What is multiple sclerosis (MS)?

Multiple sclerosis (MS) is a chronic disease that affects the central nervous system. It affects more than 25,000 people in Australia and is 3 times more common in women than in men.

MS means there is damage to the protective sheath (known as myelin) that surrounds the nerve fibres in the brain and spinal cord. This damage causes scars, or lesions, in the nervous system, meaning that the nerves can’t send signals round the body properly.

A person's risk of developing MS is increased if they have a close relative with the condition.

The cause of MS is not known, but theories include that it is an autoimmune disease; that it is caused by genetic or environmental factors (it is more common the further away from the equator you live); and that it is caused by a virus.

There is currently no known cure for MS although there are treatment options. MS affects different people in different ways, and treatment often involves managing symptoms.

What are the different types of multiple sclerosis?

Relapsing-remitting MS (RRMS) — This is the most common form of MS and about 3 in every 4 people with MS begin with a relapsing-remitting stage.

With RRMS, new symptoms appear or existing symptoms worsen over a period of days, weeks or even months, followed by a partial or complete recovery, which is then followed by another relapse. For some people, these relapses get worse and the disability stays. Their health gradually declines. This is known as secondary progressive MS (see below).

Primary progressive MS (PPMS) — 1 or 2 people in every 10 with MS are diagnosed with PPMS. These people usually find that their symptoms become gradually worse, with no separate attacks.

Secondary progressive MS (SPMS) — Most people with RRMS will eventually experience SPMS. In this form, disability generally worsens slowly, independent of any relapses.

What are the symptoms of multiple sclerosis?

MS usually starts with mild symptoms that may or may not get worse over time. Symptoms depend on which part of the central nervous system is affected and how much damage has occurred.

The most common symptoms are:

• problems with controlling the body — like muscle spasms, weakness, loss of coordination and balance
• tiredness and sensitivity to heat (a hot day or a hot bath, or even a hot cup of tea, can make symptoms worse)
• other nervous symptom problems — including vertigo, pins and needles, dizziness, neuralgia and problems with eyesight
• continence problems — including bladder incontinence and constipation
• changes in memory, in concentration, in reasoning, in emotions, or in mood (such as depression)

The symptoms of MS vary widely from person to person. They can also come and go in any one person. MS is unpredictable.

How is multiple sclerosis diagnosed?

A range of tests can be used to diagnose MS, including an MRI to detect lesions in the central nervous system, a physical examination to check reflexes and responses, blood tests, lumbar punctures and other types of tests to measure nerve activity.

Sometimes it can take years to reach a diagnosis because there is no single test for MS. A person will be diagnosed with MS if there is evidence of lesions in different parts of the central nervous system, at different times, with no other explanation than MS.

How is multiple sclerosis treated?

Medicines can delay the progression of MS and reduce the risk of relapses. These are called ‘disease modifying therapies’. Other medicines are used to control symptoms. The best medicine for you depends on the type of MS you have. Talk to your doctor or other health professionals who care for you about the right combination of treatments for your particular situation.

Disease modifying therapies work by targeting the immune system. They slow the frequency and severity of attacks so the myelin sheaths are damaged less. These medicines are also called immunotherapies. However, these treatments do not reverse current symptoms and there can be significant side effects. These medicines are usually used for people with relapsing-remitting MS.

Steroids can reduce the severity of an MS attack by reducing inflammation and suppressing the immune system.

Medicines to suppress the immune system (called immune suppressants) are sometimes used, especially for people with progressive MS.

Controlling the symptoms of multiple sclerosis

There are medicines available that can ease muscle spasms, pain, continence problems, tiredness, depression and other symptoms.

Regular exercise, physiotherapy and occupational therapy can also help reduce symptoms and help you be as active as possible.

A well-balanced diet low in fat and high in fibre can help. Regular exercise can strengthen muscles, improve heart health and improve mood.

Resources and support

A lot of research, including stem cell research, is focused on prevention, treatment and a cure for MS.

There is also help and support available for people with MS, and their carers.

For more information, visit the MS Australia website.