Multiple Sclerosis Overview

Multiple sclerosis (MS) is a neurological condition that affects the brain and/or spinal cord. With MS, the immune system attacks the body’s myelin—a protective sheath that covers nerve fibers and aids in the speed of nerves sending signals—by producing antibodies that damage the myelin. This causes lesions and scars (sclerosis), which slow down or stop the transmission of signals from the brain and spinal cord to other parts of the body. According to the World Health Organization, it is estimated that almost two million people worldwide have MS.

There are four different types of MS:

  • Clinically isolated syndrome — when a patient experiences their first episode of symptoms that could be related to MS
  • Relapsing-remitting multiple sclerosis (RRMS) — categorized by flare-ups or new or old symptoms followed by periods of remission
  • Secondary progressive multiple sclerosis (SPMS) — the more progressive version of RRMS
  • Primary progressive multiple sclerosis —involves the gradual worsening of symptoms without relapse

As a chronic condition, MS can worsen over time and may eventually lead to permanent damage or deterioration of nerve fibers.

Causes and Risk Factors of Multiple Sclerosis

While the direct cause of multiple sclerosis is unknown, it is believed that there are a number of factors that may play a role in the development of MS. Some risk factors that may increase an individual’s risk of developing multiple sclerosis include:

  • Sex – Females are more likely to develop relapsing-remitting MS than males.
  • Age – People of all ages can develop MS, but the onset of the condition usually occurs in young adults between 20-40 years old.
  • Viral infections – Some viruses have been linked to MS, including Epstein-Barr.
  • Family history – If you have immediate family members with MS, you are at an increased risk of developing the condition.
  • Race – While further research is still needed on all populations, people of Asian, African or Native American descent are considered to have the lowest risk of developing MS, while white individuals—particularly those of Northern European descent—are at the highest risk.
  • Environment – Certain climates may increase the risk of developing MS, as low levels of vitamin D and little exposure to sunlight have been associated with a higher risk of MS.
  • Obesity – Obesity has been associated with MS in females, particularly in cases of females who have had childhood or adolescent obesity.
  • Other autoimmune diseases – Those with one or more autoimmune disorders other than MS (such as a thyroid disorder, psoriasis or type one diabetes) have a slightly higher risk of developing MS.

The factors that impact a person’s risk of developing MS range from genetic to environmental. Despite this, there is no one risk factor can be an absolute determinant of whether someone will get MS.

Signs and Symptoms of Multiple Sclerosis

The symptoms of multiple sclerosis can vary from person to person. They may also present differently depending on where the affected nerve fibers are located. MS symptoms can include:

  • Vision problems such as blurred vision or prolonged double vision
  • Fatigue
  • Numbness or weakness of the limbs, typically on one side of the body at a time
  • Cognitive problems
  • Electric shock-like sensations caused by certain neck movements
  • Lack of coordination or trouble with balance
  • Difficulty walking
  • Heat sensitivity
  • Muscle stiffness
  • Depression or other mood disturbances
  • Vertigo
  • Changes in sensation (numbness or tingling)
  • Problems with sexual, bowel and bladder functions

Some symptoms of MS appear to be more common than others. Symptoms can worsen due to a variety of external factors, such as heat or infection. If you have experienced any of these symptoms, see a doctor for further testing.

Diagnosing MS

There is no singular definitive diagnostic test for multiple sclerosis, as it is a diagnosis of exclusion. Certain tests may be used to rule out other possible conditions, though, so a doctor may recommend any of the following:

  • An MRI to examine if there is any scar tissue or damage to the brain or spinal cord
  • A spinal tap (lumbar puncture) to search for oligoclonal bands or other characteristics of MS
  • Blood tests
  • Optical tests such as an optical coherence tomography (OCT), which scan the nerves in the back of the eye to see if MS-related damage is present

Multiple Sclerosis Treatment

There is currently no cure for MS, however there are many different interventions that can be used in combination to decrease the progression and symptoms of MS. Various disease-modifying therapies (DMTs), such as physical therapy, occupational therapy and speech therapy, may be recommended. These treatments are aimed at improving the management of MS symptoms. Yearly evaluations can also help in tracking the progression of the disease and provide targeted interventions to maintain independence and mobility.

Additional treatments aimed at symptom management will depend on the patient’s specific symptoms. For example, certain medications may be prescribed for vision symptoms, cognitive symptoms or spasms. Assistive mobility devices are another option for some patients, as are alternative therapies such as acupuncture and yoga. Your provider can discuss your options with you in detail and help develop a treatment plan tailored to your symptoms and needs.

Multiple Sclerosis Complications

Although it cannot be cured, multiple sclerosis does not have an immense impact on life expectancy, especially with modern treatments. Only in rare cases is MS considered fatal, though progressive symptoms of MS can lead to the following complications:

  • Memory loss
  • Depression, anxiety and other mood disorders
  • Sexual dysfunction
  • Trouble walking without assistance
  • Loss of bladder or bowel control

Seeking proper treatment for MS symptoms may not be able to prevent these complications, but it can help control them and maintain quality of life for longer.

Multiple Sclerosis Prevention and Management

There is no known way to prevent multiple sclerosis from developing. For those who have MS, however, there are some ways to help lower the risk of symptom flare-ups. Your healthcare provider may recommend that you:

  • Practice disease-modifying therapies
  • Eat nutritious meals
  • Get enough sleep
  • Avoid smoking or using other tobacco products

Exercise also plays an important role in management of MS; it has been proven to aid in many factors from immune health to quality of life. Regardless of the symptom severity there are physical therapy interventions that can be implemented throughout the disease course. See this fact sheet for more information.

Living With MS

People with MS can live a fulfilling life, especially with the right care. There are plenty of resources available that help with the challenges that MS can cause, including:

The National MS Society

The National Multiple Sclerosis Society is a resource for patients diagnosed with MS. They provide educational information on symptoms and diagnosis, treating MS, current research and MS Nurse navigators. MS Nurse navigators are highly skilled, compassionate professionals that connect you to the information, resources and support needed. This includes financial support, emotional support, wellness strategies and personalized case management for those who qualify and much more.

Can Do MS

Can Do MS is a national nonprofit organization whose mission is to deliver free health and wellness education programs, resources and support to help families living with MS thrive. They offer in-person, virtual and on-demand educational programs on topics such as nutrition, exercise, MS symptoms, relationships, employment and more. Led by MS care specialists, including rehabilitation professionals, psychologists, nurses, doctors and nutrition specialists., these programs allow attendees to connect with others and identify solutions to common challenges of living with MS.

TGH’s Approach to Multiple Sclerosis

At Tampa General Hospital (TGH), we provide a variety of diagnostic and treatment options for multiple sclerosis. Our treatment team works with the University of South Florida (USF) Health Comprehensive Multiple Sclerosis Center, which has been nationally recognized for over 10 years. We specialize in:

MS Rehabilitation

Following an initial diagnosis of MS or an increase in MS symptoms, it is important to work with a treatment team that specializes in treating individuals with MS. Tampa General Hospital offers two locations for outpatient neurological, physical and occupational therapy. Each location includes staff with extensive treatment experience with neurological patient populations and Board-Certified Neurologic Clinical Specialists.

Psychology and Neuropsychology

Multiple sclerosis may impact your mental health and wellbeing. Symptoms including depression and anxiety are very common. Working with a rehabilitation psychologist can help provide management strategies for these stressors and ways to adjust to your current level of function. For more information, visit Tampa General Hospital Psychology and Neuropsychology or call (813) 844-3541 and press option 5. Individuals can be seen in-person or via a telehealth appointment.

At Tampa General Hospital, finding the right treatment and resources for managing MS is easy. Contact our team today to learn more about local support groups, assistance programs (such as Walk MS and FAAST ) and treatment options we offer.

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