There is no cure to multiple sclerosis. There are medications to help with easing the symptoms associated with the different stages of the disease, their severity, and progression. Alternative therapies like physical and occupational therapy have proven to improve quality of life and prevent disability (Kesselring & Beer, 2005). Research by Munger and Ascherio (2011) states vitamin D supplementation may reduce the risk of MS and promote a more favorable progression.
Main goals of medical management for multiple sclerosis are to return function after attacks, prevent new attacks, and prevent disability. Most common medical management includes injectable, oral, and infusion therapies (Kesselring & Beer, 2005).
- The use of high dose intravenous corticosteroids, like methylprednisolone, is aimed at decreasing the inflammation caused by T- Cells during an acute attack. IV steroids are only used for short term to relieve symptoms and cannot be continued for longer than a few weeks to months (Derwenskus, 2011).
- For severe attacks where high dose corticosteroids are not working, the use of plasmapheresis is recommended and highly successful in decreasing the severity of symptoms. Plasmapheresis removes the circulating antibodies that are active in this autoimmune disease and ultimately helps patients increase muscle strength and improve fatigue within a day or two after treatment, and it lasts for a few months (National Multiple Sclerosis Society, 2015).
When treating relapsing- remitting multiple sclerosis or clinically isolated syndromes of MS the first line of treatment is the use of interferons (drugs similar to proteins produced by your body) and glatiramer acetate, which are proven to decrease attacks by 30% (Derwenskus, 2011). Second choice of treatment is the use of natalizumab, which is an infusion therapy given every 4 weeks and is shown to decrease relapse by 50-60% (Derwenskus, 2011), but not preferred due to severe side effects. Another treatment used for progressive MS is the use of mitoxantrone, also an infusion therapy, which has the worst side effects and is used when nothing else has shown signs of improvement (Derwenskus, 2011).
Other common treatments to help with symptoms include Deep Brain Stimulation to help control tremors, and Baclofen Pumps or Botox to help with spasticity and to relax the muscles (National Multiple Sclerosis Society, 2015).
Rehabilitation programs that increase activity and include exercises that focus on increasing muscle strength can help with improving fatigue and prevent disability (National Multiple Sclerosis Society, 2015). 50% of patients use alternative therapies like cognitive behavioral approaches, yoga, herbal medicine, hyperbaric oxygen therapy, reflexology, acupuncture, and dietary supplementation and regiments (Martinez-Assucena et al., 2010).
