Multiple sclerosis (MS) is a chronic condition in which the body’s immune system directs itself against the central nervous system (CNS). Most often, this impacts the brain, spinal cord, and optic nerves. The symptoms of this condition can vary widely, with some people experience mild effects and others struggling to complete daily tasks.

Frustratingly, many of the symptoms of MS aren’t outwardly visible. These behind-the-scenes challenges are therefore often endured silently, while the patient’s friends and family members may assume that their appearance of health indicates minimal to no suffering. Here are some of the symptoms which, despite their invisibility, can be debilitating; along with practical coping mechanisms to help you maintain your quality of life.

Pain

Up to two-thirds of people with MS report pain. For many, it interferes with aspects of daily life, including career, recreation, mood, and their ability to complete activities. The steady discomfort is suspected to result from fatigued muscles, which are working to compensate for those weakened by the disease. Sometimes, chronic pain is reported to feel like a tight band around the chest or torso, known as the “MS hug.” It may also feel like burning, prickling, aching, or “pins and needles.”

Sharp pains, on the other hand, are believed to be from faulty nerve signals caused by the lesions produced by MS in the CNS. The damage to the nerves is called dysesthesia and can impact the legs, feet, arms, and trunk. Up to 55% of people with MS have experienced this “clinically significant pain,” and while it isn’t necessarily dangerous, it can be a source of significant frustration.

For some people, compression stockings or gloves can minimize the pain caused by dysesthesias. For others, pain is more pronounced and requires the use of medications. Doctors may prescribe anticonvulsant medications or antidepressants, which change the ways in which the CNS reacts to pain. Over-the-counter pain relievers, including acetaminophen, and warm compresses can also be used to combat pain under a doctor’s supervision.

In many cases, chronic pain is best addressed through anti-inflammatory drugs, either over-the-counter or prescription. Stretching routines may also aid in maintaining flexibility in the muscles, which could help with pain levels. Massage therapy and physical therapy may also be beneficial. Some seeking an alternative option will consider stem cell therapy due to the potential regenerative ability these stem cells offer for those with MS.

Ultimately, discomfort for MS patients varies in intensity. On days when pain is most severe, changing your routine may provide the greatest relief. Whether it’s declining a social event or using a mobility-assistive device, it’s important to find ways to put your comfort first when experiencing intense pain.

Fatigue

The fatigue MS patients experience goes beyond general tiredness: it is often described as a flu-like feeling of exhaustion or extreme muscle weakness. It occurs in 80% of people with the condition and is therefore among its most common symptoms. Although the condition itself can be the cause, it’s also possibly related conditions, such as sleep disorders, medications, and depression could be culprits behind fatigue.

To determine the best form of treatment for your fatigue, consult with your doctor to pinpoint the reason for your exhaustion. If it’s the condition itself, lifestyle management tactics developed through occupational and physical therapy could make day-to-day tasks more manageable. Scheduling rests and even short naps could help you conserve energy. Also, while it might seem counterintuitive, light physical activity might actually combat energy depletion.

For sleep-related issues, stress management, relaxation training, and sleep regulation techniques may be beneficial. If your fatigue comes on suddenly, occurs regularly, and begins to interfere with responsibilities, consider talking to your doctor about medication options.

Cognitive Issues

Cognitive impairment, including issues with memory, perception, learning, and problem-solving, is reported by nearly 50% of people with MS. Sometimes, it can be difficult to tell whether the symptom is tied to the mental fatigue or “brain fog” the condition causes, or whether the mental glitches are actually a result of the impact MS has on the CNS.

While research on the best methods for treating cognitive impairment in MS is still ongoing, there are some tactics you can implement to work around any mental challenges you may experience. Mood management is a good starting point: if you experience inexplicable mental or emotional shifts, you could be suffering from depression. This symptom may be a result of the condition itself, or it could be attributed to medications, in which case you could discuss with your treating physician to see if adjustments to your treatment may be needed.

For some people, brain exercises such as puzzles and memory games help to maintain mental acuity. The brain is a muscle, and working it out regularly is important to facilitating strength. Planning your days in advance is also a good way to minimize any challenges cognitive issues may pose. Schedule important tasks for the times of day when you feel most alert. Finally, don’t hesitate to seek out support from counselors, support groups, or loved ones. Isolation can exacerbate cognitive decline, but socialization can improve or minimize the symptom.

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