Symptom Management

Running on Empty: Dealing with Fatigue

By: Ben Thrower, M.D.Fatigue is one of the most common and most bothersome symptoms experienced by people with MS; the word itself – fatigue – does not adequately express the magnitude of the problem.
Symptom Management

Both Sides Now: A Nurse’s Guide To Managing Fatigue as an MS Patient

By: Cherie C. Binns, RN, BS, MSCNI have multiple sclerosis and I am a MS- certified nurse. This puts me in a unique position to be able to share my experiences from both sides of an MS diagnosis. In fact, it was my diagnosis that led me to make the decision to use my nurse training to help others with MS.
Symptom Management

Fatigue Management: Tips and Tricks to Conserve Your Energy

By: Tracy Carrasco, OT/L, MSCS We know that up to 90 percent of all individuals with MS report that they have experienced fatigue, and more than 50 percent admit it is their most disabling symptom. This “invisible symptom” is the most common cause of disability.
Symptom Management

Help for Urinary Incontinence

By: Dr. Sardar Ali Khan and Yiji SuhMS can decrease quality of life through a variety of symptoms. Certain ones, such as fatigue and gait impairment, receive a great deal of attention, but one of the less-talked-about symptoms is urinary incontinence – an inability to store or empty urine within the bladder, often resulting in the involuntary leaking of urine. This is a serious symptom that can result in poor physical and emotional health, as well as embarrassment and withdrawal from social interaction.
Symptom Management, Advanced-MS

Finally, Treatment for Cognitive Difficulties of MS

By: Miriam Franco, MSW, Psy.D., MSCS and Rita Carroll, Ph.D., CPCRTCognitive difficulties are common symptoms of multiple sclerosis. It’s estimated that 60 percent of folks with MS experience problems with short-term memory and have trouble sustaining concentration and attention. Some experience cognitive decline later as their disease progresses, others experience changes early on because of the location of a lesion, and some never do.
Symptom Management

When Optic Neuritis Comes Back

By: Robert K. Shin, M.D.Optic neuritis is a vision problem caused by inflammation or demyelination of the optic nerve – the nerve that connects the eye to the brain. Optic neuritis can occur by itself (idiopathic optic neuritis) or may be associated with demyelinating diseases such as multiple sclerosis or neuromyelitis optica (NMO, or Devic’s disease).
Symptom Management

Be Cool with Active and Passive Cooling Garments Options for People with MS

By: Stefanie DiCarrado, DPT, and Herb Karpatkin, PT, DSc, NCS, MSCSAlmost all persons with multiple sclerosis suffer from increased sensitivity to heat, also known as thermosensitivity. An increase in heat will often result in a worsening of symptoms such as fatigue, visual loss, spasticity, weakness and pain. The increase in heat can be due to external or internal factors. Externally, an increase in heat can result from an increased environmental temperature. Internally, core temperature can increase because of a fever from an infection or during exercise that can also lead to symptoms of thermosensitivity.
Symptom Management

The Challenges of Sexuality

By: Randall T. Schapiro, M.D., FAANManaging multiple sclerosis is about disease management, symptom management and, very importantly, about person management. Many times these overlap significantly. Such is the case when thinking about sexuality and MS. In our society, communicating about sexual dysfunction is often very difficult. It is a topic often not well discussed in the physician’s office or even at home, but is of extreme importance to the lives of those with MS.
Symptom Management

Depression Warning Signs for MS Caregivers to Watch

By: Francesco Pagnini, PhD and Deborah Phillips, PhDMost people are familiar with the concept of depression. It is a commonly used word, associated with feeling “blue” or simply feeling sad. Sometimes people say “I feel depressed,” meaning that their mood is low. Everybody experiences this type of mood fluctuation, which is part of life’s natural changes.
Symptom Management

HOPE: A Positive Psychology Guide to Coping With Depression

By: Rebecca Floyd, PhD, Kimberly Lewis, PhD, and Lara Stepleman, PhDConventional depression treatments typically focus on reducing negative behaviors, thoughts, and feelings. Positive psychology promotes daily practice of self-management strategies that increase positive mood and thinking. These strategies empower you to feel happier by changing perceptions and capitalizing on your positive qualities.
Symptom Management

Depression and MS: The Road to Recovery

By: Lara Stepleman, PhD, Rebecca Floyd, PhD, and Kimberly Lewis, PhDLiving with MS can be stressful. Feeling sad or irritable, wanting to be left alone, and difficulty concentrating or sleeping are common reactions to stress. But what if you notice that these experiences occur more often or worsen over time? Might you be suffering from depression?
Symptom Management

Foot Drop and Functional Electrical Stimulation

By: Maureen Shanahan, R.N.Like many people with MS, I have a condition known as foot drop. This condition occurs when the peroneal muscle in the front of the calf is weakened ? or is only weakly stimulated by the central nervous system ? preventing the proper lifting of the forefoot and toes during walking.
Symptom Management

Prevention of Pressure Sores

By: Daniel Silverman, M.D.Contrary to popular belief, it is not MS, but immobility, that creates an increased risk for pressure sores. Pressure sores (also commonly known as “bedsores,” “pressure ulcers,” “dermal ulcers” and “decubitus ulcers”) are the result of breakdown of the skin due to the effects of friction.
Symptom Management

Another Option for Neurogenic Bladder

By: Judith Lynn NicholsIt is estimated that 50 to 80 percent of those with MS experience some change in bladder function. This is called neurogenic bladder and is caused by loss of myelin in the central nervous system that may interrupt communication between the bladder and the brain. Various urinary symptoms, including difficulties in storing, emptying, or a combination of the two, may result. During the thirty-some years that I’ve lived with MS, my one unremitting symptom has been neurogenic bladder.
Symptom Management

Perimenopause

By: MSF Staff and reviewed by the MSF Medical Advisory BoardIf you find yourself attributing every physical and emotional symptom you experience to MS, you are in good company. But if you are in your early-to mid-40s, some symptoms, such as weight gain, sleep disturbances, or volatile mood swings, may have nothing to do with MS. You may be among the 80 percent of all women who will experience perimenopause.
Symptom Management, Women

MS Symptoms May Bully Kids with MS

By: MSF Staff and reviewed by the MSF Advisory BoardThe number of children (under age 18) with MS in the U.S. is estimated to be 8,000 to 10,000. As with adult MS, diagnosis can be difficult. Children don’t always understand that they should talk about what they are experiencing, or they may have difficulty describing the symptoms they feel, which can compound the problem.
Symptom Management, Pediatric

Slowing Down and Swelling Up: Ankles and Feet are at Risk when Mobility Declines

By: MSF Staff and reviewed by the MSF Medical Advisory BoardSwollen feet and ankles are common in MS, and are caused by an accumulation of lymphatic fluid (lymphedema). They are considered to be a secondary symptom of the disease, because they most often develop due to a lack of mobility instead of arising as a direct result of demyelination.
Symptom Management, Family-Friends

Clearing a Path to Better Understanding: Strategies for Overcoming Cognitive Communication Challenges

By: Frederick W. Foley, Ph.D.The ways in which the MS experience can affect the capacity to communicate with family, friends, coworkers, and others are numerous. People with MS sometimes feel that others do not understand what they are going through. Misunderstandings are common, and the person with MS may struggle to find a way to communicate clearly.
Symptom Management

When Words Won't Come Easily: Understanding and Improving MS Speech and Communication Symptoms

By: Marissa A. Barrera, MS, MPhil, MSCS, CCC-SLPResearch investigating physical and sensory disorders in individuals with MS is immense, while cognitive-communication deficits associated with MS have received little attention. The lack of research for communication disorders and MS is shocking given that between 45 percent and 65 percent of individuals living with MS experience difficulties with memory, attention, distractibility, problem-solving, word-finding and other cognitive functions as symptoms of the disease.
Symptom Management

MS and Migraine: More than Meets the Eye

By: Daniel Kantor, M.D.Multiple sclerosis and migraine share a lot more than the first letter of their names. While many people have MS, many more people worldwide have migraines and other types of headache. There is a perception that migraine is more common in people with MS, and there is some reason to think that this may be true. However, there are a few issues surrounding migraines and MS that need to be further explored.
Symptom Management

Waste Management as You Age

By: Michelle Stern, M.D.Bowel and bladder issues are common for people with multiple sclerosis at any age. But as one gets older, some of these issues may be directly related to the aging process itself and not to MS. Some of the causes can also be reversible. If you note a change in your bowel and bladder, don’t just chalk it up to the disease process or an irreversible cause from aging. This article will delve into issues affecting the bowel and bladder and help give understanding on a topic that most people are reluctant to ask their physician about.
Symptom Management

Focusing on Visual Disturbances of MS

By: Robert Shin, M.D.Humans are very visual. We use our eyes to read, watch television, drive, and enjoy a variety of activities. So when diseases such as MS disturb vision, it can have a significant impact on quality of life. People with MS can have many different kinds of vision problems, the most common being optic neuritis, diplopia, and nystagmus.
Symptom Management

Putting a Lid on Smell and Taste Disorders

By: MSF Staff and reviewed by the MSF Medical Advisory BoardDoes your salsa seem less zesty than usual? Your gumbo lost its punch? Don’t blame the chef just yet. Your MS may have something to do with it.
Symptom Management

Reining in Pseudobulbar Affect

By: MSF Staff and reviewed by the the Multiple Sclerosis Foundation Medical Advisory BoardWhen coping with a chronic and unpredictable disease such as MS, it is common to experience a wide range of emotions. However, people with MS who have a condition known as pseudobulbar affect (PBA) can be caught off guard by episodes of uncontrollable laughing and/or crying that may be inappropriate, unrelated to the situation at hand, or not expressing their actual mood.
Symptom Management

Spasticity

By: Darlene Stough, RN, MSCN, CCRPSpasticity is caused by damage to the brain and/or spinal cord from MS or other conditions. Reflexes become hyperactive, resulting in increased muscle tone, muscle stiffness and tightness, cramps, spasms, clonus (involuntary shaking), pain, and difficulty controlling the muscles. Some people with MS report that they have to “fight their muscle tightness” to move when they have spasticity. This is because muscles contract when they shouldn't, and don't relax when they should.
Symptom Management

Coping with Paroxysmal Symptoms

By: Cherie C. Binns, RN, BS, MSCNFor most people with MS, “paroxysmal symptoms” is not a familiar term. Paroxysmal symptoms are characterized by sudden onset, brief duration, and rapid disappearance. With patients exhibiting these events, brain wave studies do not identify them as seizures. These paroxysms may appear as brief twitching or spasms coming on suddenly and disappearing fully within seconds. They may or may not lead to an MS diagnosis. They are not “MS seizures.”
Symptom Management

The Symptoms That Can Slow You Down

By: Patty Bobryk, MHS, PT, MSCS, ATPIn the world of rehabilitation, mobility is commonly defined as “the quality of moving freely.” This definition incorporates all movement-related issues when looking at an individual’s mobility, including walking, transferring, moving around in bed, getting in and out of a car, getting up and down from the floor, and the list goes on.
Symptom Management

The Many Shadows of MS Related Depression

By: Robert Godsall, Ph.D.There are many causes for depression, each reflecting different influences, yet most of these causes fall into two categories: organic or situational. Organic factors typically reflect biological vulnerabilities, such as family history of depression, while situational factors are most associated with life events, such as loss of a loved one due to death or divorce.
Symptom Management

Numbness and Weakness

By: Ellen Whipple Guthrie, Pharm. D.Individuals with MS tend to experience a variety of symptoms that can interfere with activities of daily living and decrease their quality of life. We will examine two common symptomatic problems, numbness and weakness, and explore their various treatment options.
Symptom Management

Monkey Brain-Mind Hopping and MS

By: Kathleen S. Rand, M.A.Have you ever had the sinking feeling when you got up to do something and then couldn’t remember what it was? Or had the experience of not being able to concentrate with your mind jumping from one thought to another? This mind hopping experience can be called “Monkey Brain.” Think of it as a little monkey hopping from tree branch to tree branch inside your mind, unable to land anywhere for any length of time.
Symptom Management

Eye Movement Abnormalities in MS

By: Edward J. Atkins, M.D.MS can lead to interruption of pathways involved in vision. Because there is some healing that occurs after a demyelinating attack, the symptoms improve considerably in the majority of cases, but patients may be left with some ongoing visual disability, and relapses or progressive visual disability may occur. For help with eye movement abnormalities, speak to your neurologist. A neurologist who is an MS specialist, or a neurologist and ophthalmologist with additional training in neuro-opthalmology, will have the knowledge to offer you the most up-to-date recommendations on complex treatments.
Symptom Management

Give Me A Hug, But Not an MS Hug

By: MSF Staff and reviewed by the Multiple Sclerosis Foundation Medical Advisory BoardAs a rule, most people agree that a hug is warm greeting in a cold world. But there are exceptions to every rule – and in this case that exception is the MS Hug.
Symptom Management

Optic Neuritis and MS

By: Edward J. Atkins, M.D.At disease onset, individuals with MS might experience a variety of symptoms including numbness, tingling, pain, weakness, and balance problems, but visual symptoms are the presenting symptom up to 50% of the time. Over the course of the disease, virtually 100% of those with MS will have some visual problem, including visual loss and/or various distortions of vision. As with other neurological symptoms in MS, these visual problems can come and go, fluctuate in severity, or be permanent.
Symptom Management

Understanding the Rarer Symptoms of Multiple Sclerosis

By: Marion Brandis, MA, RN, MSCNBecause people with MS are not protected from acquiring other illnesses or diseases, it is very important that new or unusual symptoms be evaluated to determine if they are a part of the MS picture or are caused by some other underlying disease process. But unusual and rare manifestations can be a part of the MS constellation of symptoms, so it is important to identify management strategies where possible. While not all MS symptoms are easily treated, most can be addressed successfully with medications, or with non-pharmacological approaches and modalities that bring partial or full relief.
Symptom Management

Sensory Problems in MS

By: Ellen Whipple Guthrie, Pharm.D.Sensory problems, or disturbances in feeling, are often one of the earliest symptoms of MS and occur in 20 to 50 percent of individuals with the disease.
Symptom Management

Getting the Word Out: Speech Difficulties and MS

By: MSF Staff and reviewed by the Multiple Sclerosis Foundation Medical Advisory BoardThe conversation skips along until… the long pause. That word that just won’t come out, or the odd quality to your voice that starts when it does, can be frustrating and embarrassing.
Symptom Management

Primary and Secondary MS Symptoms: Symptoms Causing Symptoms

By: Kathleen Costello, MS, CRNPPeople with MS often call me to ask about a new or returning symptom. No matter what the problem, their first question is often: “Do you think this is my MS?” Initially, the answer is not always clear. Identifying symptoms and discovering their cause requires a thorough investigation, as well as open communication between the person with MS and their healthcare provider. Some symptoms may be a direct result of multiple sclerosis, some may be a complication of a MS symptom, and some may not be related to MS at all.
Symptom Management

Maintaining Dignity with Bladder and Bowel Problems

By: Marie Namey, RN, MSN, MSCNBladder and bowel problems due to MS are distressing and may interfere with personal, social and vocational activities. Changes in elimination patterns can create feelings of loss of control, embarrassment, dependency, and isolation. Bladder and bowel problems can also disrupt sleep.
Symptom Management

Urinary Tract Infections

By: MSF Staff and reviewed by the Multiple Sclerosis Foundation Medical Advisory BoardIf you experience urinary urgency or frequency, a burning sensation when urinating, abdominal or lower back pain, elevated body temperature, increased spasticity, or dark, foul-smelling urine, a urinary tract infection is probably present.
Symptom Management

Lhermitte's Sign

By: MSF Staff and reviewed by the Multiple Sclerosis Foundation Medical Advisory BoardLhermitte’s sign (also known as Lhermitte’s phenomenon) is the name given to a brief electric shock-like sensation that occurs when flexing or moving the neck. This sensation radiates down the spine, often into the legs, arms, and occasionally, the trunk.
Symptom Management

Seizures in MS

By: Greg Robert Zarelli, M.D.One of the less common problems associated with MS is seizures. Their incidence among the MS population has been estimated to be as much as 5 percent, compared to only 3 percent in the general population. While seizures may occur as part of MS, they may also be the result of an infection, fever, or abrupt cessation of certain medications. To understand how an individual with MS could potentially develop a seizure disorder, we have to understand the fundamental make up of the brain.
Symptom Management

Summertime Survival Strategies

By: MSF Staff and reviewed by the Multiple Sclerosis Foundation Medical Advisory BoardHeat can have a detrimental effect on people with MS. This is because the efficiency of MS-damaged nerve cells decreases as the core temperature of the body rises. New symptoms or an exacerbation of current symptoms can occur during this season if precautions aren't taken.
Symptom Management

Rounding Up Those Elusive ZZZZ's: Strategies for the Sleepless

By: Robin Adams McBrideIf we are to believe the ads, sleeplessness pervades our society. But for those of us with MS, the solution is rarely as simple as a new mattress or a sleeping pill.
Symptom Management

Bladder Problems and MS

By: Laura McCatty, RN, MSCN, CCRN Let's talk about bladder problems. Probably not your favorite topic, but ignoring them won't make them go away. There are techniques for managing bladder problems. Educate yourself so that you determine the quality of your daily life - not your bladder!
Symptom Management

Fighting Fatigue

By: MSF Staff and reviewed by the Multiple Sclerosis Foundation Medical Advisory Board“Who would have thought that getting dressed in jeans and a shirt (not even socks!) could be a major production, take forever to do, and then you’d have to rest?” -- Renee, Women Living with Multiple Sclerosis
Symptom Management

Dysphagia and MS

By: MSF Staff and reviewed by Multiple Sclerosis Foundation Medical Advisory BoardStudies indicate that as many as half of all MS patients experience some difficulty in swallowing, a symptom called dysphagia (dis-FAY-juh). Dysphagia occurs more frequently in advanced stages of MS, although it can occur at any time during the disease course. To better understand dysphagia, it is helpful to first examine the normal swallowing process.
Symptom Management

Cognitive Deficits in Multiple Sclerosis

By: By Jennie Q. Lou, MD, MSc, OTR/L,; Carolyn Tischenkel; and Lindsey DeLangeMost people with MS experience intermittent cognitive symptoms. Even if your cognitive symptoms are present all or most of the time, with the proper approaches to symptom management, you may be able to control the intensity, and reduce the disruptive effects. The benefits of managing your cognitive symptoms can accumulate over time. Cognitive symptoms are complex and hard to understand, and sometimes seem to threaten your grasp of reality. But they're not fundamentally different from any of your other symptoms. Many of these symptoms can be treated once they are identified.
Symptom Management

Drug Treatment and Cognitive Dysfunction

By: Robert E. Godsall, Ph.D.MS causes widespread demyelination of the central nervous system (CNS) associated with inflammatory damage. This damage often occurs in an area of the brain known as the white matter region. The white matter region transmits nerve impulses from one part of the brain to another. In MS, such white matter changes are often associated with varying degrees of cognitive dysfunction.
Symptom Management