Multiple Sclerosis, also known as MS, is a condition that affects the central nervous system, interfering with the protective sheath, known as myelin, that surrounds the nerve fibres in the brain and spinal cord. This causes scars or lesions in the nervous system, meaning nerves can’t send signals around the body properly.
There is no clear cause of MS and no single diagnostic test to confirm MS. Because symptoms vary from person to person and can fluctuate over time, it can take months or years to have a diagnosis.
In recognition of World MS Day (30 May), we spoke with a Care Squared OT to learn a little more about this disease.
What are the types of MS?
There are 3 types of MS:
Relapsing-remitting MS – this is the most common presentation where a person experiences clearly defined attacks or episodes of symptoms, followed by periods of remission. Symptoms may either fully or partially resolve during remission. Around 85% of people are initially diagnosed with this form of MS.
Secondary-progressive MS – most people with RRMS will eventually move to SPMS, where their symptoms gradually worsen over time regardless of any relapses and recovery.
Primary Progressive MS – people with this form of MS show progressive deterioration from the onset. There may be episodes of acute symptoms with partial remission, but overall symptoms will accumulate.
What symptoms are associated with this condition?
Symptoms vary widely from person to person depending on which area of the nervous system is affected.
Common symptoms include:
• Fatigue – feeling excessively tired, and having limited energy. This is often exacerbated by heat
• Reduced motor control – people may experience muscle spasms, weakness, reduced coordination and poor balance.
• Bowel and bladder problems including incontinence and constipation
• Neuropsychological symptoms can include depression, cognitive difficulties and memory loss. Cognitive changes are often described as a ‘Cognitive fog’
• Vision changes including double or blurred vision, changes to colour vision, areas of poor vision or blind spots, and involuntary eye movement (nystagmus) may occur.
• Other neurological symptoms might include vertigo, pins and needles, dizziness, neuralgia (stabbing/burning sensation)
How can Occupational Therapists support clients with MS?
OT’s can work with participants who have MS at any stage of their journey. An OT can evaluate the difficulties a person is having carrying out their day-to-day activities and offer interventions and strategies to assist. This may be concerning self-care activities such as having a shower, dressing and eating; productive activities such as home management, caregiving, paid employment and volunteering, and leisure activities.
Some interventions we may use include:
• Energy conservation techniques to help preserve function and independence
• Learning new ways to complete tasks
• Environmental modifications such as grab rails, ramps or installing a step-free shower to improve safety and mobility around the home
• Assistive technology prescription can include small items to make life easier (e.g. adaptive devices to use in the kitchen) or more complex items such as powered wheelchairs and scooters.
What are the misconceptions surrounding MS?
Many misconceptions are surrounding MS, with some more prevalent ones speaking to the severity and treatment of MS. These misconceptions include:
- That MS can’t be treated – this isn’t the case now. There are disease-modifying treatments that can reduce the number and severity of attacks and slow the progression of the disease.
- That you will end up in a wheelchair – around 75% of people with MS will never lose the ability to walk. They may have some balance difficulties or fatigue quickly, but not everyone will need a wheelchair full time
- MS is fatal – whilst MS cannot be cured, it is not fatal. Life expectancy may be reduced by around 7 years (but this is changing with improved treatment) and many people live a healthy and active life for many years post-diagnosis.
For more information on MS and World MS Day, visit The National Voice For People With MS.