Mid-Week MOT: Multiple Sclerosis
Multiple Sclerosis (MS) is a progressive disorder affecting the central nervous system (brain and spinal cord).
There are approximately 100,000 sufferers in the UK with 3 times as many women as men affected (according to figures from the MS Society). The condition typically begins in the 20's or 30's and there are 4 different types.
What is MS :
MS is a neurological disease with widely varying symptoms. Sufferers can be affected in different body parts and may have some or all of the symptoms at some point. It is currently incurable but research is progressing rapidly and treatments to alleviate symptoms are effective and available. The disease is not inherited but there may be a genetic link, with a 2% chance of parents passing it on and a 3% chance of one or more siblings being affected.
The cause of MS is unknown but it is thought to be an autoimmune condition whereby the body's immune system attacks its own nerve fibres, stripping them of their protective, conducting and insulating fatty sheath called myelin. This leaves the fibres unprotected and vulnerable to damage, slowing, distorting or blocking the nerve signals. The damage shows on MRI scanning as plaques or scars along the spinal cord and brain and these lesions steadily increase the degree of disability suffered.
MS appears to be far less prevalent in hot, sunny countries so researchers are investigating a link to low levels of sunshine and vitamin D.
Other links being considered are the presence of the Epstein Barr virus (glandular fever culprit) and the increased incidence in smokers and people who were obese in childhood or adolescence (causing an overactive immune system and increased inflammation).
Signs and symptoms:
Signs and symptoms include - vision problems (optic neuritis), dizziness, fatigue, bladder problems, balance disturbance, numbness or tingling in limbs, poor memory and cognitive function, loss of libido and muscle spasms.
Sufferers do not always have all the symptoms and these symptoms do not always lead to an MS diagnosis. It takes a long time and many consultations with a neurologist before the diagnosis can be made.
There are 4 types of MS:
85% of cases are relapsing/remitting MS (RRMS) - symptoms present themselves for anything between 24 hours and 3 months or more and then resolve. The patient can be symptom free for years and then an attack is triggered by things like stress, infection or pregnancy. Each attack, or relapse, may have new symptoms or see the return of old ones. In order to be classed as an attack of MS, there has to be no change in body temperature and a minimum of 24 hours of symptoms. This prevents other concurrent illnesses being overlooked and blamed on MS.
Relapsing/remitting MS can become secondary progressive MS (SPMS)- where there is a sustained build up of disability in between and in spite of relapses. 65% of RRMS sufferers will go on to develop this after 15 years or so. There has to be 6 months of steady progression before this is diagnosed.
10-15% of cases are primary progressive MS (PPMS) - this is where the patient has a steady worsening of symptoms without remission. This represents a poor prognosis and many of these patients will be using a wheelchair and have severe disability quite early in the disease progression.
Sometimes, symptoms are present and then completely disappear. This is diagnosed retrospectively after 10-15 years of being symptom free, as benign MS.
Treatments for MS centre around resolution of relapses and slowing the progression with disease modifying drugs and immune system suppressants such as Mitoxantrone, Ocrelizumeb and Beta Interferon. Drug therapy should be started soon after diagnosis.
Short term steroids are used to combat inflammation during episodes and the use of manual therapy for muscle spasms and balance issues.
MS is a lifelong condition but research is on going and advances in medication means many symptoms are manageable and progression can be slowed.
For further information please visit these websites -
If you think you may be suffering with any of the symptoms mentioned then please do chat with your GP or practice nurse.
For osteopathy in High Wycombe and beyond, call Lucy from OsteoFusion on 07833 321604 or visit www.osteofusion.co.uk.
Thanks for reading.