Multiple Sclerosis: What You Need to Know About MS

As the diagnosis of MS continues to grow, so do the number of studies surrounding the still mysterious illness. Science hasn’t been able to pinpoint a precise cause (or causes). We don’t really know why people develop MS, although ongoing research has pointed to a number of risk factors that seem to converge and trigger the condition.

When we hear the term “MS” we tend to shudder as if we heard the word “cancer” - and rightfully so. It’s a dreaded disease that often progresses for years at a time, promoting slow deterioration. Unless science intervenes with a cure, multiple sclerosis is eventually terminal, although in some cases natural causes or other illnesses may end life before MS does.

But what exactly is MS? And what are the symptoms and risk factors to be aware of? Answering these questions will remove the mystery shrouding the disease.

What Is Multiple Sclerosis (MS)?

MS is considered an autoimmune disease because your immune system attacks your central nervous system (CNS) in different places at various times. Your CNS is considered the command center of your body and includes your brain, spinal column, and optical nerves.

All messages from your brain to your body originate in your CNS. Malfunctions at this level can affect any part of your body. This is why MS symptoms vary so widely from person to person. It all depends on which CNS nerves have been damaged and which cognitive or bodily functions are affected.

Essentially, multiple sclerosis causes nerve damage. When your immune system attacks, it damages the myelin coating surrounding CNS nerves. This disrupts the signals between nerves in the brain and between nerves in the brain and body. Eventually, the exposed nerves are also damaged.

But what makes your immune system begin this onslaught on your central nervous symptom? That’s the big question for researchers. Like most autoimmune disorders, the key is pinpointing triggers that initiate the disease.

What Are multiple Sclerosis Symptoms

MS symptoms are unpredictable, and as mentioned, vary widely among individuals. It depends on where the damage is occurring at any given time. You may experience only two symptoms while someone else has many others. Your first symptoms may appear entirely different than someone else’s initial symptoms.

But here is an overview of the more common symptoms experienced among MS patients:

Fatigue

According to studies, 75-90% of people with multiple sclerosis experience a noticeable form of fatigue. And for many people, it’s the most prominent symptom, as is the case for many patients with autoimmune disorders. This fatigue can become overwhelming and affects daily life at home and work, even if you have no other physical limitations.

MS Hug (Dysesthesia)

For some, an MS hug is one of the first symptoms of MS and feels like a tight hug or squeezing sensation around your torso. Some liken it to an enormous blood pressure cuff tightening around your body.

Numbness or Tingling

Another early symptom of MS can be numbness or tingling in your face, torso, arms, or legs. It can be a lack of sensation (numbness) or a pins-and-needles feeling (tingling). It usually comes and goes on its own and is often on one side of the body. It can be an indicator of nerve damage.

Spasticity

This commonly occurs in the legs and involves involuntary muscle spasms. You can experience muscle spasms in other areas of your body but most people experience leg spasms. Spasticity varies in intensity.

Weakness

While some of your muscle weakness can be due to damaged nerves that stimulate muscle movement, deconditioned muscles from lack of use is another common culprit. Because of pain, spasticity, or nerve damage in other parts of the body, mobility can become limited, creating weakness in lesser used muscles.

Vision Problems

Changes in vision are common first symptoms of multiple sclerosis and typically include:

• Optic neuritis
• Neuromyelitis optica
• Blurred vision
• Poor color vision
• Painful eye movement

Difficulties Walking

Many other symptoms can contribute to gait challenges. Weakness, spasticity, fatigue, loss of balance, and vision problems can create mobility challenges, especially when it comes to walking. Physical therapies and certain medications can sometimes alleviate this symptom.

Dizziness and Vertigo

If you have MS, you may experience dizziness, feelings of being lightheaded, or even bouts of vertigo. Vertigo is when it feels like you or your surroundings are spinning.

Bladder Problems

About 80% of people with MS develop a dysfunctional bladder. This is usually because nerves that communicate with the bladder have been damaged or the bladder nerves themselves have been damaged. When you experience bladder problems due to nerve damage it’s referred to as neurogenic bladder. It’s sometimes possible to manage bladder symptoms through medications, intermittent self-catheterization, and fluid management.

Bowel Problems

Possible bowel symptoms include two extremes: constipation and loss of bowel control. Which symptom you experience depends on which nerves have been damaged. You can usually manage these symptoms through diet, physical activity, fluid intake, and medication.

Sexual Problems

When nerves in your CNS are damaged, it can affect your sexual responses. Other reasons for MS-related sexual dysfunction include fatigue, depression, and spasticity.

Pain

Pain is another prominent symptom of multiple sclerosis. A commonly cited study found that about 55% of participants with MS had clinically significant pain at some point during their illness, and nearly half experienced chronic pain.

Cognitive Changes

These changes occur at a high level of brain function and have been reported to affect over 50% of MS patients. changes affect your ability to learn and remember new information, process incoming information, focus, problem solve, organize information, and accurately perceive your environment.

Depression

Clinical depression is another common MS symptom and rates are higher among people with multiple sclerosis than with other chronic and debilitating illnesses. If you have MS, your depression may be a primary symptom directly related to damage caused by the disease, or it could be a secondary symptom triggered by the other challenging symptoms MS causes, like pain and fatigue.

Emotional Changes

In addition to depression, you might also experience mood swings, anxiety, and uncontrollable instances of laughing and crying. Neurologic and immune changes can trigger these reactions as well as the stress of living with MS.

Less Common Symptoms Include:

Even though these symptoms aren’t as typical, be sure to discuss them and any new symptoms with your doctor.

• Itching
• Speech problems
• Loss of taste
• Tremors
• Swallowing difficulties
• Seizures
• Hearing loss
• Breathing problems

What Are the Causes and Risk Factors for MS?

Researchers haven’t pinpointed a specific cause of multiple sclerosis, but they do believe they have identified likely risk factors that may trigger MS or that may combine to trigger the disease. They’ve grouped these risk factors into three major categories:

• Immunological
• Environmental
• Infectious

Immunological Factors

The autoimmune response involved in multiple sclerosis is highly complicated (as is the human immune system). So here is a basic summary of what’s going on inside your body:

• Something triggers your immune system to attack your CNS
• T cells in your lymph system are activated and enter your CNS
• T cells release chemicals that cause inflammation and nerve damage
• T cells activate other immune system cells
• Cells that would normally mediate inflammation are deactivated
• Special “Killer” T cells directly attack specific nerve cells
• B cells are activated and produce proteins that cause further CNS damage

Researchers are still studying this process and the immune response to discover possible ways to slow or stop it.

Environmental Factors

As with immunological risk factors, scientists continue to study the environmental factors that could contribute to multiple sclerosis. Here is a list of the most researched factors:

Where You Live

Scientists have found that the further away from the equator you live, the more likely you are to develop MS. In the U.S., this means that northerners are at higher risk than southerners. If you move from a higher-risk area before the age of 15, research suggests you adopt the risk of your new location rather than your previous one. These findings suggest that exposure to these yet unknown environmental factors before puberty may predispose you to MS at a later time.

And although there are some hypotheses about why living further from the equator puts you at greater risk, researchers have no definitive answers for why this may be the case.

Vitamin D Deficiency

Data is piling up to suggest that a deficiency in vitamin D escalates your risk for MS. Since sun exposure is a natural source of this vitamin, it could be at least part of the reason that people living closer to the equator have a lower risk of developing MS. However, this has yet to be proven. Why vitamin D? It supports immune function and may protect against immune system dysfunction in diseases like MS.

Smoking

Some studies have shown that smoking increases your risk of developing MS, increases its severity, and speeds up the progression of the disease.

Obesity

Obesity is a risk factor for multiple sclerosis, especially during the period from childhood to young adulthood. Obesity during these years increases risk more so than obesity that develops in later years. But obesity at any age increases chronic inflammation throughout the body and is also believed to raise your risk of MS.

Infectious Factors

Viruses are another possible trigger that initiates the onset of MS. Several viruses and bacteria are being investigated, including:

• Human herpes virus-6
• Epstein-Barr virus (EBV)
• Chlamydia pneumonia
• Measles
• Canine distemper

However, researchers are most interested in the impact of EBV, the virus that causes mononucleosis. Growing research suggests that if you’ve ever had mono, you’re more at risk for multiple sclerosis.

MS Risk Factors: The Takeaway

Much is still unknown concerning the causes of MS. However, some likely risk factors are preventable, which allows you to shift your focus to prevent what you can. Maintaining a healthy weight, not smoking, and taking a vitamin D supplement if needed can mediate your risk factors. Otherwise, taking care of your health and making wise choices will also go a long way toward prevention.

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