Expert Advice: Understanding Multiple Sclerosis: Causes, Symptoms and Treatment

Multiple sclerosis (MS) is an incredibly complex and debilitating condition. According to MS Australia, MS is the most common acquired chronic neurological disease affecting young adults, with the average age of diagnosis falling between 20 to 40. And with no cure and no known single cause of MS, this condition remains a bit of a mystery.

Read on to learn more about what MS is, as well as the causes, symptoms and treatments available. 

What is multiple sclerosis?

Multiple sclerosis (MS) is a chronic and often disabling neurological disorder that affects the central nervous system (CNS), including the brain, spinal cord and optic nerves. In MS, the immune system mistakenly attacks the protective covering of nerve fibres, known as myelin. Myelin acts like insulation around nerve fibers and facilitates the smooth transmission of electrical impulses between the brain and the rest of the body.

The immune system’s attack on myelin leads to inflammation, damage and the formation of scar tissue (sclerosis) in multiple areas of the CNS. This process disrupts the normal flow of electrical impulses along the nerves, resulting in a wide range of symptoms. The severity and specific symptoms can vary widely among individuals with MS and often depend on the location and extent of nerve damage.

Types of multiple sclerosis

MS can manifest in different ways. There are several distinct types of MS that are based on the pattern of symptoms and disease progression. 

Relapsing-Remitting MS (RRMS)

As the most common form of MS, individuals with RRMS experience episodes of new or worsening symptoms, known as relapses or exacerbations, followed by periods of partial or complete recovery (remission). During remission, there can be no apparent progression of the disease.

Secondary Progressive MS (SPMS)

Some individuals with RRMS eventually transition to secondary progressive MS. In this stage, there is a gradual and steady worsening of neurological function over time, with or without occasional relapses or remissions. The progression tends to be more consistent than in RRMS.

Primary Progressive MS (PPMS)

PPMS is characterised by a steady worsening of symptoms from the onset, without distinct relapses or remissions. People with PPMS may experience occasional plateaus or temporary improvements, but overall, the disease progresses without the typical pattern seen in RRMS.

The course and progression of MS tend to vary significantly among individuals, with some transitioning from one type to another over time. Due to the nature of the condition, it’s essential for individuals with MS to work closely with healthcare professionals to monitor and manage their symptoms effectively. Treatment plans are often tailored to the specific type of MS and the individual’s unique circumstances.

What are the causes of multiple sclerosis?

The exact cause of MS is still not fully understood, but it is believed to involve a combination of genetic, environmental and lifestyle factors:

  • Genetics: There is evidence that a genetic predisposition plays a role in susceptibility to MS. Individuals with a family history of MS have a slightly higher risk of developing the condition. However, MS is not directly inherited and it’s likely that multiple genes are involved.
  • Environmental factors: Certain environmental factors may contribute to the development of MS, especially in individuals with a genetic predisposition. For example, infections, like the Epstein-Barr virus that causes glandular fever, and vitamin D deficiencies have both been linked to MS.
  • Geography and climate: MS prevalence varies geographically, with higher rates observed in temperate climates and at higher latitudes. This has led researchers to investigate the potential role of sunlight exposure, vitamin D production and other environmental factors in the development of MS.
  • Immune system dysfunction: MS is considered an autoimmune disorder, where the immune system mistakenly attacks the body’s own tissues. In the case of MS, the immune system targets the myelin sheath, which is the protective covering around nerve fibers in the CNS. This immune response leads to inflammation and the formation of scar tissue.
  • Smoking: Cigarette smoking has been identified as a potential environmental risk factor for MS. Smokers, especially those with a genetic predisposition, may have an increased risk of developing the condition.

What are the symptoms of multiple sclerosis?

Everyone experiences MS differently with no two people experiencing the exact same symptoms. MS symptoms can be an isolated incidence, they can come and go or they can even vary in intensity over time. 

Common symptoms of multiple sclerosis include:

  • Fatigue,
  • Visual disturbances,
  • Dizziness and vertigo,
  • Anxiety,
  • Tremors,
  • Muscle weakness and coordination problems,
  • Sensory disturbances,
  • Cognitive difficulties,
  • Bowel and bladder issues, and
  • Emotional changes.

Multiple sclerosis treatment

While there’s no known cure for MS, there are a number of treatments used to help manage symptoms and modify the course of the disease. 

There are currently 16 ‘disease modifying treatments’ (DMTs) registered for use in Australia. DMTs are a group of medications designed to modify the course of MS by reducing the frequency and severity of relapses, as well as slowing down disease progression. Different DMTs work in various ways, from suppressing the immune system to targeting specific inflammatory pathways. The specific DMT depends on factors like the type of MS, the individual’s health and their preferences.

Alternatively, when it comes to multiple sclerosis, occupational therapy (OT) can help you to regain your independence and function. From building your capacity to complete simple everyday tasks to providing complex home modifications, an OT will work with you to understand your goals and help you achieve them. 

At Community NeuroRehab Service, we have a number of highly skilled occupational therapists who specialise in helping people with neurological conditions, like MS. We recommend a multi-disciplinary approach to treat Multiple Sclerosis including Physiotherapy, Occupational Therapy and Exercise Physiology. Reach out to us to see how our OTs can help you manage your condition.