Multiple sclerosis

Multiple sclerosis is one of the most common disorders of the nervous system and affects about 85,000 people in the UK. This summary explains what causes it and how physiotherapy can help.

What is multiple sclerosis?

Multiple sclerosis (MS) is a disorder of the brain and spinal cord that often appears first in early adulthood. It is unpredictable, and affects different people in very different ways. Symptoms may include any of the following: muscle stiffness or spasms, weakness, difficulties with walking, poor balance, fatigue, tremor, depression and incontinence. Some people will have one or two episodes, recovering completely in between, while others have repeated relapses, and some see a gradual progression in their symptoms, leading to more severe disability.

What causes multiple sclerosis?

MS is thought to be due to a combination of genetic and environmental factors, although the chances of MS arising twice in the same family are very low. The symptoms are caused by damage to the covering of the nerves. When the condition is active, parts of the brain and spinal cord become inflamed, then scarred and hardened (the word ‘sclerosis’ means hardening). This interferes with the transfer of messages between the brain and other parts of the body.

How can physiotherapy help?

MS is treated by a team of healthcare professionals, of whom physiotherapists play a key role. As the ‘movement expert’ on the team, the physiotherapist’s main aim is to help the person achieve their potential for physical independence, flexibility, strength and fitness levels, and can be a useful source of advice and practical tips on any new movement problems that arise. Physiotherapy is particularly useful when the physical symptoms are changing, or during the recovery phase after a relapse.

What will happen when I see a physiotherapist?

The specific treatment will depend on which symptom you are experiencing at the time, but any visit is likely to include:

  • advice about a range of exercises or physical activity
  • advice on posture and relaxation

It may also include:

  • specialised stretches to relieve stiffness or spasms. (With your permission the physiotherapist can train a relative or carer how to do these for you)
  • advice on walking aids.

In the meantime, how can I help myself?

  • Eat a well-balanced healthy diet, with plenty of fruit and vegetables.
  • Try to keep as active and physically fit as possible. After a relapse, see a physiotherapist for an assessment and review of your exercise programme.
  • Learn to recognise the symptoms of fatigue and try not to get overtired.
  • Draw on support when you need to – this will help you stay motivated to maintain a healthy lifestyle as far as possible.

Are there physiotherapists with extra training in this area?

Physiotherapists with a special interest in treating people with MS are likely to be members of the Association of Chartered Physiotherapists Interested in Neurology.

Where can I get more information?

Multiple sclerosis: Understanding NICE guidance – information for people with multiple sclerosis, their families and carers, and the public

By the National Institute for Clinical Evidence, with the MS Trust and MS Society (2003). Booklet (available to download online) providing advice and information about MS and current treatment.  www.rcplondon.ac.uk

MS Society

UK charity that provides support and services for people with MS and those who care for them. It offers a range of advice and runs information centres, support groups, respite care and a telephone helpline. T 0808 800 0888 (helpline) W www.mssociety.org.uk

MS Trust

UK charity that provides information, education, research and support for anyone affected by MS, education programmes for health professionals, funding for practical research and campaigning for specialist services. T 01462 476 700 (information service) W www.mstrust.org.uk

Association of Chartered Physiotherapists Interested in Neurology (ACPIN)

http://www.acpin.net/