Managing wellness with multiple sclerosis (MS) generally requires several different kinds of health care professionals. Some may be responsible for treating physical aspects of the condition, and others may help with the mental or emotional effects.
Assembling a good MS health care team — and making sure all of its members communicate — can make a huge difference in your overall health. A good first step is understanding the different types of health care professionals who may be able to contribute to your treatment.
Because MS is a condition of the central nervous system, your neurologist — rather than primary care provider — will probably be the leader of your MS treatment team. A neurologist is a physician who specializes in nervous-system conditions. They can work with you to monitor disease activity and track your disease course. They can also help you find other specialists who treat the symptoms of MS and provide referrals for insurance coverage.
You may want to find a neurologist who specializes in treating multiple sclerosis. The National Multiple Sclerosis Society has a provider directory that you can consult to find one in the United States. You may also find recommendations from trusted health care providers, friends, loved ones, or others affected by MS — including MyMSTeam members, who may be able to share their recommendations for neurologists in your area.
Nurse practitioners and physician assistants work with neurologists to help implement your treatment. MS nurses can help with the practical aspects of MS, such as educating you on medications and other treatment options. They can also help you coordinate a treatment plan with other specialists.
Physical therapists teach you special exercises to maximize your health, including your gait and your balance. Many MyMSTeam members report great experiences with their physical therapists. “Physical therapy helped me with my walking and balance,” one MyMSTeam member wrote. “The key is to do the exercises on your own at home as instructed. Physical therapists also have a lot of helpful little hints that you can apply to your everyday life.”
A physiatrist is a medical doctor who specializes in physical rehabilitation. They can diagnose rehabilitation issues and create exercise plans to treat those issues. From there, your physical therapist will do the hands-on work of teaching you how to do those exercises properly.
Occupational therapists teach you tips and tricks to conserve energy and keep your independence. Unlike a physical therapist who teaches you exercise methods, an occupational therapist teaches you how to better execute daily tasks and improve your quality of life.
As a MyMSTeam member put it, “Occupational therapists help with getting dressed, eating, and using special self-help devices to keep you doing things yourself, instead of depending on others.”
Another member explained the difference in their experiences with their occupational and physical therapists: “The occupational therapist set me up with things like bathroom bars and a bath seat. I also am working with an occupational therapist who is assisting me in getting function back in my hands. I also was seeing a physical therapist who helped me with specific aids and exercises to help me walk better and fall less.”
People with MS often experience mood and cognitive changes because of changes in the brain, and dealing with MS can be stressful and draining in and of itself. Depression is one of the most common symptoms of MS. Treating emotional and mental symptoms is just as important a part of your MS care as treating your physical symptoms. A good set of mental health providers can be an important part of your MS health care team. As one MyMSTeams member said, “I would recommend reaching out to someone like a therapist, even if it's just for venting. Mine has been a lifesaver!”
Several types of professionals provide mental health care, including:
One MyMSTeam member shared positive experiences working with a neuropsychologist. “My neuropsych evaluation was the best thing I did,” they wrote. “It gave me a lot of helpful information — and, most of all, taught me that stressing over the little things, like forgetting a word here and there, only made it worse and happen more frequently.”
Neuropsychologists also work in tandem with neurologists on cognitive assessment. “I was sent to a neuropsychologist for an assessment, and he concluded that I have mild to severe cognitive impairment,” shared another MyMSTeam member. “This gives me a baseline for my neurologist to compare to when I have future assessments.”
Ophthalmologists may be able to detect the earliest signs of MS and consult with other doctors for a diagnosis. One MyMSTeam member said, “My ophthalmologist didn't actually diagnose me, but saw blood on my retina, which, after much testing, led to my diagnosis by a neurologist.”
You may want to consult with a neuro-ophthalmologist, who is a type of ophthalmologist trained to treat eye problems that originate in the nervous system. MyMSTeam members report having positive experiences with neuro-ophthalmologists, although they warn that appointments can be time-consuming: “A visit lasts a long time because they will dilate your eyes and study your optic nerves and some other stuff too,” one member cautioned. “It’s very informative for you and your doctors!”
MS can cause bladder problems, such as an inability to empty the bladder, having to urinate too often, urinary leakage, and frequent urinary tract infections. Urologists treat conditions of the urinary tract, and they have several different treatments they can use to improve MS symptoms. Urologists can also help with other bladder-related processes, like catheterization.
Additionally, urologists treat conditions related to the penis, prostate, and testes. MS can cause difficulty maintaining an erection and with male fertility, and urologists can help with these problems as well.
Up to 40 percent of people with MS experience impairment in speech and swallowing. Speech pathologists can teach you exercises to strengthen specific muscles related to swallowing and speech. They can also help you with speaking skills that will combat speech dysfunction. Certain medications can also ease these problems.
Your pharmacists play a special role in your MS team. They can educate you on how and when to take medication. If you can, stick with one pharmacy provider, as they’re more likely to catch any potentially dangerous medication interactions.
Going to several medical professionals can provide you with the best comprehensive care available. But if your doctors aren’t in communication with you and with each other, you could receive confusing information, undergo repetitive testing, or risk unintended side effects if your doctors don’t know all the medications that you’re taking. Here are a few tips for taking a team approach.
MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 165,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.
Are you living with multiple sclerosis? Share your experience in the comments below, or start a conversation by posting on MyMSTeam.