Multiple sclerosis living in adults

Overview

Multiple sclerosis, or MS, is a long-lasting condition that affects the brain and spinal cord. In MS, the body's immune system mistakenly attacks the protective coating around nerve fibers, called myelin. This damage slows or blocks messages between the brain and the rest of the body, causing a wide range of symptoms.

MS is one of the most common neurological conditions in young adults. About 2.8 million people worldwide live with MS. It is more common in countries farther from the equator.

MS usually appears between the ages of 20 and 40, but it can start at any age. It affects women about 3 times more often than men. It is also more common in people of northern European descent, but it can affect anyone.

Symptoms

Common symptoms

• Fatigue – a deep, physical tiredness that is not relieved by rest.
• Numbness or tingling in the face, arms, legs, or fingers.
• Vision problems, such as blurred or double vision, or pain when moving the eye.
• Muscle weakness, spasms, or trouble with coordination and balance.
• Problems with thinking, memory, or concentration (often called 'brain fog').
• Bladder or bowel issues, like urgency or leakage.

Symptoms in children

• MS is rare in children, but when it occurs, symptoms are similar to adults.
• Children may also have more frequent relapses at first.
• Young people with MS often need extra support at school and at home.

Symptoms in older adults

• MS symptoms may be mistaken for normal aging or other conditions like arthritis.
• Older adults with MS may notice more trouble with walking, balance, and falls.
• Fatigue and memory changes can become more noticeable.

Causes

Main causes

• The immune system attacks the myelin sheath that wraps around nerve fibers in the brain and spinal cord.
• This damage disrupts nerve signals and causes the symptoms of MS.

Risk factors

• Family history – having a close relative with MS slightly increases your risk.
• Geography – people who live farther from the equator are more likely to get MS.
• Vitamin D – low levels of vitamin D may be linked to a higher risk.
• Smoking – smokers have a higher chance of developing MS and may have a faster disease course.
• Epstein-Barr virus – nearly all people with MS have had this common virus, though most people who have it never develop MS.

When to see a doctor

See a doctor urgently if:

• If you notice sudden or severe symptoms that affect your vision, movement, or breathing.
• If you have a high fever along with MS symptoms – this could mean an infection.

Book a routine appointment if:

• If you have ongoing symptoms like numbness, tingling, or fatigue that do not go away.
• If you are worried about changes in your walking, balance, or thinking.

Diagnosis

There is no single test for MS. A neurologist (a doctor who specializes in the nervous system) will review your symptoms, medical history, and do a physical exam. They may order tests to rule out other conditions and look for signs of damage typical in MS.

Tests that may be done

• MRI scan – this creates detailed pictures of the brain and spinal cord to look for areas of myelin damage (lesions).
• Spinal tap (lumbar puncture) – a sample of fluid around the spinal cord is tested for signs of MS.
• Evoked potentials – tests that measure how quickly your nerves respond to visual or electrical signals.

What to expect at your appointment

The diagnosis process can take weeks or months because MS symptoms can be similar to many other conditions. Your doctor will carefully rule out other causes. When you are diagnosed, your healthcare team will work with you to create a plan that fits your needs.

Treatment

There is no cure for MS, but many treatments can help manage symptoms, reduce the number of relapses (flare-ups), and slow the progression of the disease. Treatment is tailored to each person and may change over time.

Self-care at home

• Get plenty of rest and pace your activities to manage fatigue.
• Stay physically active with gentle exercise like walking or swimming.
• Avoid overheating – stay cool in hot weather or during exercise.
• Eat a balanced diet rich in fruits, vegetables, and whole grains.
• Manage stress with relaxation techniques, hobbies, or talking to a counsellor.

Medical treatments

For relapsing forms of MS, doctors may prescribe disease-modifying therapies (DMTs) taken as injections, pills, or infusions. These help reduce the number of attacks. For specific symptoms like muscle stiffness, bladder problems, or pain, there are other medicines and therapies. Always take medications exactly as prescribed and discuss any side effects with your doctor.

When is surgery considered?

Surgery is not a common treatment for MS. In very rare cases, surgery may be used for complications such as severe spasticity or mobility issues, but this is decided on a person-by-person basis.

Living with this condition

Living with MS means learning to manage symptoms as they come and go. Some days you may feel well, other days you may need extra rest. Planning your day, setting priorities, and asking for help when needed can make a big difference.

Lifestyle tips

• Maintain a regular sleep schedule to help with fatigue.
• Exercise regularly – even gentle activity like stretching or yoga can help with strength and mood.
• Stay cool – use fans, air conditioning, or cool baths if you are sensitive to heat.
• Build a support network of family, friends, and healthcare professionals.
• Avoid smoking and limit alcohol – both can make MS symptoms worse.

Diet and exercise

There is no special 'MS diet', but eating well helps your overall health. A diet rich in fiber, lean proteins, and healthy fats supports energy and digestion. Regular exercise improves strength, balance, and mood. Work with a physiotherapist to find activities that are safe and enjoyable for you.

Mental health and emotional wellbeing

Living with MS can be stressful and may lead to feelings of anxiety, sadness, or depression. It is normal to feel overwhelmed at times. Talking to a counsellor, joining a support group, or reaching out to loved ones can help. If you have thoughts of harming yourself, call your local emergency number or a crisis helpline immediately.

Prevention

Currently, there is no known way to prevent MS. Research is ongoing, but the exact cause is still not fully understood.

Vaccines

Vaccines are generally safe for people with MS. In fact, staying up to date with recommended vaccines (like the flu shot) can help prevent infections that could trigger relapses. Always talk to your doctor about which vaccines are right for you.

Screening programmes

There is no routine screening test for MS. If you have symptoms or a family history, discuss your concerns with your doctor.

Complications

If left untreated

• More frequent and severe relapses.
• Permanent nerve damage leading to long-term disability.
• Problems with walking, balance, and muscle control.
• Increased risk of infections like urinary tract infections due to bladder issues.
• Depression and social isolation.

Long-term outlook

While MS is a lifelong condition, most people do not become severely disabled. With modern treatments, many people with MS can maintain a good quality of life, work, and enjoy their hobbies. The disease is different for everyone, so it is important to work closely with your healthcare team to find the best plan for you.

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