What is multiple sclerosis (MS)?

This week is MS (multiple sclerosis) Awareness Week. Most of us have heard of it – most of us know that a diagnosis of MS is ‘not good’, to say the least. But what does it really mean, and how much should we worry?

This week is MS (Multiple Sclerosis) Awareness Week. Most of us have heard of it – most of us know that a diagnosis of MS is ‘not good’, to say the least. But what does it really mean, and how much should we worry?

What is MS?

MS is an auto-immune disease – that means that your own immune system, which normally protects you by fighting off infection, recognises part of your body as an enemy. In MS, the myelin sheaths which surround and protect your nerves are affected. At first, these sheaths (like insulation around electrical wires) get inflamed; later, scarring develops.

What causes MS?

MS affects about 1 in 1,000 people. If a close relative (parent, sister or brother) is affected, your risk is about 1 in 100. MS probably has several causes – it may be that you inherit a tendency to get it, but don’t get symptoms until the disease is triggered by a viral infection. We know that MS is less common in countries near the equator, and more common in Scotland and Scandinavia than in England or Wales. This may be to do with viral infections (like colds) spreading more in cooler countries.

What are the symptoms?

Symptoms depend on which part of your nervous system is affected, but usually they affect just part of your body at first. They include:

  • Double or blurred vision.
  • Numbness or tingling.
  • Weakness or spasms of some muscles.
  • Dizziness or balance problems.
  • Problems passing water.

There are several different kinds of MS. They include:

  • Relapsing-remitting MS, where symptoms last a few weeks, go away completely or nearly, and different symptoms come on months or even years later. About 9 in 10 people with MS have this kind.
  • Primary progressive MS - symptoms don’t settle and gradually get worse.
  • Secondary progressive MS - after several years of relapsing-remitting MS, the symptoms gradually become permanent.

What does it mean for my life?

MS can’t be cured but there are many treatments which will help. In the longer term, most people with MS will have some problems with day-to-day tasks that other people take for granted. But there are lots of solutions including:

  • Medicines to reduce inflammation, muscle spasms, etc.
  • Physiotherapy to maintain mobility.
  • Occupational therapy to provide alterations and gadgets in your home to help you to live independently.
  • Counselling to help you cope with your symptoms and feelings.

Ten years after being diagnosed with MS, about half of sufferers don’t have any disability at all and, after 25 years, half of sufferers are still not in a wheelchair. In other words, a diagnosis of MS doesn’t mean you are bound to be crippled for life. There really is life after MS.

Cannabis as medicine

In June 2010, the first cannabis-based drug was licensed for treating muscle spasms in MS. Is this a medical advance? Or a slippery slope to turn us all into drug addicts?

Of course, there’s more to this than meets the eye. Muscle spasms affect most people with MS at some point and can be extremely hard to treat. This new treatment, Sativex®, provides a very carefully controlled dose of active ingredients in cannabis. It doesn’t work for everyone, but at least half of people who take it get improvement in their muscle spasms. The most common side-effects are dizziness and tiredness.

Should we worry about ‘cannabis on prescription’? We need to bear in mind that other drugs used ‘recreationally’ (most of us would say other drugs that are abused) have been prescribed for years. If you have cancer, you’ll almost certainly need morphine regularly at some point. If you have a heart attack, you will automatically be given a dose of diamorphine – that’s heroin to you and me. So no, this new drug is not the end of civilisation as we know it.

Dr Sarah is unable to provide medical advice or respond directly to questions concerning your health. If you have health concerns we recommend contacting your GP.