Have questions about MS?
BiogenCare For MS has lots of answers.
Below is a list of frequently asked questions that people living with MS and their supporting friends and family have had.
Frequently asked questions about MS
What causes MS?
Multiple sclerosis is a disorder of the brain and spinal cord. MS causes inflammation or swelling around small blood vessels in the brain and spinal cord, and leads to the formation of damaged areas on the surface of the brain called “lesions.” This inflammation appears to be caused by the immune system, which normally protects the body against viruses, bacteria and other biological invaders, but is actually attacking the body.
The inflammation and damage of myelin by the immune system weakens the transmission of nerve impulses sent between the brain , the spinal cord and the rest of the body. When the brain cannot communicate with the nerves and muscles the way it is supposed to, various symptoms of MS (such as vision problems and difficulty with muscle movement, coordination and balance) can occur.
To learn more about what causes MS, please visit the UNDERSTANDING MS section of this website.
What are the common symptoms of MS?
Some people have very few symptoms, especially in the early stages. The symptoms some people experience may not be the same as someone else’s. What is more, symptoms may vary from one MS relapse (attack or flare-up) to the next.
Depending on the area of the CNS that has been affected and the degree of damage, different symptoms may occur, including the following:
- Blurred vision or visual loss
- Difficulty walking or staying balanced
- Weakness or fatigue
- Difficulty with bladder or bowel control
- Challenges with memory or other thinking skills
- Speech problems
To learn more about the common symptoms associated with MS, please visit the DIAGNOSING MS section of this website.
How is MS diagnosed?
When MS is considered as a potential diagnosis, an individual’s medical history and neurological exam are the mainstay. With that, a diagnosis of MS must include evidence of disease activity separated in time (lesions that formed at different points in time) and space (lesions in at least two separate areas of the central nervous system).
The diagnosis of MS is one made only once other potential causes for symptoms have been ruled out.
To learn more about MS diagnosis, please visit the DIAGNOSING MS section of this website.
What are disease-modifying therapies (DMT)?
Disease modifying therapies (DMTs) target the immune system in different ways to block the immune attack against myelin. The goal of DMTs is to counter an overactive immune system, helping to prevent inflammation and damage to slow the progression of MS. Several DMT treatment options are available, and treatment goals should involve disease, lifestyle and medical considerations.
To learn more about disease-modifying treatments (DMTs), please visit the TREATING MS section of this website.
How does MS progress over time?
Research shows that MS continues to progress, even when a person is not having relapses.
The symptoms of MS become worse over time as more nerves become damaged. The progression of MS varies depending on how much nerve damage there is, how quickly it happens and where it occurs.
To learn more about how MS progresses over time, please visit the UNDERSTANDING MS section of this website.
What is the Expanded Disability Status Scale (EDSS)?
The EDSS is a clinical rating scale based on the judgment of the examiner, ranging from 0 to 10 in half-point increments.
The score increases the more your ability is affected. For example, a score of 0 signifies a normal neurological examination, a score of 4 signifies disability but self-sufficient, and 6 means “needing assistance” such as a cane to walk. It is important to remember that 75% of people with MS will never need to use a wheelchair. Few people will ever have a score higher than 6 – in fact, nearly 60% of people with MS will still have an EDSS score of 6 or below, 15 years after diagnosis.
To learn more about the EDSS Scale, visit the DIAGNOSING MS section of this website.
What are the differences between relapsing and progressive types of MS?
With MS, the course of illness and range of symptoms can vary from person to person, but there are very different types of the disease. Some are considered “relapsing
” types of MS, while others are considered “progressive
With the relapsing types of MS, people will experience periods of visible disease activity (relapses) alternating with periods of remission or recovery. Others will experience only a gradual and steady progression of disability, called progressive MS.
To learn more about the differences between relapsing and progressive MS, please visit the UNDERSTANDING MS section of this website.
Who gets MS?
Most commonly seen in people of Northern European background, more than two million people are estimated to suffer with MS worldwide. Canada is known to have one of the highest rates of MS in the world
, currently affecting approximately 100,000 Canadians.
MS is three times as likely to occur in women than in men, and although MS can occur at any age, it is commonly diagnosed between the ages of 20 to 40, although onset may be earlier.
To learn more about who gets MS, please visit the UNDERSTANDING MS section of this website.
What are the benefits of medication/treatment?
It is important to remember that MS medications are designed to reduce the basic disease activity.
There are many medicines available to help treat MS. Some are used to treat the underlying course of the disease by adjusting the way a person’s immune system is acting. Others focus on attempting to find ways around the problems MS can cause, and help patients regain some of the abilities it can affect.
With treatment, the progress of MS may be slowed down, possibly leading to fewer relapses or a reduction in symptoms. Many may not be able to feel them working at all (as they are working behind the scenes to help slow disease), but sticking to a treatment plan is the best possible strategy for managing MS.
To learn more about the benefits or early treatment, please visit the TREATING MS section of this website.
What forms or types of medication are available for MS treatment?
There are three forms of therapy presently approved for use in Canada: oral medications, infusion treatments and injectable therapies.
Depending on the form of therapy selected, choices may range from: daily, multiple times a week, weekly, once every two weeks, monthly or once a year. The frequency in which medication is delivered is an important factor that should be considered when making treatment decisions.
To learn more about forms or types of medication available for use in Canada, please visit the TREATING MS section of this website.
How will I know if my MS is getting worse?
The progression of MS varies depending on how much nerve damage there is, how quickly it happens and where it occurs. Research shows that MS continues to progress, even when a person is not having relapses. This happens because MS has two components: the invisible disease and the visible results of it.
Keeping track of changes in symptoms is very important. It can provide a healthcare team with information that can be compared over time.
To learn more about MS progression and how symptoms may change over time, please visit the DIAGNOSING MS section of this website.
Will I be prone to depression or emotional changes?
One of the most challenging symptoms people affected by MS (including those who have the disease and their family members) have identified is depression. They want to know how to recognize, understand and manage the mood changes that are so common with this disease.
Addressing mood changes, along with using diet and exercise to help manage their MS, are the areas that people consistently identify as being high priorities in their efforts to achieve personal wellness while living with this disease.
Other common emotional symptoms that can occur with MS include:
- Mood swings or emotional liability
To learn more about managing depression or other emotional changes related to MS, please visit the LIVING WITH MS section of this website.
How can I best handle the stress that may come with having MS?
To really give themselves a mental break, people living with MS need to be able to identify what is stressful in their lives and find ways to avoid it (if possible). Techniques to help individuals manage stress and take back control may include:
- Calming the mind
- Learning to relax
- Starting mornings off right
- Practicing regular physical activity
- Mindful breathing exercises
- Simplifying the everyday things in life
To learn more about the impact of stress on MS, please visit the LIVING WITH MS section of this website.
Can diet have an impact on MS?
Although there are no particular diets that have been shown to affect the disease process in MS, food fuels the body and provides energy. People living with MS should aim to eat a healthy, balanced diet that provides basic vitamins, nutrients and calories to support requirements for energy and fitness. Maintenance of general good health is important for everyone, not just people living with a chronic disorder.
To learn more about the impact of diet on MS, please visit the LIVING WITH MS section of this website.
Will I be able to continue working?
Career choices are personal ones and going over options will help identify priorities and lead to rational and informed decisions.
Some people have a mild form of MS and never experience any symptoms that prevent them from working. Others cope with varying degrees of disability that temporarily or permanently affect their ability to function at work. Some people may be advised by their doctor, employer or family members to stop working.
Exploring employment options may involve thinking about :
- Whether or not the potential for flexible work hours are possible
- Challenges regarding work stations may need to be addressed (either needing to be relocated to a more accessible place or adjusted if need be).
- Is there any interest in changing the type of work that is being done, if necessary?
- Additional training or education may also need to be examined.
How does MS affect mobility?
MS affects nerve cells, or neurons, that carry messages to and from the brain and the rest of the body. This slowed or sometimes altered nerve performance can result in muscle weakness, spasm, muscle stiffness (spasticity) and sensory changes, which can all affect a person's ability to move around.
There are many approaches that can be taken to help manage mobility issues including exercise, physical therapy, mobility aids and medical treatments.
To learn more about the impact of MS on mobility, please visit the DIAGNOSING MS section of this website.
Can MS interfere with pregnancy?
MS is typically diagnosed when a person is between the ages of 20 to 40 years old, the family building years. If someone living with MS is planning on starting a family, a discussion should be had with their healthcare professional to understand the risks and benefits of treating MS during pregnancy.
Biogen has developed a helpful guide that helps to answer many of the questions some may have. To learn more please visit the RESOURCES section of this website.
Is it safe to travel if I am living with MS?
Most people with MS can travel safely with some advanced research and planning. Staying active is beneficial and travel is a good way to get out and get moving.
Those living with MS might want to consider potential side effects and the need for a schedule (frequency of treatment). Having a discussion with a doctor can help establish whether safe travel with medications is possible and what preparations might need to be made before leaving.
To learn more about traveling with MS, please visit the LIVING WITH MS section of this website.
What is the role of MRI in diagnosing MS?
Magnetic resonance imaging (MRI) is the diagnostic tool that currently offers the most sensitive way of imaging the brain, spinal cord or other areas of the body. It is a tool that makes it possible to visualize and understand much more about the underlying progression of the disease.
MRI is the preferred imaging method to help establish a diagnosis of MS and to monitor the course of the disease.
In providing a relatively accurate measure of disease activity, MRI has enhanced our ability to diagnose the disease, which in turn allows for earlier treatment exploration. Because MRI is also a tool that helps track the progression of the disease, assessing progression can help individuals make informed decisions on treatment options.
To learn more about MRI, visit the DIAGNOSING MS section of this website.
What is a personal treatment plan?
Once treatment goals have been established, an individual and their healthcare professional will develop a personalized treatment plan that will likely consist of two parts:
1. The use of MS-specific therapies and treatments.
2. Additional therapies or treatments to help with symptoms that people may experience due to their MS is outlined in more detail in the LIVING WITH MS section.
To learn more about personal treatment plans, please visit the TREATING MS section of this website.
Can I make a full recovery from MS?
MS is a disorder of the brain and spinal cord. It can cause various symptoms. In most cases, episodes of symptoms come and go at first for several years. In time, some symptoms can become permanent and can cause disability. At present there is no cure for MS; the various medicines and therapies that are available may help reduce the number of flare-ups and can help to ease symptoms and disability, but they will not cure it.
What are the benefits of treating MS early?
It is important to start treatment as early as possible after diagnosis, because studies suggest that relapses in the first two years can impact early disease progression. Even in instances where disease activity may be going unnoticed, MS can continue to damage the central nervous system (CNS), leading individuals to experience new symptoms later on.
Once MS is identified, the goal is to reduce early disease activity – both the clinical symptoms (for example, numbness, tingling, vision impairment, etc.) and the underlying changes in the central nervous system (CNS) that may not be readily apparent.
To learn more about the benefits or early treatment, please visit the TREATING MS section of this website.
How can I manage relapses?
The good news is that not all relapses (attacks) require treatment.
Mild sensory changes (numbness, pins-and-needle sensations) or bursts of fatigue that do not significantly impact a person’s activities can generally be left to get better on their own. For severe relapses involving loss of vision, severe weakness or poor balance – which interfere with a person’s mobility, safety or overall ability to function – most neurologists recommend treatment with corticosteroids.
To learn more about managing relapses, please visit the LIVING WITH MS section of this website.
Is MS fatal?
MS is neither contagious nor fatal. People with MS have a life expectancy that is similar to that of the general population. The leading causes of death in the MS community are heart disease, cancer and stroke.