Written by Ann Pietrangelo | Published on June 24, 2013
Medically Reviewed by George Krucik, MD, MBA – See more at:
Multiple Sclerosis is a neurodegenerative and inflammatory immune condition that causes problems throughout the body.
MS gradually breaks down the protective cover (myelin sheath) around the nerves. This makes it hard for the brain to communicate to the rest of the body. This can cause dizziness, vertigo, depression and emotional changes, confusion, forgetfulness, and headache. In some cases, MS can cause tremors, seizures, and other cognitive problems.
The Effects of MS on the Body Systems
Multiple sclerosis (MS) is thought to be an autoimmune disease and progressive neurodegenerative condition. It affects the nervous system, which gradually impacts the whole body. The Multiple Sclerosis Foundation (MSF) reports that as many as half a million people in the United States have been diagnosed with MS, and hundreds more diagnoses are made every week (MSF, 2009). Women are diagnosed with MS at least twice as often as men—usually between the ages of 20 and 50—according to the National MS Society (NMSS).
The exact cause of MS is unknown, and there is currently no cure. However, there are many treatments available that can slow the disease’s progression or ease its symptoms. Although everyone’s experience with MS is different, there are common symptoms that occur throughout the body for many individuals.
Learn four possible causes of multiple sclerosis »
The Nervous System
When someone has MS, their body’s immune system slowly attacks its own myelin sheath, which is composed of the cells that surround and protect the nervous system including the spinal cord and brain. When these cells are damaged, the nerves are exposed, and the brain has difficulty sending signals to the rest of the body.
The disconnection between the brain and the organs, muscles, tissues, and cells served by the damaged nerves causes many of the classic MS symptoms, such as dizziness, vertigo, confusion, memory problems, and emotional or personality changes. Depression and other changes in the brain can be a direct result of MS or an indirect result from the difficulty of coping with the condition.
In rare or advanced cases, nerve damage can cause tremors, seizures, and cognitive problems that closely resemble other neurodegenerative conditions such as dementia.
Vision and Hearing
Vision problems are often the first sign that something is wrong for many people with MS. Double vision, blurriness, pain, and problems seeing contrast can begin suddenly and affect one or both eyes. In many cases, vision problems are temporary or self-limiting, and likely result from nerve inflammation or fatigue of the eye muscles.
Although some people with MS experience permanent vision problems, most cases are mild and can be effectively treated with steroids and other short-term treatments.
Although it’s rare, people with MS may experience hearing loss or deafness. These types of hearing problems usually resolve on their own, but can be permanent in some cases. Most hearing problems are due to damage to the brainstem. These conditions are so rarely caused by MS that patients should be evaluated for potential unrelated causes.
Speaking, Swallowing, and Breathing
According to NMSS, speech problems such as slurring, poor articulation, and volume control issues occur in up to 4 out of 10 individuals with MS (NMSS). They often occur during relapses or times of fatigue. Other speech problems can include changes in voice pitch or quality, nasality, and hoarseness or breathiness.
Speech problems can be caused by breathing difficulties that are brought on by weak or damaged nerves that control muscles in the chest. Difficulty controlling the muscles involved in breathing can begin early in the disease and worsen as MS progresses. This is a dangerous yet rare complication of MS that often can be improved through work with a respiratory therapist.
Swallowing problems are less common than speech difficulties, but can be far more serious. They may occur when nerve damage weakens muscles and hinders the body’s ability to control the muscles involved in swallowing. When proper swallowing is disrupted, food or drink can be inhaled into the lungs and may result in infections like aspiration pneumonia. Coughing and choking when eating and drinking can be signs of swallowing problems and should be evaluated immediately. Speech or language therapists can often help with trouble speaking and swallowing.
Arms and Legs
Many people with MS experience a wide variety of symptoms that affect their limbs. Damage to the myelin sheath often results in pain, tingling, and numbness of the arms and legs. Problems with hand-eye coordination, muscle weakness, balance, and gait may occur when the brain has trouble sending signals to the nerves and muscles.
These problems may start slowly and worsen as nerve damage progresses. Many people with MS first feel “pins and needles” and have difficulty with coordination or fine motor skills. As the condition worsens, limb control and ease of walking may become disrupted. In these cases, canes, wheelchairs, and other assistive technologies can aid in muscle control and strength.
The Skeletal Structure
People with MS are at higher risk of developing osteoporosis due to common MS treatments (steroids) and inactivity, according to NMSS (NMSS). Weakened bones can make individuals with MS susceptible to fractures and breaks. Although conditions like osteoporosis can be prevented or slowed through physical activity, diet, or supplementation, weak bones can make MS balance and coordination problems even riskier.
A growing body of evidence suggests that vitamin D deficiencies may play an important role in the development of MS. Although its exact impact on individuals with MS is not yet well understood, vitamin D is vital to skeletal health and immune system health (Zabad, 2010).
The Immune System
Most researchers and medical professionals believe that MS is an immune-mediated disease. This means that the body’s immune system attacks healthy nerve tissue, which results in nerve damage that affects the whole body. Immune system activity seems to result in the inflammation responsible for many MS symptoms. Some symptoms may flare up during an episode of immune system activity and resolve when the episode ends.
Some research is investigating whether suppressing the immune system with medication will slow the progress of MS. Other therapies try to target particular immune cells to prevent them from attacking the nerves. However, drugs that suppress the immune system may make patients more vulnerable to infection.
Some nutrient deficiencies may affect immune health and worsen MS symptoms. However, most MS physicians only recommend special diets when a specific nutrient deficiency is present.
Bladder and Bowel Function
Problems with bladder and bowel function commonly occur in MS. NMSS reports that at least 8 in 10 people with MS experience bladder dysfunction (NMSS). Bowel problems can include constipation, diarrhea, or loss of bowel control. In some cases, diet and physical therapy or self-care strategies can reduce the impact of these problems on daily life. Other times, medications or more intense intervention may be necessary.
The use of a catheter may occasionally be necessary. This is because nerve damage affects how much urine those with MS can comfortably hold in the bladder. This can result in a spastic bladder or urinary tract (UTIs), bladder, or kidney infections. These problems can make urination painful and very frequent, even overnight or when there is little urine in the bladder.
Most people can effectively manage bladder and bowel problems and avoid complications. However, serious infections or hygiene problems may arise if these problems are left untreated or unmanaged. Discuss any bladder or bowel issues and their treatment options with your doctor.
The Reproductive System
MS does not directly impact the reproductive system or fertility. In fact, many women find that pregnancy offers a nice reprieve from MS symptoms. However, NMSS reports that two to 4 in 10 women will experience a relapse during the postpartum period (NMSS).
Sexual dysfunction, such as difficulty experiencing arousal or orgasm, is common in people with MS. This can be caused by nerve damage or by MS-related emotional problems such as depression or low self-esteem. Fatigue, pain, and other MS symptoms can make sexual intimacy awkward or unappealing. However, in many cases, sexual problems can be addressed successfully through medication, over-the-counter aids (such as lubricant), or a bit of advanced planning.
The Circulatory System
Circulatory system problems are rarely caused by MS, although weak chest muscles can lead to shallow breathing and low oxygen supply. However, lack of activity due to depression, difficulty using muscles, and a preoccupation with treating other problems may prevent people with MS from focusing on the risk of cardiovascular disease.
A recent study found that women with MS have a significantly increased risk of cardiovascular problems such as heart attack, stroke, and heart failure (Jadidi et al., 2013). However, physical therapy and regular physical activity may help alleviate MS symptoms and reduce cardiovascular risk.
Primary Versus Secondary MS Symptoms
Most of the problems described above are primary symptoms associated with MS. This means that they’re directly caused by the nerve damage resulting from attacks to the myelin sheath. Some primary symptoms can be treated directly by trying to slow the nerve damage and prevent MS attacks.
However, once nerve damage exists, secondary symptoms can arise. Secondary MS symptoms are common complications of primary MS symptoms. Examples include UTIs that result from weak bladder muscles, or a loss of muscle tone that results from an inability to walk.
Secondary symptoms can often be treated effectively, but treating the source of the problem can prevent them altogether. As the disease progresses, MS will inevitably cause some secondary symptoms. Secondary symptoms can often be well-managed with medication, physical adaptation, therapy, and creativity. Depression, job loss, isolation, and relationship problems are often described as tertiary symptoms because they’re further removed from the actual course of the disease.
Treating MS from Head to Toe
While there’s no cure for multiple sclerosis, a wide variety of pharmaceutical treatments, herbal remedies, and dietary supplements help alleviate symptoms and modify the disease.
Disease-Modifying MS Treatments
Disease-modifying medications include:
interferon beta 1a (Avonex, Rebif)
interferon beta 1b (Betaseron, Extavia)
glatiramer acetate (Copaxone)
dimethyl fumerate (Tecfidera)
Disease-modifying medications for MS often aim to prevent or reduce the severity of MS attacks, slow or prevent further nerve damage, and prevent further disability.
Physical and Alternative MS Treatments
No matter the stage of the disease, physical and non-medication therapies for MS can be very useful to treat symptoms. Popular therapies include:
In addition, many people with MS use alternative treatments in place of or in addition to pharmaceuticals and the therapies listed above. Alternative or complementary treatments could include herbal remedies, dietary supplements, and physical interventions.
Popular alternative MS treatments include:
vitamin D supplements
coenzyme Q10 supplements
Although many alternative treatments for MS aren’t well researched, many people experience some relief with certain therapies. Always discuss with your doctor before using them to avoid medication interactions or complications with existing health problems.
Multiple sclerosis affects everyone differently: that is, you’ll experience a unique set of symptoms and respond to treatments individually. Therefore, you and your doctors should customize your treatment regimen to address your MS symptoms specifically and alter it as the disease progresses or relapses. A carefully designed treatment plan can help make MS a manageable condition.