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Symptom Management

MS Symptom Management

Several drugs and other treatments are available for MS symptom management. MS nurse and physiotherapist teams will help you by assessing symptoms and making an informed plan for symptom treatment. Given the nature of their actions, some drugs will need monitoring to find the right dose for each patient. Of the available drugs, not all are well tolerated and more practical ways of approaching symptom management may lessen the impact of MS symptoms.  

Fatigue - Amantadine is one drug that may be prescribed for fatigue, but the side effects can be difficult and are often not well tolerated. Behavioural approaches to managing fatigue such as FACETS may be more helpful.

Spasticity  - Stiffness affecting joint movement, painful contractions and muscle pain can be well managed but there must be a balance between treating the spasticity and not revealing underlying muscle weakness that impairs mobility. The usual treatment for spasticity is physiotherapy exercises, stretches and Baclofen. Dose adjustment may be needed. Occasionally Zanaflex may be prescribed.

Pain - In MS, pain is often due to damage to the nerves that carry pain impulses and is referred to as neuropathic pain. Normal pain control may not work but gabapentin may be used to lessen the impact of this difficult to treat type of pain. Pain can also be caused by muscle or skeletal misalignment or muscle strain. Such problems need to be referred to an orthotic or musculoskeletal specialist or physiotherapist.

Anxiety - Not surprisingly, given its nature, MS may give rise to several unexpected problems, concerns and anxieties. Where clinical psychology support is available consultations to help overcome anxieties and adjust to cope better with stress are very valuable. Sadly, this specialised support is not always available and when it is, NHS waiting lists tend to be long. MS Research constantly campaign for better support, but resources are limited. Several research groups are testing group sessions to see if waiting lists can be reduced or anxiety lessened. In a few cases, treatment with antipsychotic drugs may help.   

The Role of Exercise

The need to maintain fitness through exercise, despite possible continuing impairment, is often emphasised. Several MS exercise classes and groups are available across the UK. Exercise helps to maintain cardiovascular fitness and some research shows that it may help reduce the development of disability and inhibit nerve damage. Much more research is needed but appropriate exercise has many benefits.  

Difficult to Treat Symptoms

Some symptoms are “difficult to manage” symptoms, where there are few or no effective drugs or other treatments. An example of this is MS related tremor which, like ataxia, is a complex movement disorder for which there are currently no effective treatments. MS Research is committed to seeking research programmes that will help to treat these difficult symptoms. MS Tremor continues to be one of our research targets as it is a rare but complex problem causing significant difficulties in daily living.  

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