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A diagnosis of multiple sclerosis (MS) may be unexpected and overwhelming — but it can also bring clarity and a path forward to treatment. MS is a complex, lifelong condition affecting the central nervous system (CNS), causing a wide variety of symptoms. Learning about MS is an important step to help you access the best possible care and support.
This article provides a starting point to help you understand the basics of MS, including what it is, how it may impact your life, and where to find effective treatment and support.
Multiple sclerosis is a disease of the central nervous system, which includes the brain and the spinal cord. MS can be treated, but there is no cure. Symptoms vary widely among individuals, but mobility and cognitive issues are among the most common.
MS is an autoimmune disease in which inflammation damages the myelin sheath, a protective layer around nerve fibers. This damage creates lesions, or areas of scar tissue, in the central nervous system. The process, called demyelination, interrupts communication within the CNS, leading to the symptoms of MS.
Most people with MS eventually develop some degree of disability. Although symptoms of MS can significantly affect one’s quality of life, the disease is rarely fatal. Health experts understand that MS involves an immune system malfunction, but research continues into why some people develop MS and others do not.
Read more about causes of MS and risk factors.
An estimated 1 million people in the United States and more than 2.8 million worldwide are living with MS. MS has a strong geographic pattern: The further a region is from the equator, the more prevalent the condition is in that region.
MS can occur in people in all racial and ethnic groups. In the U.S., it is most common in white individuals of northern European ancestry, followed by African Americans, Asian Americans, and Hispanics/Latinx, according to the National Multiple Sclerosis Society.
Females are more likely than males to develop MS, according to the National Multiple Sclerosis Society. According to the nonprofit, 74 percent of people in the U.S. with the condition are female and 26 percent are male.
Multiple sclerosis is most commonly diagnosed between the ages of 20 and 50, but it is sometimes diagnosed in children and older adults.
Other MS risk factors may include smoking, childhood obesity, low levels of vitamin D, and exposure to the Epstein-Barr virus.
There are several types of MS, each with its own unique disease course. The most common form is relapsing-remitting multiple sclerosis (RRMS): About 85 percent of people who are newly diagnosed with MS have this type.
RRMS has a clear pattern of relapses (also called flare-ups or exacerbations) and remissions. During remission, people with RRMS may recover fully or partially and exhibit no symptoms. During relapses, people experience a flare of disease activity and more intense symptoms.
About 15 percent of people with MS have primary progressive MS (PPMS). In PPMS, the disease generally progresses without clear relapses or periods of remission. Instead, symptoms gradually worsen over time.
Most people initially diagnosed with relapsing-remitting MS eventually develop a pattern of progressive worsening of symptoms and increased disability. When this happens, the disease may be reclassified as secondary progressive MS (SPMS). People with SPMS may continue to experience disease flares associated with inflammation as with RRMS, or flares may give way to a more steadily progressive course.
Clinically isolated syndrome (CIS), as classified by the National Multiple Sclerosis Society, is considered an early presentation of MS rather than a distinct type. For some people, CIS marks the first time they experience neurologic symptoms similar to those of MS. Not everyone who experiences CIS will go on to develop MS.
Less common types of MS include pediatric MS (a type of MS diagnosed in people under 18) and tumefactive MS.
MS can cause a wide array of symptoms depending on which parts of the CNS it affects. Common symptoms of MS include:
Some people with MS experience a temporary worsening of symptoms during infections or when they become overheated.
Get more details about symptoms of MS.
There is no single test to diagnose MS. Following a physical exam and a medical-history assessment, your doctor will conduct several tests. They will also need to rule out conditions that may cause similar symptoms, including other demyelinating diseases or brain tumors.
During a neurological exam, your doctor will look for signs of nerve damage. This provides an objective assessment of signs and symptoms that may suggest MS or another condition.
Magnetic resonance imaging (MRI) uses a strong magnetic field and radio waves to show the location, extent, and number of lesions on the brain, spinal cord, and optic nerves. MRI can also reveal “silent” damage to the CNS that is not causing symptoms.
An evoked potential test measures electrical activity in the brain in response to specific stimuli. It is sometimes used as part of the diagnostic process for MS.
A lumbar puncture — also called a spinal tap — is used to analyze the cerebrospinal fluid, the fluid that protects the CNS. This test can help detect immune activity in the CNS, which may support an MS diagnosis.
Read more about how MS is diagnosed.
There are more than 20 disease-modifying therapies (DMTs) approved by the U.S. Food and Drug Administration (FDA) to treat MS. Additional medications and therapies are used to manage specific MS symptoms separately.
DMTs help slow MS disease progression and reduce the rate of relapses. They work by suppressing elements of the immune system and reducing the autoimmune response. Most people with MS take DMTs on a long-term basis. Starting treatment with a DMT soon after diagnosis has been proven effective at helping slow the progression of MS and delaying disability.
There are several classes of DMTs that each work in a different way. They are also administered in different ways and on different schedules. Some are taken orally every day, some are injected under the skin several times a month, and some are infused intravenously at a clinic at longer intervals.
You’ll work together with your neurologist to decide on a treatment plan for MS. Be sure to share your treatment goals and preferences with your neurology team. It’s important to note that while DMTs slow MS progression, they do not directly improve symptoms.
MS symptoms are managed separately using different types of medication and therapies. Doctors sometimes prescribe corticosteroids to control flare-ups. Plasmapheresis (plasma exchange) may also be used to treat MS flares, especially for people that cannot tolerate high doses of steroids.
Antidepressants can also be used to help manage MS symptoms such as depression, fatigue, or neuropathic pain.
Some doctors recommend muscle relaxants to manage symptoms like spasticity (muscle tightness) and stiffness.
People who have severe fatigue may sometimes be prescribed medications to help with wakefulness, such as stimulants.
Specialist therapists can also help with many symptoms of MS. Depending on your MS symptoms, you may find speech therapy, physical therapy, or occupational therapy useful.
Read more about treatments for MS.
Most people with MS live nearly as long as those without the condition — on average, about seven years shorter than the general population. However, MS can lead to significant disability over time. Effective MS management can help reduce the risk of serious complications, such as severe infections or choking due to swallowing difficulties.
An MS diagnosis can be challenging, but treatments are available to slow its progression and help manage symptoms. Working with your health care team is essential. Finding a neurologist who listens to your concerns and collaborates with you to create a personalized treatment plan can make a significant difference in your care and quality of life. Finding a care team that supports your goals and values your input is an important step in managing MS effectively.
MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 216,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.
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My son was diagnosed with MS three years ago at the age of fifty six. He had bulging discs in his back and a bleed which is why he had a scan in the first place it showed he had lesions in the brain… read more
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