Multiple Sclerosis

What is multiple sclerosis (MS)?

Multiple sclerosis is a neurological condition that affects the nerves in the brain and spinal cord, also known as the central nervous system. ‘Sclerosis’ means scarring or hardening of patches of tissue. ‘Multiple’ is added because this happens at more than one place in the brain and/or spinal cord¹.

Once diagnosed, multiple sclerosis stays with a person for life, but treatments and specialists can help them to manage the condition and its symptoms.

It’s estimated that there are more than 100,000 people diagnosed with multiple sclerosis in the United Kingdom.

Are there different types of MS?

There are three main types of multiple sclerosis²:

1. Relapsing remitting multiple sclerosis – someone with relapsing remitting multiple sclerosis will have episodes of new or worsening symptoms. These typically worsen over a few days, last for days to weeks to months, and then slowly improve over a similar time period. Symptoms they’ve experienced before might come back, or they might get new symptoms. Around 85% of people with MS are diagnosed with this type
2. Secondary progressive – after many years (usually decades), many, but not all, people with relapsing remitting MS go on to develop secondary progressive MS. Symptoms gradually worsen over time and they have a build-up of disability, independent of any relapses
3. Primary progressive – in primary progressive multiple sclerosis, symptoms gradually worsen and accumulate over several years, and there are no periods of remission, though people often have periods where their condition appears to stabilise. Primary progressive multiple sclerosis affects about 10-15% of people diagnosed

“It is not known why people get multiple sclerosis. It’s likely to be due to a combination of genetics, environmental influences and lifestyle factors.”

What causes MS?

It is not known why people get multiple sclerosis. It’s likely to be due to a combination of genetics, environmental influences and lifestyle factors. What is known is that multiple sclerosis is an autoimmune condition that affects your brain and spinal cord.

A substance called myelin protects the nerve fibres in the central nervous system, which helps messages travel smoothly between the brain and the rest of the body. In multiple sclerosis, the immune system mistakes myelin for a foreign body and attacks it. This damages the myelin and strips it off the nerve fibres, leaving scars known as lesions or plaques. This damage disrupts messages travelling along fibres – messages can slow down, become distorted, or not get through at all. As well as losing the myelin, there can sometimes be damage to the actual nerve fibres. It’s this nerve damage that causes the increase in disability that can occur over time³.

What are the effects of MS?

The central nervous system links everything your body does, so multiple sclerosis can cause many different types of symptoms. The specific symptoms that appear depend on what part of the central nervous system has been affected, and the job of the damaged nerve. That’s why multiple sclerosis is different for everyone.

Main symptoms can include⁴:

• Fatigue
• Pain
• Vision problems, such as blurred vision
• Swallowing difficulties
• Problems controlling the bladder, and bowel problems
• Numbness or tingling in different parts of the body
• Muscle stiffness and spasms (spasticity)
• Tremor
• Difficulty walking
• Tremor and problems with balance and co-ordination (ataxia)
• Speech problems
• Difficulties with memory, thinking, learning and planning
• Mental health issues

What postural challenges can result from multiple sclerosis?

• Fatigue
• Muscle weakness
• Poor postural control
• Increased thoracic kyphosis
• Posterior pelvic tilt
• Poor sitting balance
• Contractures 
• Windsweeping or knees knocking together
• Involuntary movements
• Sensory impairments