MS may be caused either by damage to the
nerves (neuropathic pain - associated with stabbing pains, extreme skin sensitivity and burning sensations) or by damage to the tendons, ligaments, muscles and bones (
musculoskeletal pain). This second type of pain is not caused directly by MS but can develop through altered posture and positioning. In order to treat pain effectively, it is important to identify the cause. For example, neuropathic pain may be best managed using drugs, whereas musculoskeletal pain is best treated by a physiotherapist and/or occupational therapist.
Spasm: Nerve damage can cause muscles to contract into tight, often painful spasm. This symptom is not only distressing, but if it is not treated effectively, the functioning of the muscles can be affected. Therapists and doctors both play an important role in the management of spasm and may recommend a combination of exercise and drug therapy.
Mobility: Difficulties with walking can be caused by balance or co-ordination problems, dizziness, muscle stiffness (spasticity) or weakness. This aspect of MS should be managed by a multi-disciplinary team and input from a physiotherapist is very important.
Treatments for MS
Understanding of the best ways of treating MS is improving all the time with potential new drug therapies in development and better ways of managing symptoms being developed.
The treatment of MS can be divided into
three areas
- Symptom management: The majority of treatment involves managing specific symptoms such as bladder problems or fatigue. Depending on the symptom, this might involve a combination of drug treatment, input from therapists and the development of management strategies. .
- Drugs to treat relapses: Corticosteroids (or steroids) are often given for a few days, either in the form of tablets or by a drip into a vein. While there is no evidence that steroids make any difference to the long-term course of the disease, they can be effective at speeding up recovery from relapse.
- Drugs which modify the disease course: Three beta interferon drugs, Avonex, Betaferon and Rebif, and another disease modifying drug called glatiramer acetate (Copaxone), can be prescribed for people with certain types of MS.
