Multiple Sclerosis

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Condition: Multiple sclerosis (MS) is a brain and nerve disease where the immune system attacks the fatty material that wraps around nerves.

Background: About 400,000 Americans and 2.5 million people worldwide have MS. It usually gets worse over time and there is no cure, but there are treatments that can slow the disease.

Risk Factors: The cause of MS is not known. MS is more common in women than men and in white people compared to other races. It is also more common where the weather is cold and humid such as in northern states and Canada. MS usually affects young adults but it may also be seen in children.

History and Symptoms: MS varies from person to person. At first, people with MS often have tingling or numbness, weak or stiff muscles, trouble walking, or vision or speech problems. Fatigue, trouble thinking, and bladder and bowel problems are common. There are different types of MS. The most common is called RRMS (relapsing-remitting) where symptoms may disappear and then come back again. Later on, many people shift to a type called SPMS where symptoms keep getting worse. The most severe types affect about 15% of people with MS. 

Physical Exam: The doctor will check vision, thinking, reflexes, and whether you can feel different sensations.

Diagnostic Process: A spinal tap and an MRI of the brain and spinal cord will probably be done to look for signs of MS.

Rehab Management: Steroids may be given for a short time when symptoms are very bad. For long-term treatment, several drugs slow the disease. They are used along with other therapies to help relieve symptoms.

Physical Medicine and Rehabilitation (PM&R) physicians, also known as physiatrists, treat a wide array of medical conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons.  They manage pain, spasticity and have expertise to recognize and treat many different aspects of Multiple sclerosis.

When you are diagnosed with a condition such as MS, you will be seeing your Neurologist, your primary Care Doctor, a Urologist, a Pulmonologist and several other doctors. They all focus primarily on one particular aspect of your care and so there is not always a lot of crossover between specialties. On the other hand, PM&R physicians intersect between all specialists related to your condition and know how to improve your health by focusing on your functional ability with MS. They can assist you and provide interventions to restore or maintain function at every stage of MS.  They can manage and also make recommendations for pain, spasticity exercise and refer you to physical and Occupational therapists if needed to improve your function.  They are also very helpful in educating you and your family regarding your condition. It may be frustrating and if you feel your care is vary compartmentalized; PM&R physicians can help you by coordinating your care.

Other Resources for Patients and Families:  Family support is very important to help patients cope with the condition and stick to their treatment plan.

Patient and Family Handouts (printable PDF):

Multiple Sclerosis - English

Esclerosis Múltiple - Español


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