Treatment can make living with MS easier. Some drugs (called “disease-modifying”) make it less likely that a patient will have a future MS attack or develop new MRI lesions. In some cases, disease-modifying drugs have also been shown to slow progressive MS symptoms.
Your type of treatment will depend on the type of MS that you have, whether your disease is active or in remission, and the types of symptoms you’re experiencing. Your care provider may prescribe medicines, physical therapy, speech therapy and other treatments at home. To optimize your care, you may be referred to another specialist, such as a urologist to help manage bladder symptoms, a nutritionist to make dietary recommendations, an ophthalmologist to help diagnose and manage visual deficits, a physical medicine and rehabilitation expert to design a personalized stretching and exercise program, or a pain specialist.
Medicines and treatments that are used to manage MS are described below.
- Hig- dose steroids are sometimes administered during a relapse to make the attack shorter and less severe. Steroids can be given by vein or in pill form, generally over a span of 3 – 5 days. For patients with particularly severe attacks that don’t respond to steroids, a procedure called therapeutic plasma exchange (referred to as TPE or PLEX) may be prescribed. During plasma exchange, a patient’s blood is passed through a filtering device to remove toxic agents from the blood.
- Disease-modifying therapies are given over long periods of time to patients with CIS, RRMS or active SPMS to suppress MS attacks and to minimize future neurological disability. Certain disease-modifying therapies may be indicated in individuals with PPMS who are younger and/or have evidence of active (inflammatory) disease.
- Symptomatic treatments are prescribed to control or alleviate symptoms and improve quality of life. These include drugs, physical therapy, speech therapy, cognitive rehabilitation and assistive devices.
You and your doctor will decide together if and when you should start any of these treatments.
Your doctor may prescribe a disease-modifying drug depending on the type of MS you have, your symptoms, your sensitivity to potential side effects and how your body responds. There are now over 15 drugs used to decrease the risk of future MS attacks and worsening neurological disability. They include:
Interferon beta-1a (Avonex, Rebif, Plegridy)
Interferon beta-1b (Betaseron, Extavia)
Glatiramer acetate (Copaxone, Glatopa)
Dimethyl fumarate (Tecfidera)
Diroximel fumarate (Vumerity)
Treating specific symptoms can alleviate suffering and improve quality of life. Symptoms that are often controlled or relieved with medicine include:
- Muscle stiffness (spasticity)
- Urinary urgency or hesitancy
- Pain and abnormal sensations
- Medicines can also help with sexual problems, emotional problems and walking problems
- Medicine may be used only some of the time or regularly, depending on how severe or constant a certain symptom is. Changes in diet, routine, exercise and other habits can also help manage some of these symptoms.
- Rehabilitative interventions are often employed in combination with medicines. Physical therapy, occupational therapy and speech therapy can help you manage some physical problems caused by MS. The Ohio State University Wexner Medical Center’s physical therapy department offers MS-specific therapies such as aqua therapy in our pools, assistive device clinic therapy, cognitive rehabilitation and assistance with driving tests. We have a dedicated team of MS-trained and specialized physical therapists in multiple locations to fit your individual needs.
MS Specialty Clinics
Due to the complexity and diversity of MS, we’ve started an MS Quality of Life Clinic at the Ohio State Wexner Medical Center, dedicated to a thorough appraisal of each individual patient’s symptoms and the challenges they impose.
We develop a comprehensive and multidisciplinary treatment plan to address each symptom. This plan often involves referrals to a team of collaborating providers, each of whom has an interest in the care of patients with MS and advanced training in their respective fields. The team includes physical therapists, speech therapists, fatigue and sleep disorders specialists, neuropsychologists, psychiatrists, pain experts and urologists.
Many of these experts will evaluate and manage patients on the same day during a MS Multidisciplinary Symptoms Management Clinic. We may order advanced testing, such as a neuropsychology battery to provide a detailed assessment of cognitive strengths and weaknesses, urodynamic testing to better diagnose bladder issues and tests to evaluate how MS has impacted the visual system.
Specially trained neuropsychologists might initiate cognitive rehabilitation therapy, which involves teaching stress reducing exercises as well as coping mechanisms to help patients overcome challenges with memory, concentration and fatigue. Physical therapists devise a personalized exercise regimen, which may involve water-based therapy, strengthening and stretching exercises and gait and balance training.