Living With Multiple Sclerosis: Tips for Managing Your Symptoms

Multiple sclerosis (MS) is an autoimmune disease where your immune system attacks your nerves. MS can cause many different symptoms, like weakness, numbness, pain, and balance problems. 

Receiving a diagnosis of MS can be overwhelming. The symptoms of MS can be challenging, and they can change over time. Your future disease course can also feel uncertain. 

Even though MS isn’t curable, there are still many ways you can protect and support your health. Read on for more information about MS, tips for living with MS, and strategies for managing symptoms in your daily life. 

What is multiple sclerosis?

MS occurs when your body’s immune system mistakenly attacks cells in the central nervous system, including the brain, spinal cord, and the optic (eye) nerve. This damages the myelin — the protective sheath that covers nerves — and the nerves themselves. And it leaves scars in your central nervous system. 

The symptoms of MS depend on where this nerve damage and scarring occurs. For example, if it occurs in the eye, it may cause loss of vision. If it occurs in the spinal cord, it could cause numbness, weakness, or even paralysis. If it occurs in the brain, it could cause imbalance or cognitive (thinking) difficulties. 

There are four main types of MS:

• Clinically isolated syndrome: This is when you experience only one episode of MS symptoms.

• Relapsing-remitting MS: This is the most common category. People with this type of MS have attacks, followed by periods of recovery.

• Secondary progressive MS: This is similar to relapsing-remitting, but your symptoms worsen over time.

• Primary progressive MS: In this type of MS, your symptoms steadily get worse from the beginning, without starting with a relapsing-remitting period.

The cause of MS is still unknown. But just like most autoimmune conditions, it’s likely that MS is caused by a combination of genetics and environmental triggers. 

Here is some of what we know so far about who gets MS:

• MS is most common in North America and Europe. It is less common in East Asia and sub-Saharan Africa.

• MS is seen twice as often in women. 

• Women are often diagnosed between the ages of 20 and 40. 

• There is a connection between MS and living in northern areas (due to less ultraviolet light being available in places with less sunlight). 

• MS sometimes runs in families and in identical twins. If one twin has MS, the other will get it 25% of the time.

How does multiple sclerosis affect daily life?

How much MS affects your daily life will depend on the type and severity of symptoms you experience. Common symptoms of MS may include:

• Fatigue 

• Vision difficulties

• Weakness or balance problems

• Numbness

• Bladder or bowel issues

• Muscle spasms

• Mood changes

Factors in your life can sometimes make your symptoms worse — like stress, poor sleep, or dietary habits.

Can better sleep habits help with multiple sclerosis symptoms?

Yes. Not only do many people with MS have difficulty sleeping, but poor sleep can also make MS symptoms get worse. 

Focusing on healthy sleep habits is important. Your goal is to get at least 7 hours of quality sleep per night. Here are some suggestions:

• Avoid caffeine use after noon.

• Practice good sleep hygiene: This includes going to bed and waking up at the same time, using your bed only for sleep, and keeping your room cool and dark.

• Avoid eating before bed.

• Avoid screens before bed.

• Avoid alcohol.

• Consider working with a therapist to improve sleep habits.

• Consider discussing medication options with your healthcare provider.

How can dietary changes help with my multiple sclerosis symptoms?

While there is no “MS diet,” eating healthy food is important for people with MS. There may be specific food changes that can help your symptoms. Here are some general recommendations:

• Eat a low-fat and high-fiber diet, similar to a Mediterranean diet.

• Limit alcohol intake.

• Avoid skipping meals.

• Make sure your vitamin D level is in the upper range of normal.

Vitamin D is very important for bone and immune health. Studies have found low vitamin D is a risk factor for MS. Vitamin D deficiency is common, so you may want to have your blood level tested. You can get vitamin D through sun exposure (10 to 15 minutes per day) or a supplement.

There have been studies looking at biotin (a B vitamin) and omega-3 fatty acids for MS, but studies have not shown significant improvement with either of these supplements.

Benefits of exercise for people with multiple sclerosis

Exercise is beneficial for people with MS. Physically, exercise helps you keep up your strength, flexibility, and balance. It can also help with fatigue and prevent falls and spasticity. 

Emotionally, exercise helps improve quality of life and mood. Exercise can also have social benefits, like going to group exercise classes.

What should I avoid with multiple sclerosis?

MS flares can sometimes be caused by your environment. Here are some known triggers for MS symptoms in some people:

• Stress

• Sleep deprivation

• Climate extremes

• Heat 

• Infections

• Smoking

Multiple sclerosis pain management

People with MS commonly experience pain. The type and severity of pain can vary. It’s important to have a plan for pain, so you know what to do when you have a flare-up. 

Your healthcare provider may recommend over-the-counter pain medications, topical pain medication, or prescription medications for pain. Sometimes Botox shots can be helpful. 

There is also new information coming out on using medical cannabis (marijuana) to treat MS pain and spasms. Cannabis is currently used for MS in Europe and Canada, but it is not approved yet in the United States.

Tools that can help

It’s a good idea to have different types of tools for managing your MS symptoms. This can include creating a great healthcare team, being involved in MS support groups, and having assistance ready for when you need it.

Create your multiple sclerosis healthcare team

Your healthcare team is essential and should be accessible when you need them. You will need to have doctors and support people that you trust. Depending on your needs, your healthcare team might include:

• Primary care provider

• Neurologist

• Psychologist

• Physical therapist

• Social worker

• Nutritionist

• Occupational therapist

• Speech therapist

Here are some suggestions to think about when assembling your team:

• Make sure that your providers help you understand your diagnosis and disease process.

• Ask about and understand the medications you are taking for MS. 

• Consider bringing a support person to your appointments, to make sure your questions are being answered and you understand the plan. 

• Make sure your healthcare team helps you address issues related to anxiety, depression, financial concerns, or other life stressors.

• Be sure you know who to reach out to when questions or concerns arise.

Multiple sclerosis support groups

Joining an MS group can provide community and support. There are many groups out there, including online or local in-person groups. These can help you connect with others in similar situations. Support groups can also guide you on issues related to your MS symptoms, or even things like insurance or employment concerns.

Get assistance with mobility 

Staying mobile and safe is vital for people with MS. You may want to consider the following:

• Invest in the right shoes to help you walk safely and comfortably.

• Make adaptations in your car to continue to drive safely.

• Make modifications to your home to reduce the risk of falls and accidents.

• Look into mobility aids, like a cane or walker to prevent falls.

• Consider a service dog to help with safety and mobility.

Helpful tools

Consider finding other tools or gadgets to help with your day-to-day activities. 

For example: 

• Cooling vests or hats to avoid overheating

• Delivery services to help with shopping

• Jar openers

• Remote controls for lights, appliances, and other electronics

• Cane strap

• Reaching aid

• Smartphone or tablet apps to track symptoms, remember medications, or keep up to date on research

Why trust our experts?

Written by:

Christina Palmer, MD

Christina Palmer, MD, is a board-certified family physician with a focus on chronic care management, women’s health, and mental health. She’s the co-author of “Open Heart: When Open-Heart Surgery Becomes Your Best Option.”.

Edited by:

Tanya Bricking Leach

Tanya Bricking Leach is an award-winning journalist who has worked in both breaking news and hospital communications. She has been a writer and editor for more than 20 years.

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