Guide to Your Multiple Sclerosis Diagnosis

The first step to understanding your new multiple sclerosis (MS) diagnosis is to learn as much as you can about the condition.

Your MS symptoms and the progression of your condition may be different from other people's experiences. So, it's essential to sit down and do some research about your specific diagnosis.

Gaining a better understanding of your MS diagnosis may help you feel less overwhelmed. It can also prepare you to begin treatment and to continue living your life.

This guide will give you an overview of the causes of MS, types, treatments, and more.

MS is a progressive neurological disease. It affects the central nervous system (CNS), which consists of your brain and spinal cord. Progressive means it gets worse over time.

The cause of MS isn't actually known.

What scientists do know is that MS can be considered an autoimmune disease, which means your own immune system incorrectly attacks your body.

In MS, your immune system mistakenly attacks the protective outer layer of your nerve fibers, which is known as the myelin sheath.

Nerve cells, also known as neurons, communicate by sending electrical signals through the nerve fibers. If the myelin sheath is damaged, nerve cells are unable to properly send electrical signals throughout your body to their intended target.

In other words, when MS damages the myelin sheath, your brain can't communicate well with the rest of your body. This leads to problems with movement, sensation, memory, speech, and cognition.

Scientists still don't fully understand why the immune system attacks the myelin sheath.

Genetics, infections, head trauma, smoking, obesity, lack of vitamin D, and other unknown environmental factors are thought to play a role.

However, more research is needed to confirm these theories.

It's important to confirm which type of MS you have with your doctor. There are four basic types of MS:

Relapsing-remitting MS (RRMS)

RRMS is the most common type of MS. Roughly 85 percent of people newly diagnosed with MS have RRMS.

People with RRMS experience clearly defined periods of relapse — also called flare-ups or exacerbations — when their symptoms worsen. The relapses are then followed by periods of recovery, or remission, when symptoms fully or partially disappear.

Primary-progressive MS (PPMS)

Only 15 percent of people who are newly diagnosed with MS have PPMS.

Unlike RRMS, people with PPMS don't typically experience clearly defined relapses and remissions. Instead, they tend to experience worsening neurologic function right away. PPMS generally advances faster than RRMS.

Secondary-progressive MS (SPMS)

SPMS is usually diagnosed after you've already had RRMS for some time. Most people who receive an RRMS diagnosis will eventually develop SPMS. People with SPMS experience progressive worsening of function over time.

Clinically isolated syndrome (CIS)

As the name suggests, clinically isolated syndrome (CIS) means that you've had only a single episode of neurologic symptoms. CIS may be your first clinical episode of MS. However, having CIS doesn't mean you'll definitely develop MS.

Symptoms can be difficult to predict. No two people with MS will have exactly the same symptoms. Your symptoms may also change over time.

Common symptoms of MS

• fatigue
• numbness and tingling in one or more limbs or your legs and trunk
• weakness
• pain
• walking (gait) difficulties
• dizziness
• balance issues
• bladder problems
• constipation
• sexual problems, like erectile dysfunction in men
• changes in cognition, difficulty processing new information, memory problems, and difficulty concentrating
• depression
• blurred vision
• muscle spasms

Less common symptoms of MS

• speech problems, like slurring or loss of volume
• problems swallowing (dysphagia)
• uncontrollable shaking (tremors)
• seizures
• breathing problems
• hearing loss
• headaches
• partial paralysis

There's no cure for MS. Some people have mild flare-ups and don't need treatment at all. People who do need treatment typically need to take a combination of medications and make several lifestyle changes.

Medications

Your doctor will discuss all the available MS medications with you. They may recommend one medication or a combination of several medications.

Medication options for MS include:

• over-the-counter medications such as aspirin or ibuprofen
• corticosteroids, such as prednisone and methylprednisolone, to reduce nerve inflammation
• plasma exchanges
• disease-modifying therapies for RRMS, such as:
  • beta interferons
  • glatiramer acetate (Copaxone, Glatopa)
  • fingolimod (Gilenya)
  • dimethyl fumarate (Tecfidera)
  • teriflunomide (Aubagio)
  • natalizumab (Tysabri)
  • alemtuzumab (Lemtrada)
  • ocrelizumab (Ocrevus)
• ocrelizumab (Ocrevus), the only FDA-approved treatment specifically for PPMS
• muscle relaxants
• Pain medications
• medications to reduce fatigue, such as modafinil (Provigil)
• medications for bladder dysfunction
• medications for sexual dysfunction

Some of these medications are taken orally, while others are injected. Talk to your doctor about which method is a better choice for you.

It's also important to keep in mind that the disease-modifying therapies for MS can come with side effects. You and your doctor will carefully review many factors before choosing a treatment. This includes considering the severity of your disease, other health issues, and costs.

Physical and occupational therapy

Physical therapy or occupational therapy can teach you about exercises and assistive devices that'll help you get around. Incorporating these into your life can make day-to-day tasks a bit easier.

Mental health therapy

Living with a chronic condition like MS can lead to excess stress, putting you at a higher risk for anxiety and depression. If you feel extremely sad or anxious, consider speaking to a mental health professional.

Lifestyle changes

Lifestyle changes play a role in your overall treatment plan. Here are a few that you will likely put into practice as you begin treatment:

• eating a healthy, well-balanced diet, rich in fruits, vegetables, whole grains, and lean proteins
• maintaining a healthy sleep routine
• quitting smoking
• avoiding excessive alcohol intake
• exercising regularly
• reducing stress
• using assistive devices
• keeping cool, as MS symptoms often worsen when the body temperature rises

You don't have to make all of these lifestyle changes at once, but it's a good idea to start planning for them now.

If you're not sure how to effectively change your diet, start an exercise routine, or reduce stress, speak with your doctor.

Your doctor can refer you to healthcare professionals like dietitians, occupational and physical therapists, and mental health counselors to help you reach your goals.

Complementary and alternative therapies

Along with traditional medical treatment, you may consider complementary and alternative (CAM) therapies. The National MS Society recommends that you continue taking your prescribed treatments even if you decide to add CAM to your treatment plan.

Examples of CAM for MS include:

• yoga
• acupuncture
• meditation
• massage
• vitamin D supplements
• eating a low-fat diet
• omega-3 fatty acid supplements
• lipoic acid supplements
• vitamin D supplements

Always speak to your doctor before starting a new MS treatment, which includes CAM therapy.

MS is unpredictable. There's no way to really know what course your disease will follow. Some people with RRMS rarely experience flare-ups, while others have them more frequently. Those with PPMS will experience gradual worsening of their symptoms without experiencing attacks.

Roughly 50 percent of people with RRMS will have difficulty walking 15 years after diagnosis and will need a cane or other assistance to get around. About 10 to 15 percent of the total MS population have rare attacks and experience slight disability 10 years after diagnosis.

MS is a manageable condition. In fact, there's only a slight difference in projected life span for people with MS compared to the general population.

There are many resources available for people living with MS and their caretakers. This includes national and international organizations, nonprofits, phone apps, and blogs and websites created by other brave individuals living with MS.

To get help right away, you can contact an MS Navigator from the National MS Society. These professionals can provide you with MS information, resources, and support. They can help you with things ranging from insurance and treatments to diet and exercise tips.

You can reach an MS Navigator by calling their toll-free number, 1-800-344-4867, or filling out their online form.

Healthline's own MS Buddy (iPhone; Android) application also allows you to connect with others who have MS and get access to the latest MS news and research.

A diagnosis of MS can leave you with a lot of questions. One of the first steps you can take is doing research about your specific diagnosis to help you understand your symptoms, treatments, and future. Being able to understand your MS is key to living fully with this condition.