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Finding the Right Multiple Sclerosis Treatment

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What Is Multiple Sclerosis (MS)? Everything to Know

Medically Reviewed By Heidi Moawad, M.D.

Multiple sclerosis (MS) is a condition affecting the central nervous system. It causes disruptions in the function of the brain and spinal cord. Many researchers believe that MS is an autoimmune condition. It is thought that the immune system attacks the body’s myelin, which is a coating that protects nerves.

Symptoms of MS usually begin when a person is in their 20s–40s. Early symptoms typically affect vision. The condition can also affect balance, control of movement, memory, and sensations.

Read on to find out more about MS. This guide includes information about the symptoms of MS, causes, treatments, and more.

Key facts about multiple sclerosis

  • Multiple sclerosis (MS) is a neurological condition whereby the immune system attacks the coating of the nerves.
  • Experts do not yet know what causes MS, although it may link to genetic, immune, and environmental factors.
  • Initial symptoms typically affect vision, muscle control, and sensations.
  • While there is no cure, symptoms of MS can be managed with medication.

What are the types of multiple sclerosis?

A person is being pushed in a wheelchair.
South_agency/Getty Images

There are three main types of multiple sclerosis (MS):

  • relapsing remitting MS (RRMS)
  • primary progressive MS (PPMS)
  • secondary progressive MS (SPMS)

Relapsing remitting MS

RRMS accounts for around 8–9 out of 10 MS diagnoses. An individual with RRMS will experience episodes of relapse accompanied by either new or worsening symptoms. These symptoms will gradually worsen over days or months before eventually getting better.

Around two-thirds of people with RRMS will develop SPMS.

Primary progressive MS

PPMS is a type of MS in which symptoms gradually worsen over several years after their onset. You will not usually experience any relapse or remission with PPMS. However, symptoms can become stable.

Secondary progressive MS

SPMS is progressive MS that develops from RRMS.

Similar to PPMS, symptoms of SPMS gradually worsen over time. Once RRMS becomes SPMS, you will no longer experience episodes of relapse and remission accompanied by improvement of symptoms.

What are the symptoms of multiple sclerosis?

Multiple sclerosis (MS) can affect your:

  • vision
  • muscle control
  • balance
  • sensations
  • memory

Initial symptoms

Initial symptoms of MS typically begin between the ages of 20–40 and can include:

  • blurred vision
  • double vision
  • distortion of certain colors
  • blindness in one eye

Other symptoms

Other symptoms of MS include:

  • muscle weakness
  • balance and coordination difficulties
  • difficulties walking or standing
  • numbness or a “pins and needles” sensation
  • pain
  • bladder urgency
  • speech impediments
  • tremors
  • dizziness
  • difficulties concentrating or paying attention
  • memory problems

In severe cases of MS, you may also experience partial or complete paralysis.

What causes multiple sclerosis?

Experts do not know exactly what causes multiple sclerosis (MS). Many researchers believe it results from the immune system attacking myelin, the protective coating that covers the nerves.

Current research on the possible causes of MS focuses on:

  • immunology or the study of the immune system
  • environmental factors
  • genetics
  • infectious agents such as viruses

Immunology

An immune response can cause inflammation and damage within the central nervous system. This response involves cells called T cells and B cells.

T cells are part of the immune system and are activated in the lymph system. They travel through the blood vessels into the central nervous system. Once there, they release chemicals that can cause inflammation. They can also damage myelin, nerve fibers, and cells that are responsible for making myelin.

T cells can also activate B cells. B cells can produce antibodies that can cause further damage to your central nervous system.

Environmental factors

Certain environmental factors may increase your risk of MS. These include:

  • low levels of vitamin D in the blood
  • smoking
  • obesity
  • geographical location, as MS occurs more frequently further from the equator

Genetics

Although MS is not an inherited condition, there may be genetic risks. There are around 200 genes that may contribute to the risk of developing MS.

Infections

Having an infection may increase your risk of MS. In particular, exposure to the Epstein-Barr virus makes you more likely to develop MS.

Is multiple sclerosis hereditary?

Multiple sclerosis (MS) is not hereditary, meaning it cannot be passed from one generation to the next. However, certain genes may make you more likely to develop MS.

In the general population, the risk of developing MS is around 1 in 750–1,000. However, in identical twins, if one twin has MS, then the risk of the other twin developing MS is around 1 in 4.

There is also an increased risk that you will develop MS if you have a parent, sibling, or child with the condition.

What are the treatments for multiple sclerosis?

Treatments for multiple sclerosis (MS) focus on reducing the severity of symptoms and treating and preventing relapses.

Treating relapse

Treatment for relapse of MS symptoms may include steroids. This involves a course of steroid injections administered in the hospital over a few days.

You will only take steroids for a short period of time to help reduce the risk of side effects.

Possible side effects of longer-term steroid use include:

  • weight gain
  • diabetes
  • osteoporosis

Contact your doctor if you take steroids and have concerns about side effects.

Disease-modifying medications can also help to reduce the severity and frequency of relapses. These include oral, injectable, and intravenous medications.

Talk with your doctor about any disease-modifying medications they recommend and how frequently you may need to take them.

Medication for symptoms

Medications used to manage MS will depend on which symptoms you experience. It is important to inform your doctor of all your symptoms so they can recommend the correct treatment.

Your doctor may prescribe medication to treat the following symptoms:

  • bladder dysfunction
  • bladder infection
  • bowel dysfunction
  • depression
  • vertigo
  • fatigue
  • itchiness
  • pain
  • sexual problems
  • spasticity
  • tremors
  • walking difficulties

Contact your doctor if you have any concerns or questions about medications for MS symptoms.

Other treatments

Depending on which symptoms of MS you experience, your doctor may also recommend other treatments such as:

  • Regular exercise: This can help with fatigue.
  • Stretching exercises: Stretching can help with muscle stiffness and spasticity.
  • Physiotherapy: This can help with musculoskeletal pain and posture.
  • Fatigue management courses: These can help you cope with fatigue.
  • Cognitive behavioral therapy: Therapies such as cognitive behavioral therapy can help with spasticity.
  • Occupational therapy: This can help you to adapt to changes.
  • Sex and relationship therapies: Relationship counseling or sex therapy can help with sexual problems.
  • Speech and language therapy: This can help with speech and swallowing problems.

Contact your doctor if you have any questions about your current treatments or treatments that may be available to you.

When should I contact a doctor?

Contact your doctor as soon as you experience symptoms of multiple sclerosis. Receiving an accurate diagnosis can help you to begin treatment as soon as possible. Getting the right treatment is essential for helping you to manage symptoms.

Our MS appointment guide can help you to prepare for your appointment.

How do doctors diagnose multiple sclerosis?

There is no individual test for diagnosing multiple sclerosis (MS). To make a diagnosis, your doctor may take a full medical history and carry out a physical examination.

Tests and exams your doctor may arrange to help diagnose MS include:

  • neurologic exam
  • visual evoked potential testing
  • MRI
  • spinal fluid analysis
  • blood tests to rule out other conditions

Once you receive a diagnosis, your doctor may recommend follow-up MRIs to monitor the progress of your condition.

How common is multiple sclerosis?

Multiple sclerosis (MS) affects almost 1 million people in the United States.

Doctors typically diagnose MS in people between the ages of 20–50. However, it can also occur in young children and older adults.

MS is three times more common among females than males.

What are the complications of multiple sclerosis?

Multiple sclerosis (MS) is rarely fatal. However, if you have a severe form of MS, you may experience complications. These can include:

  • chest infection
  • bladder infection
  • difficulties with swallowing
  • blindness or loss of vision in one eye

You may also experience mental health problems such as depression and anxiety. These are more common among people with MS than in the general population.

Contact your doctor if you have concerns about complications of MS.

Can I prevent multiple sclerosis?

As the exact cause of MS is unknown, it may not be possible to prevent it. However, following your treatment plan can help to reduce your risk of relapse.

Other frequently asked questions

Here are some more frequently asked questions about multiple sclerosis (MS).

What are the first signs of multiple sclerosis?

MS typically affects your vision first. You may experience blurry or double vision.

Does the Epstein-Barr virus cause multiple sclerosis?

Exposure to the Epstein-Barr virus may increase your risk of MS. You may be up to 32 times more likely Trusted Source National Institutes of Health Governmental authority Go to source to develop MS if you are exposed to the Epstein-Barr virus.

What is the most common cause of multiple sclerosis?

Although the exact cause of MS is unknown, research is ongoing.

One study looked at 801 active duty U.S. military personnel with MS. It found that only one Trusted Source National Institutes of Health Governmental authority Go to source out of the 801 tested negative for the Epstein-Barr virus before the onset of the condition. This suggests that the Epstein-Barr virus may be associated with MS.

Is multiple sclerosis curable if it is caught early?

It is not possible to cure MS. However, medications can help to control the condition and reduce the severity of symptoms.

What is the life expectancy for somebody with multiple sclerosis?

The average life expectancy for an individual with MS is around 510 years shorter than the average person. However, with advances in treatment, this gap continues to get smaller.

Summary

Multiple sclerosis (MS) occurs when the immune system attacks the central nervous system, damaging the myelin that protects the nerves. This can result in vision problems, muscle weakness, and problems with coordination. It can also affect sensations and memory.

There are three types of MS: relapsing remitting MS, primary progressive MS, and secondary progressive MS. With relapsing remitting MS, you may experience a relapse of symptoms that gradually worsen and then improve. With primary and secondary progressive MS, symptoms gradually worsen over time.

Treatments for MS focus on reducing the severity of symptoms and preventing relapse. Your doctor will be able to recommend medications that are right for you. It is important to contact your doctor if you experience symptoms of MS or if you are experiencing relapse.

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Medical Reviewer: Heidi Moawad, M.D.
Last Review Date: 2022 Aug 15
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