Immunotherapy and physical therapy can reduce symptoms of multiple sclerosis
By Jay Nachman
Multiple sclerosis (MS) is a disease of the immune system. In MS, the body attacks insulation around
the nerves, called myelin. The myelin gets stripped or damaged. This causes communication problems
between the brain and the rest of the body.
The effects of MS vary with each person. It can affect the motor functioning of the arms and legs. This
may lead to subtle clumsiness, mobility challenges or balance problems. Other patients might have tingling, an inability to sense things appropriately or vision issues.
“It’s a whole variety of symptoms. Motor issues, sensory and vision, and balance are the most common first symptoms. (These) might bring patients to seek medical attention,” said Dr. Petra Brayo, assistant professor of clinical neurology in the Lewis Katz School of Medicine at Temple University.
MS is not fatal. “I always tell patients they are more likely to die with MS than from MS,” Dr. Brayo
said. “There can be complications from MS. You can lose your ability to walk or become bedbound.
With that, they might have bedsores that end up getting infected and that might lead to other medical complications. But MS in and of itself rarely results in the loss of major functions.
The first symptoms of multiple sclerosis often start between ages 20 and 40. Women are slightly more
likely to get the disease than men. The oldest person Dr. Brayo has seen with a new diagnosis of MS
was in their 70s.
Most people with MS have “disease progression.” The nervous system is trying to compensate for some of the injury that happened.
“What we call the brain reserve slows down with aging,” Dr. Brayo said. “There are no new attacks, but we end up seeing instead this element of progression. The symptoms that somebody had in the past might slowly get worse over time. So, patients might start noticing that their mobility is getting worse. For
example, they would always have issues with the right leg. It would be the right leg getting worse, not
necessarily that the left leg would start to have symptoms.”
MS patients are treated with immunotherapy, which can be taken orally, through IV infusion or by
injection. As patients age, the focus is on managing symptoms. It’s less about initiating immunotherapies to quiet the immune system and prevent new attacks. Immunotherapies tend to be stopped as patients get older to avoid the risk of infections and other complications from suppressing the immune system, Dr. Brayo said.
Another treatment for MS is to work with a physical therapist who can help strengthening weak limbs and other parts of the body.
“For most of my patients, our goal is to optimize the quality of life,” Dr. Brayo said.
A lot of the current research into MS is studying what causes the progression of the disease. “Why do certain patients progress more than others? And with that, the goal would be to find therapies that would slow down that progression or, ideally, stop it,” Dr. Brayo said. Some medications that are in the clinical trial phase are promising, she added.
According to the National Multiple Sclerosis Society, caregivers “may even neglect their health and well-being. But if you are a care partner, paying attention to your needs will actually help you support
your loved ones, too.” The website www.NationalMSSociety.org (see “Caring for Someone with MS” section) has tips for caregivers. The society also has MS Navigators. These skilled, compassionate professionals help connect MS patients and their caregivers with information, resources and support. Resources include respite care, support groups, online communities, health care provider search, financial support and education. To schedule an appointment with an MS Navigator, call 1-800-344-4867, weekdays, 9 a.m. to 7 p.m.
Jay Nachman is a freelance writer in Philadelphia who tells stories for a variety of clients.
