There is no cure for multiple sclerosis, but medicines can slow down the disease’s progression and help control symptoms. People with MS may also need to make lifestyle changes, such as resting more often or limiting screen time. Rehabilitation programs can also be helpful, as they can help a person with MS to manage their symptoms and get back to their daily lives.
There are many different types of MS, and the way that each type affects a person can be very different. Some people experience only a few mild symptoms, while others develop significant disability. Most people with MS experience periods when symptoms worsen (referred to as a flare-up) followed by long stretches of no new symptoms or improvement of existing ones. These stretches are known as remission. Symptoms that do not go away include cognitive problems, such as memory and attention deficits, and physical issues, such as muscle weakness and spasticity or balance problems.
The earliest stage of MS is called relapsing remitting MS (RRMS). In this phase, symptoms appear and disappear over time, with a period of remission lasting from a few months to several years. The majority of people with MS have RRMS, which is the most common form of the condition.
A few people with MS will experience an early progression of the disease, and this is known as secondary progressive MS (SPMS). SPMS usually starts 10-15 years after onset of RRMS and gradually worsens over time. This phase of the disease can be hard to diagnose, because it does not always present with a single relapse. MRI is the best diagnostic tool for MS, and it can also exclude MS mimics, such as sarcoidosis or infections like tuberculosis.
Medicines that can be used to treat a flare-up of MS include corticosteroids, which reduce inflammation and suppress the immune system. Examples of these medications include Solu-Medrol (methylprednisolone) and Deltasone (prednisone). However, this treatment is only temporary and does not stop the progress of MS.
More recent treatments for MS focus on modifying the function of the immune system, repairing damaged myelin and protecting neurons from damage. NIH supports translational studies, which aim to bring these therapies from laboratory research to the clinic so that they can help people with MS.
Some of these new drugs are available as tablets, while others are injected under the skin. All of them have demonstrated some level of effectiveness in clinical trials. In particular, fingolimod (Fingore) and siponimod (Mayzent) have been shown to significantly reduce relapse rates and help to slow progression of the disease. Ozanimod (Zeposia) has been approved to treat relapsing and secondary progressive MS, and it is also being studied for PPMS.
Other treatments that may be helpful for MS include physiotherapy and occupational therapy, which can teach people with MS to manage their symptoms and improve their quality of life. These can include pacing activities, using assistive devices to help with mobility and balance, and learning how to use an electric stimulator to control pain in their muscles and nerves. Psychological support groups can also be beneficial for many people with MS.
