How is MS treated?
There are many health professionals who can help to manage the symptoms of MS, including specialist nurses, physical therapists, occupational therapists, dietitians, continence advisors, and social workers. In addition, there are various medical treatments that may be prescribed at different times. Corticosteroids are often used and may help to shorten the duration of a relapse, although they probably do not affect eventual long-term disability. Treatment with oral corticosteroids (eg, prednisolone) is usually tapered off over two to three weeks; intravenous corticosteroids (eg, methylprednisolone [Solu-Medrol]) are often used for three to five days.

Adrenocorticotrophic hormone (ACTH) can also be given by intramuscular injection for short periods. Long-term use of corticosteroids is not justified because of the numerous complications that can occur. A class of drugs called immunomodulators is available for the treatment of MS. Interferon beta-1a (eg, Avonex, Rebif) and interferon beta-1b (eg, Betaseron, Extavia) are given by injection into a muscle (intramuscular) or under the skin (subcutaneous). These drugs may reduce the frequency and severity of relapses in people with relapsing-remitting MS but it is not known whether they have any effect on long-term progression of the disease. Glatiramer acetate (Copaxone) is another type of immunomodulator that may be suitable for some patients with relapsing-remitting MS. Copaxone is given by subcutaneous injection. There are also oral formulations available for relapsing forms of multiple sclerosis such as fingolimod (Gilenya), teriflunomide (Aubagio), and dimethyl fumarate (Tecfidera).

Natalizumab (Tysabri) is a selective immunosuppressive agent that may be used in some people with relapsing-remitting MS. It is given by intravenous infusion every 4 weeks. This drug carries a warning on the label regarding an increased risk of a rare but serious condition called progressive multifocal leukoencephalopathy, so your neurologist would decide with you if the benefits of taking this drug outweigh the risks.

Muscle relaxants may help to reduce muscle spasticity. These include baclofen (Gablofen), diazepam (Valium), dantrolene (Dantrium), and tizanidine (Zanaflex). Pain caused by nerve damage may occur in people with MS—most painkillers have no effect on this type of pain. Using a TENS (transcutaneous electromagnetic nerve stimulation) machine may block the sensation of pain in some people, but in others the symptoms may become worse after use. If sharp, cramping pains occur at night, carbamazepine (Tegretol) may be given. Other techniques for severe pain relief may be used, such as acupuncture, anesthetic nerve blocks and surgical procedures.

Further information
National Institute of Neurological Disorders and Stroke: www.ninds.nih.gov/disorders/multiple_sclerosis/multiple_sclerosis.htm

Last Updated: May 2013