Living with a chronic illness can be challenging, especially when it comes to managing the symptoms and finding effective treatment options. One such illness is multiple sclerosis, which affects over 2.8 million people globally [1]. This is a CNS disorder that lasts for a very long period and is very unpleasant during that time. In MS, the body's own system attacks the protective sheath around the nerve fibers, and defects in brain-to-body communication arise. Common symptoms of MS include fatigue, trouble walking, numbness or tingling in limbs, muscular weakness or spasms, issues with coordination and balance, incontinence or bowel dysfunction, vision problems, and cognitive impairments.

Early therapies are necessary to decrease disability and enhance survival despite the lack of a cure for multiple sclerosis. This article will shed light on various treatment options available for MS. So, let's get started!

1.   Treatments for Multiple Sclerosis relapse:

The primary objective of the treatment options for MS attacks is to lower inflammation and speed up healing.

• Corticosteroids like prednisone or methylprednisolone are often given to make MS attacks less severe and last less time.

• Plasmapheresis is another choice for treating MS attacks that are very bad. During this treatment, the plasma in a patient's blood is taken out and replaced with either a different fluid (corticosteroids) or donation plasma. Plasmapheresis helps get rid of dangerous antibodies in the blood that can lead to inflammation and make MS attacks worse.

A 2022 case study has shown the effectiveness of plasmapheresis in the management of acute attacks of multiple sclerosis symptoms [2].

2.   Treatment for multiple sclerosis symptoms

The treatment for symptoms of multiple sclerosis focuses on managing and easing the different problems that people with MS face.

Fatigue:

The fatigue that comes with MS isn't like normal tiredness. It can be overwhelming and crippling, making even easy jobs feel hard. There are a number of ways to treat this condition, which is good news.

• Amantadine. It is an effective drug for fatigue in MS because it gives the patient more energy, makes them less tired, and reduces sleepiness.

• Regular exercises. People who have multiple sclerosis may feel better and have more energy if they work out regularly. Before starting a new exercise program, you should talk to your healthcare team so they can give you advice that is right for you.

• Energy-saving techniques. With these methods, you pace yourself throughout the day, put activities in order of value or how much you enjoy them, and take breaks when you need to. People with MS can better control their symptoms and avoid getting too tired by using these ways to save energy.

• Cognitive-behavioral therapy (CBT). It helps people learn healthy ways to deal with stress and change harmful ways of thinking and acting that come with being tired.

Visual Problems

Vision problems include blurriness, double vision, inability to concentrate, and incorrect color perception. Some ways to treat vision problems in MS are:

• Steroids. Inflammation of the optic nerve is reduced by these, alleviating symptoms including hazy vision.

• Gabapentin. It's an anticonvulsant used to alleviate nerve discomfort and sometimes used to aid with visual issues as well.

Muscle spasms

There are many ways to treat muscle spasms.

• Physiotherapy. It primarily focuses on stretching exercises that target specific muscle groups.

• Medication. Doctors prescribe baclofen or gabapentin to stop muscle cramps. Other medicines for fatigue include Tizanidine, Diazepam, Clonazepam, and Dantrolene.

Mobility problems

People with multiple sclerosis (MS) may struggle with movement issues that make regular tasks challenging.

• Vestibular rehabilitation therapy. It is a branch of physical therapy that works on the vestibular system in the inner ear to improve balance and reduce dizziness.

• Mobility aids. These are very important for helping people with MS who have trouble moving around. People who use canes, walkers, or scooters are able to go about with more ease and safety.

• Exercise. Consistent exercise is associated with increased muscular strength, greater range of motion, and better overall balance.

Neuropathic pain

Neuropathic pain may be alleviated with the following treatments:

• Medication. Anticonvulsants, like gabapentin or pregabalin, can be given. These drugs mitigate discomfort by interrupting the transmission of pain signals that are aberrant. Duloxetine, carbamazepine, and amitriptyline are a few more options.

• Complementary therapies. Some patients have reported improvement after using alternative treatments such as acupuncture, massage, and transcutaneous electrical nerve stimulation (TENS).

Musculoskeletal pain

MSK pain can be alleviated by:

• Physiotherapy. To alleviate discomfort and enhance mobility, a trainer might devise a program of targeted muscle relaxation and strengthening exercises.

• Medicines. Muscle relaxants like baclofen or gabapentin can be among these medicines. The discomfort and cramping in the muscles will be relieved.

• Heat therapy or massage. Applying heat packs to the affected area can help loosen up tight muscles, and massage methods can improve blood flow and reduce stress.

Cognitive symptoms

People with MS can have a hard time thinking, learning, and remembering things, which can have a big effect on their quality of life. Brain fog" and cognitive impairment are common terms used to describe these mental problems. There are several ways to deal with brain issues.

• Compensatory techniques. Use schedules or apps to set reminders, make lists, or take notes during talks or meetings as a way to make up for it.

• Cognitive rehabilitation therapy (CBT). It can also be helpful because it gives people tasks to help them improve their memory and focus.

3.   Treatment to reduce MS relapses

A key part of handling multiple sclerosis is to reduce MS relapses. The goal is to prevent or minimize the occurrence of new symptoms or exacerbations. The medical term for these treatments is "disease-modifying therapies."

They may be administered orally or intravenously. They work to lessen the scarring and damage to the myelin sheath (the protective covering of your nerves) that is linked to multiple sclerosis flare-ups.

Limited data suggests that these medicines may also assist in reducing the progression of MS impairment [3].

Not all people with multiple sclerosis can benefit from disease-modifying treatments. Only persons with relapsing-remitting MS or relapsing forms of main or secondary progressive MS are given these medications.

Conclusion

Living with multiple sclerosis can be hard, but there are many treatments and support services that can help people deal with the condition well. By giving help, advice, and emotional support, these options try to improve the quality of life for people with MS. Multiple sclerosis may be treated well with both conventional medical care and changes in how the person lives. A healthy food full of nutrients is good for your health as a whole, and regular exercise improves your strength, flexibility, and balance and makes you feel less tired. Resting when you need to is also important because it helps you keep up your energy.

References

1. Walton, C., King, R., Rechtman, L., Kaye, W., Leray, E., Marrie, R. A., Robertson, N., La Rocca, N., Uitdehaag, B., van der Mei, I., Wallin, M., Helme, A., Angood Napier, C., Rijke, N., & Baneke, P. (2020). Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Multiple sclerosis (Houndmills, Basingstoke, England), 26(14), 1816–1821. https://doi.org/10.1177/1352458520970841
2. Bunganic, R., Blahutova, S., Revendova, K., Zapletalova, O., Hradilek, P., Hrdlickova, R., Ganesh, A., Cermakova, Z., Bar, M., & Volny, O. (2022). Therapeutic plasma exchange in multiple sclerosis patients with an aggressive relapse: an observational analysis in a high-volume center. Scientific reports, 12(1), 18374. https://doi.org/10.1038/s41598-022-23356-w
3. Finkelsztejn A. (2014). Multiple sclerosis: overview of disease-modifying agents. Perspectives in medicinal chemistry, 6, 65–72. https://doi.org/10.4137/PMC.S13213