alternatives.

How can I manage my multiple sclerosis symptoms?

Let your doctor know every time you have problems with multiple sclerosis symptoms. He or she may be able to prescribe medicines that will help reduce or relieve them.

Vision problems
Things you can try include:

• Buying a phone or cell phone with bigger numbers and voice activation features
• Adding a magnifying light to your computer or desk
• Using low-vision aids to make your computer screen easier to read
• Labeling refrigerator and freezer shelves in large print so it's easier to find items
• Using an organizer for your makeup and toiletries

Weakness
Things you can try include:

• Using an assistive device to help you move more easily. This includes scooters, canes, crutches, and wheelchairs
• Starting an exercise program to improve strength and flexibility once you've discussed it with your healthcare professional. It's important to note that exercise does not cause relapses in multiple sclerosis.
  • No studies have shown that exercise leads to an increase in disease activity
  • Instead, exercise can improve many MS symptoms, including weakness, bladder and bowel problems, fatigue, and depression
  • People with MS who are not physically active can be at a higher risk for heart disease, muscle weakness, fatigue, and broken bones

Pain
Things you can try include:

• Starting a physical therapy program to learn strengthening exercises and ways to prevent overuse of muscles
• Asking your doctor if a prescription or over-the-counter medicine could help ease your MS pain

Bowel and bladder problems
Things you can try for your bowels include:

• Drinking at least 6 to 8 glasses of fluid every day
• Adding more fiber to your diet - especially if you have limited mobility, which can increase constipation
• Being as active as you can
• Using fiber supplements or stool softeners as needed, and only as advised by your doctor

Things you can try for your bladder include:

• Drinking at least 6 to 8 glasses of fluid every day
• Drinking cranberry juice
• Avoiding caffeine
• Using absorbent pads when necessary
• Advance planning - learn where bathrooms are at the mall, movie theater, or wherever you spend your free time

Balance/coordination problems
Talk to your doctor before you start any new physical activities. Things you can try include:

• Aerobic exercise (walking)
• Stretching exercises
• Physical therapy
• Using an assistive device, such as a brace or cane

Fatigue
Things you can try include:

• Getting as much sleep as possible at night and taking naps during the day
• Doing things in the morning or when you usually have the most energy
• Focusing on one task at a time to conserve energy
• Asking your doctor about physical therapy that can help you simplify daily tasks
• Thinking about the weather when you make plans to avoid heat and try to stay cool
• Asking your doctor if there are any medicines that can help reduce your fatigue
• Reducing stress

Cognitive impairment
Things you can try include:

• Creating a consistent daily routine to make remembering easier
• Keeping a daily diary with appointments, reminders, and "to do" lists
• Using electronic organizers for phone numbers and addresses
• Keeping important papers and other things in one place that's easy to find
• Taking a break if you feel lost or overwhelmed
• Keeping your sense of humor—a little laughter can go a long way

Mood changes/depression
Things you can try include:

• Talking to your doctor about medication and counseling
• Joining a self-help or support group to meet and gain strength from other people with MS

Intimacy

It's sometimes hard to talk about the sexual difficulties associated with MS. Sexual dysfunction is a symptom that can be helped with counseling and medication. But most importantly, try to communicate as honestly as you can with your partner.