Comprehensive treatment plays a vital role in addressing MS, encompassing medical interventions, exercise, nutrition, sleep management, and addressing comorbidities. In past issues of InforMS, you’ll find deeper dives into many of these topics – visit MSCenter.org/Informs to browse our back issues. Here, we’ve touched on the basics of why each of these elements is so important to those of us living with MS.
Medical Interventions and Adherence to MS Treatment
While MS has no cure, we’ve come a long way in recent years in our ability to effectively treat the disease. Medical interventions aim to modify the course of MS, slow disease progression, alleviate symptoms, and manage relapses. Every patient and every situation is different, and no one treatment plan will be right for everyone, but modern MS treatment on the whole is helping people live better, healthier lives than they likely would without medical intervention.
Further Reading
The following InforMS Issues contain more thorough information on many of the topics addressed in this article. All are available for reading in our complete InforMS Archives at
MSCenter.org/informs
Disease-modifying therapies (DMTs) are prescribed to slow down disease progression by reducing the frequency and severity of relapses. These treatments work by modulating the immune system, targeting inflammation, and protecting the nervous system.
We know that modern DMTs can have significant impact on the course of MS for many individuals, yet sticking with prescribed MS treatments isn’t always as automatic as you might think. And it turns out that MS patients aren’t alone — it’s common among those living with all chronic illnesses to just not take their medicine. A report in 2012 in the journal US Pharmacist said that a collection of studies showed adherence rates can be as low as 50 to 60 percent. With the success of many recent developments in MS treatment, hopefully those numbers will be on the rise for the MS community.
Symptom management is another critical aspect of medical interventions. Medications can be prescribed to alleviate specific symptoms such as muscle spasms, fatigue, pain, and bladder dysfunction. Physical and occupational therapy can also play a significant role in improving mobility, coordination, and daily functioning.
Exercise
Regular physical exercise has been shown to have numerous benefits for individuals with MS. It can improve strength, flexibility, balance, and cardiovascular fitness. Exercise also helps manage weight, reduce fatigue, and improve mood and mental wellness.
Physical exercise is also a powerful tool in strengthening the brain’s ability to fight MS. Research shows that even small amounts of physical activity can have an impact on cognition, cognitive decline, and neuroplasticity (the brain’s ability to adapt).
Tailoring exercise programs to individual abilities and limitations is essential. Low-impact activities like walking, swimming, and yoga can be beneficial. Additionally, strength training exercises targeting specific muscle groups can help improve overall functionality, especially when MS has impacted movement or strength, or caused spasticity in certain areas.
You should always consult with a member of your MS care team, healthcare professional, or physical therapist experienced in working with MS patients to develop a safe and effective exercise routine. Remember that an exercise regimen that works for you is important – if you go too far or too fast, it’s unlikely that you’ll maintain your exercise routine, and small, low-impact efforts are better than no efforts at all.
Nutrition
A healthy diet plays an important role in managing MS symptoms and supporting overall wellness.
In a study published in the journal Neurology in 2018, researchers presented a large-scale cross-sectional study of dietary screener questionnaires. The dietary questionnaires were completed in 2015 by nearly 7,000 participants in the North American Research Committee on MS (NARCOMS) Registry. The study results suggested that a healthy diet and healthy lifestyle are associated with lower levels of disability and symptom severity in MS.
Participants in the study whose diets were higher overall in fruits, vegetables, legumes, and whole grains, and lower in added sugars from sweets and sugar-sweetened beverages as well as red meat were associated with lower disability levels. Overall diet quality also had association with less severe depression. These findings are consistent with other smaller-scale studies of diet in MS patients.
While no specific diet is proven to be the one specific “best choice” for people living with MS, certain dietary patterns have shown potential benefits. The Mediterranean diet, for example, is rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, and has been associated with reduced inflammation and improved cognitive function.
Consulting with a healthcare professional or a registered dietitian can be a great help in developing an individualized nutrition plan based on your specific needs and dietary restrictions.
Sleep
Quality sleep is crucial for overall health and wellness, and it plays a significant role in managing MS symptoms. Many individuals with MS experience sleep disturbances, including insomnia, sleep apnea, or frequent nighttime awakenings. Addressing these issues can help improve cognitive function and enhance overall quality of life.
Fatigue remains one of the most commonly-reported symptoms of MS, and while it may sound fairly innocuous to those who’ve never experienced it, people living with MS fatigue know it can be one of the most debilitating aspects of this disease. While a good night’s sleep isn’t a cure for fatigue, it can be an important tool in your arsenal to stave off bouts of fatigue or lessen their impact on your ability to function during the day.
“Sleep Hygiene” is a term we use to describe aspects of establishing an environment and lifestyle that promotes good sleep. This can include establishing a consistent sleep routine, creating a dark, quiet, and comfortable sleep-friendly environment, and practicing relaxation techniques before bedtime. Addressing underlying factors like pain that keeps you awake, bladder problems that get you up in the middle of the night, or medication side effects is also important. If sleep problems persist, consulting with a sleep specialist can provide further guidance and support.
Dealing with Comorbidities
“Comorbidities” is the term we use to talk about various other things a person may be dealing with in addition to their MS. Usually they are chronic conditions and can often complicate MS treatment in various ways.
Most commonly, comorbidities seen in MS can include depression, anxiety, and diabetes. They can also include cancers, arthritis, and age-related conditions like osteoporosis and cardio-pulmonary diseases.
It’s critical to treat these conditions alongside MS to improve overall health and wellness. That will often mean working with healthcare providers including your neurologists, primary care doctors, and specialists. Each member of your care team should be aware of everything you’re dealing with, even if it’s not their area of expertise.
Treatment plans should be personalized, considering how the medications used for MS and the comorbid conditions might interact. Regular check-ups, preventive measures, and making lifestyle changes like managing stress and quitting smoking can also be helpful in managing comorbidities. It’s all about taking steps to stay healthy and manage these conditions effectively.
