Treatment for MS works best when it is started early, before any permanent damage has occurred. There are many options for treatment, but there are four main goals for any MS treatment plan:
- Control how often flare-ups and relapses happen
- Shorten recovery time from flare-ups and relapses
- Keep the disease from getting worse
- Prevent any complications
Different treatments can help control specific symptoms of MS:
- Bladder problems: medication and physical therapy
- Bowel problems: medication and diet changes.
- Depression: medication and mental health therapy
- Erectile dysfunction: medication
- Pain: medication and physical therapy.
- Muscle spasms: medication
- Problems with strength, balance and movement: physical therapy
- Communication problems: speech therapy
- Muscle stiffness or spasms: oral pain medication, medical cannabis and physical therapy.
- Mental health counseling and support
- Lifestyle changes, such as stress reduction, rest, exercise, a healthy diet, avoiding becoming overheated and not smoking
Anyone with MS may benefit from:
To manage an MS relapse, a steroid medication may be prescribed to reduce inflammation caused by a relapse. Steroids may be given orally, by injection or by intravenous (IV) infusion. Steroids are only used to shorten an attack. They are not long-term medications, and they do not change the course of MS.
Several long-term medications are used to reduce MS activity and progression. These medications are called disease- modifying agents. They include:
- Beta interferons. These medications, injected under the skin, can reduce frequency and severity of relapses.
- Copaxone (glatiramer acetate). This medication, also injected under the skin, may block immune system attacks on myelin.
- Tecfidera (dimethyl fumarate). A pill taken twice a day, this medication may reduce relapses.
- Gilenva (fingolimod). This medication, taken in pill form once a day, may reduce the number of relapses.
- Aubagio (teriflunomide). Also a pill taken once a day, this medication may reduce the number of relapses.
- Tysabri (natalizumab). This medication, given by IV infusion, blocks immune system attack cells from entering the brain and spinal cord. This reduces flares and relapses.
- Lentrada (alemtuzumab). Another medication given by IV infusion, it decreases the amount of immune cells that may cause an MS attack. It decreases flares and relapses.
There are some nonmedical therapies for MS as well. Stretching exercises can help reduce stiffness and increase mobility. Massage therapy may help with muscles that are tight or prone to spasms. Meditation, yoga, acupuncture and relaxation techniques also may help reduce some MS symptoms.
Research into future treatment options for MS includes creating new myelin and implanting cells to help with impulses along damaged nerves.
New Treatment Option
A new medication for MS is the drug Ocrevus (ocrelizumab), approved by the Food and Drug Administration in 2017, for people with primary-progressive and relapsing MS. It became the first drug ever approved for PPMS. The drug is given as an IV infusion every six months.
This drug is an antibody that binds to immune attack cells, called B cells, and reduces their numbers. Testing of this drug found that it reduced the progression of disability from PPMS by about 25 percent. In people with relapsing MS, this drug reduced relapses by close to 50 percent compared with treatment with Rebif (interferon beta-1a).