Managing MS symptoms
Making sense of MS: In this film we ask people what advice they could give about managing the symptoms of MS.
Managing MS often involves two different approaches:
- symptomatic treatments – to manage the individual symptoms of MS
- disease modifying drugs – to treat the underlying condition.
This section focuses on the different options for treating MS symptoms.
Learning to manage your symptoms takes time and you may need to try several options to find out what works best for you. Reading up about the different options can be helpful, so you can talk them through with your GP or MS team.
Treatment for MS may include medication, therapies, such as physiotherapy, and self-management techniques. Some people explore the use of complementary or alternative medicines (CAMs).
There are also disease modifying drugs (known as DMDs or DMTs) which can reduce the number and impact of relapses and reduce the build-up of disability which can occur if you don't recover completely from relapses. Most DMDs are for people with relapsing remitting MS (RRMS), but there are some that are licenced for use by people with progressive MS. MS Decisions, our interactive decision aid can help if you are considering a DMD.
Treating MS symptoms
What are symptomatic treatments?
Symptomatic treatments help relieve the physical or mental symptoms of a condition. They don't treat the underlying cause, or change the course of the condition. There's a wide range of treatments which are used to manage MS symptoms, they include:
- drug treatments – such as medication for pain or spasticity
- therapies – like physiotherapy to help with muscle stiffness, or cognitive behavioural therapy for pain, anxiety or depression
- management techniques – for example learning to pace yourself to minimise fatigue
- rehabilitation – which can improve day-to-day living. Depending on your needs, this might include services such as physiotherapy, speech and language therapy, cognitive rehabilitation therapy or an occupational therapist may give you aids or equipment that can help
- complementary and alternative medicines – this includes treatments such as acupuncture, Pilates and mindfulness which fall outside conventional medicine, but are recognised as being helpful in improving physical and mental wellbeing.
There's a wide range of possible treatments so we will point you to the relevant resources for more detailed information. You may prefer to focus on information about the symptoms that are troubling you now. It can be a bit overwhelming to read about all the possible symptoms of MS. Not everyone experiences all of them so you might like to leave aside information that is not relevant to you.
When should I seek treatment?
It can be difficult to know when to seek treatment and when to sit things out, especially if you're still learning about your MS. There are a few things you can look out for which may explain why your symptoms are worse at the moment.
- Do you have an infection such as a cold, flu, tummy bug or a bladder infection? If so, this can cause a flare up of symptoms. Your symptoms will improve as you recover from the infection so you should look after yourself in the usual way for a cold, flu or tummy bug, or visit your GP or MS nurse to see if you need antibiotics for a bladder infection.
- Are you too hot? Many people with MS are sensitive to heat. You may find that hot weather makes your symptoms worse and the same can happen if the central heating is too high. Do what you can to get cool and symptoms should improve.
- Are you too cold? Some people find that being too cold makes their symptoms flare up although this is not as common as heat sensitivity.
- Are you feeling under pressure? Stress can make your symptoms harder to live with and, for this reason, finding a technique that makes you feel more in control can be helpful.
When to seek support from a health professional is a personal decision. However, if none of the above apply, or your symptoms don't improve after a few days, you might want to consider getting support from your GP or MS team.
- If you have new symptoms, your symptoms are suddenly much worse, or if you are having serious difficulty walking it's probably worth contacting your MS nurse straight away – especially if you experience relapses.
- Sometimes symptoms creep up on you and suddenly a slow, gradual worsening over months or years might add up to a big change you can't ignore. You should have your MS reviewed about once a year but, if this isn't happening or your appointment is a long way off, you can ask for a review.
- If your symptoms are worrying you, interfering with your quality of life, or impacting negatively on family or friends – don't suffer in silence.
Remember, new symptoms may not be due to MS, so speak to your GP or MS team if you're concerned. Also, make sure you keep up with any vaccinations, or health screening for conditions such as diabetes, high blood pressure or cancer, where appropriate.
Why do MS symptoms vary from day to day?
Making Sense of MS: Lindsay Harrison, MS Specialist Nurse, and Ben Turner, Consultant neurologist, explain why MS symptoms can vary so much.
Which health professionals will support me?
Although you will be in charge of managing many aspects of your MS, like taking medication as prescribed or keeping up with exercises recommended by a physiotherapist, sometimes you might need a bit of extra support to make sure you’re on top of your symptoms, you’ve selected the best treatment option for you, or if things change.
MS services work differently in different areas, so it's a good idea to check with your team in advance who to contact, and how, if you're concerned about symptoms. Your symptoms may be reviewed by your neurologist, your MS nurse, or you may be referred to someone who specialises in a particular therapy such as a physiotherapist or speech and language therapist, or someone who specialises in the management of a particular symptom, for example a pain specialist, continence nurse or a spasticity nurse. Your GP can help with some symptoms or refer you to other services if you need them.
What if the treatment isn't helping?
Many treatments don’t start working immediately, it may take a few weeks or months before you see any benefit. Hopefully you’ll be given an idea of when you might expect to see results or be offered an appointment to review how you’re doing after an appropriate time.
For some medicines, the dose might have to be increased gradually until you find the best possible relief for you. Typically you’d start on a low dose and be advised when to increase the dose and by how much, or have a review before any changes are made.
Not all treatments work for everyone, so if the treatment really isn’t working, ask if there’s an alternative you can try. Sometimes it can be a case of trying several options, or a combination of treatments, to find what works best for you.
Unfortunately, sometimes treatments don’t get rid of symptoms completely. For instance, treatments for nerve pain may reduce the pain to a more manageable level, but you may still experience some pain in the background. The same is also true for fatigue.
Are there new or experimental treatments I should consider?
There is no cure for MS, so beware of anyone claiming they’re offering a cure. The most important thing is to use reliable sources of information to inform your decisions, such as the MS Trust. Other sources may sound convincing but they may just be opinion, marketing hype or personal experience presented as facts.
If you do find a treatment that interests you, do your research. If there’s been a genuine breakthrough, the main MS charities will be reporting it too. Look for different opinions on the research and consider what is being said. Often research reported in the press is at an early stage, so it might be a while before a treatment becomes widely available or it may never get to that point at all.
It can be tempting to try an experimental or controversial treatment, but you need to consider the risks of harm, potentially significant side effects and the costs involved. If in doubt, have a chat with your MS team or GP.
How do I find out about new treatments?
MS is a very active area of research and new treatments are coming through all the time. Keep asking if there are any new options during appointments with your MS team, especially if you feel your symptoms aren't being managed as well as you'd like.
Life with MS
Living effectively with MS means using all the resources available to manage your condition well. Find information on diet, exercise, family and relationships, travelling and more.
What is MS?
Multiple sclerosis (MS) is a lifelong condition that affects the central nervous system. This section provides an overview of MS, why it happens and what the symptoms are.
MS and life choices
A diagnosis of MS can affect the choices you make about your life and future goals. Find out about making life choices after being diagnosed.