Multiple Sclerosis (MS): Your GoodRx Guide

Definition

Multiple sclerosis (MS) is a common autoimmune disease that affects your central nervous system (brain and spinal cord). It can cause many symptoms, like vision changes, balance problems, and weakness.

When you have MS, your immune system mistakenly attacks your brain and spinal cord. This damages the protective coating on your nerves, called myelin. It can also cause scarring (sclerosis). These changes make it hard for your body’s nervous system to work properly. 

Nearly 1 million adults in the U.S. have MS.

There are four types of MS, which are related to how your symptoms change over time:

• Clinically isolated syndrome: This is where you have only one episode of MS symptoms. 

• Relapsing–remitting: This is the most common type of MS. People with this type of MS have attacks (lasting days or weeks) followed by periods of recovery. 

• Secondary progressive MS: This is similar to relapsing–remitting, but with gradually poorer recovery between periods of attacks. 

• Primary progressive MS: When you have this type of MS, your symptoms steadily get worse over time — with no recovery periods. 

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Causes

We don’t know exactly what causes MS. But just like most autoimmune disorders, it’s possible that MS is caused by a combination of genes and environmental triggers. 

There’s also some evidence that MS is linked to:

• Living in a Northern area (further from the equator)

• Having a family member with MS

• Having a low vitamin D level

• Having obesity

• Smoking cigarettes

• Having a viral infection, like Epstein–Barr or measles

The Northeast has the highest prevalence of MS in the United States.

MS can affect anyone, regardless of:

• Age

• Race

• Ethnicity

• Gender

But certain groups of people are more likely to be diagnosed with MS, including:

• Women

• People between the ages of 20 and 50

• People of European descent

Overall, women are more likely to have MS than are men, but it depends on the type of MS: Specifically, women are three times more likely to be diagnosed with relapsing–remitting MS. When it comes to primary progressive MS, men and women are equally likely to get diagnosed. 

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Symptoms

MS can cause many symptoms — and they are different for everyone. This is because your symptoms depend on which parts of your brain and spinal cord are affected. 

Common symptoms include:

• Fatigue

• Vision difficulties

• Weakness or balance problems

• Numbness

• Bladder or bowel issues

• Muscle spasms

• Mood changes

• Difficulty walking

Not only do symptoms vary from person to person, but for any given person with MS, their own symptoms can be unpredictable. 

Often, the symptoms come on as attacks: They start suddenly and last for a few days to several weeks. These attacks typically happen every 1 to 2 years. Between attacks, symptoms can get better, or even go away completely.

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Diagnosis

You and your healthcare provider will work together to get the right diagnosis. In most cases, your healthcare provider will start with an interview and physical exam. If you have MS symptoms, your provider might also suggest additional tests. These could include:

• A spinal tap (lumbar puncture) 

• A scan of your brain and spinal cord called an MRI 

• Nerve conduction tests 

• Blood work  

MS symptoms usually first appear between the ages of 15 and 45.

If you are working with a primary care provider, they may suggest that you see a specialist called a neurologist. A neurologist is a medical doctor with extra training and experience managing MS. 

To make a diagnosis of MS, your provider will be looking for:

• Evidence of two or more attacks in the brain or spinal cord

• Evidence that those attacks happened at different times

• No evidence that your symptoms are caused by another medical problem

Unfortunately, there is no single test that can diagnose MS. This makes it challenging to tell whether the first symptoms are due to MS or another condition. It often takes months or even years to be sure you have MS.

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Medications

Though there is no cure for MS, medications can help you manage your symptoms and live a full life. 

Prescription medications can:

• Modify (change) your disease: Disease-modifying therapies (DMT) are medications that keep your immune system under control. This can protect you against symptom attacks and long-term disability. 

• Treat attacks: Steroids (or corticosteroids) can block inflammation in your body — which can shorten an attack and make it less severe. Steroids are only used short-term. They don’t change the course of your disease. 

• Manage symptoms: There are many different prescription medications for bladder problems, emotional changes, pain, sexual problems, and more. Read more about your options in this article from the National Multiple Sclerosis Society.

Some people with MS also use over-the-counter medications and supplements. These might include:

• Pain relievers

• Stool softeners

• Vitamins

• Marijuana 

Talk to your provider about whether any of these options are right for you. 

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Treatments

Plasma exchange for MS attacks

Sometimes, steroids do not work for severe attacks. In those situations, some people can benefit from plasma exchange (plasmapheresis). Plasma exchange works by “cleansing” the blood of the abnormal substances that trigger attacks. 

Rehabilitation therapies

Rehabilitation specialists help people with MS maintain or bring back their mobility and functional independence. Specialists include:

• Physical therapists

• Occupational therapists

• Speech therapists

Complementary and alternative therapies

There’s evidence that complementary and alternative therapies might be helpful for some people with MS. These include:

• Reflexology

• Magnetic therapy 

• Acupuncture

Diet and lifestyle

Making changes in your daily life can also help you control your symptoms, and manage attacks. This means:

• Getting at least 7 hours of good-quality sleep per night

• Eating a low-fat, high-fiber diet

• Making sure your vitamin D levels are normal

• Exercising regularly

• Learning to manage stress

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Living

Living with MS can be challenging. It’s important to keep other parts of your health and wellness in mind. For many people, this means:

• Building a strong support network

• Creating a care team that you feel good about collaborating with

• Learning to advocate for yourself at your provider’s office

• Learning to manage stress

• Engaging in talk therapy

• Connecting with others in the MS community

It’s also important to create a care team that you feel comfortable with. A strong care team can support your overall wellness — both mentally and physically. 

Your care team may include all (or some) of the following:

• Primary care provider

• Neurologist

• Rehabilitation specialist(s)

• Mental health specialist(s)

• Case manager

• Pharmacist

• MS navigator

• Peer counselor

Having MS can also bring financial challenges. If MS is affecting your ability to work, get healthcare, or provide for yourself or your family — help is available. Check out this resource list from the National Multiple Sclerosis Society for more information. 

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