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Multiple Sclerosis

Multiple sclerosis: What you need to know

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Multiple sclerosis is a chronic disease affecting the central nervous system, particularly the brain, the spinal cord and the optic nerves. This can contribute to a large variety of symptoms across the body.

It is not possible to predict how any person will experience progression of multiple sclerosis (MS).

Many may have mild symptoms, including blurred vision and numbness in the limbs and tingling. In severe cases , an individual may experience paralysis, loss of vision and problems with mobility. That is, however, rare.

It is impossible to say precisely how many people have MS. 250,000–350,000 people in the United States live with MS according to the National Institute for Neurological Disorders and Stroke (NINDS).

The National Society for Multiple Sclerosis estimates the number could be nearer to 1 million.

Newer treatments, however, are proving effective in slowing down the disease.

What is MS?

Pain, weakness, and tingling are common symptoms of MS.
Pain, weakness, and tingling are common symptoms of MS.

Researchers do not know precisely what causes MS, but they agree the central nervous system ( CNS) is an autoimmune disease. If a person has an autoimmune disease, the immune system attacks healthy tissue, just like a virus or bacteria may be targeted.

In the case of MS, the immune system is destroying the myelin sheath that covers the nerve fibers and protects them, causing inflammation. Myelin also helps the nerves to quickly and efficiently conducte electrical signal.

Multiple sclerosis means “Multiple Area scar tissue.”

It leaves a scar, or sclerosis, when the myelin sheath disappears or sustains damage in several locations. Physicians also call plaques or lesions on these regions. They are mostly affected by:

  • the brain stem
  • the cerebellum, which coordinates movement and controls balance
  • the spinal cord
  • the optic nerves
  • white matter in some regions of the brain

Nerve fibers can break or get damaged as more lesions develop. As a consequence the brain’s electrical impulses do not flow easily through the target nerve. This means the body would not be able to perform other functions.

Types of MS

Four types of MS do exist:

Clinically Isolated Syndrome (CIS): It is a single, first episode with at least 24 hours of symptoms. A doctor can treat relapse-remitting MS if another episode happens at a later date.

Relapse-remitting MS (RRMS): This is the most common form, affecting about 85 per cent of people with MS. RRMS includes episodes of new or increasing symptoms, followed by periods of remission, during which symptoms partially or totally disappear.

Primary progressive MS (PPMS): Symptoms slowly intensify, without early recurrences or remissions. Many people may experience stable times and periods when symptoms worsen, and then improve. About 15 percent of MS-patients have PPMS.

Secondary progressive MS (SPMS): people may have periods of recurrence and relapse at first, but eventually the condition can continue to advance gradually.

Symptoms

Vision changes can be an early sign of MS.
Vision changes can be an early sign of MS.

Because MS affects the CNS which controls all of the body ‘s actions, symptoms can affect any part of the body.

The most common MS signs are:

Muscle weakness: People may develop weak muscles due to nerve damage due to lack of use or stimulation.

Numbness and tingling: A feeling of the form of pins and needles is one of the earliest symptoms of MS which may affect the face, body, or arms and legs.

Sign of Lhermitte: When a person moves his arm, known as the sign of Lhermitte, he can feel a sensation like an electric shock.

Bladder problems: a person may have trouble emptying the bladder, or urinating regularly or unexpectedly (urge incontinence). Loss of control at the bladder is an early sign of MS.

Bowel problems: Constipation can cause fecal impaction, which may contribute to incontinence of the intestines.

Fatigue: This may weaken the ability of a person to operate either at work or at home. Fatigue is among the most prevalent symptoms of MS.

Dizziness and vertigo: These are common symptoms, along with symptoms of balance and coordination.

Sexual dysfunction: Males and females can lose sexual interest.

Spasticity and muscle spasms: This is an early sign of MS. Damaged nerve fibers in the spinal cord and brain, especially in the legs, can cause painful muscle spasms.

Tremor: Some people with MS can experience involuntary quivering movements.

Vision issues: Many people may experience double or blurred vision, partial or total loss of vision, or distortion of red-green colour. Normally this affects one eye at a time. Optic nerve inflammation may cause pain while the eye is moving. Problems with vision are an early symptom of MS.

Changes in gait and mobility: MS may change the way people walk, due to muscle weakness and balance, dizziness, and fatigue problems.

Emotional changes and depression: Demyelination and damage to the nerve fibers in the brain can cause emotional changes.

Problems with learning and memory: This can make focusing, preparing, learning, prioritizing and multitasking difficult.

Pain: Pain is a common symptom of MS. Neuropathic pain is caused directly by MS. Certain forms of pain are caused by muscle fatigue or stiffness.

Less common symptoms include:

  • headache
  • hearing loss
  • itching
  • respiratory or breathing problems
  • seizures
  • speech disorders
  • swallowing problems

There is also a higher risk of:

This can affect the work and social life of an person.

People can experience changes in perception and thinking in the later stages, and heat sensitivity.

MS affects people differently. For others, it begins with a mild feeling and for months or years, their symptoms are not improving. Symptoms sometimes get worse quickly, within weeks or months.

A few people will have only minor symptoms and most people will experience major changes leading to disability. And, when symptoms escalate, most people will experience periods, and eventually get better.

The sign of Lhermitte is a typical symptom of MS occurring when a person moves his or her head.

Causes and risk factors

Researchers have no clear idea of what causes MS, but risk factors include:

Age: The majority of patients get a diagnosis between the ages of 20 and 40.

Sex: Some types of MS appear to affect women twice as often as men.

Genetic factors: Susceptibility can transmit in the genes, but scientists also agree that an environmental stimulus is necessary for the development of MS, even in people with specific genetic characteristics.

Smoking: People who smoke tend to be more prone to grow MS than non-smokers. They appear to get more tumors and brain shrinkage.

Infections: Virus exposure, such as Epstein-Barr virus (EBV), or mononucleosis, may increase a person’s risk of developing MS, but a definite correlation has not been found in research. Certain viruses that can play a role include type 6 human herpes virus (HHV6) and pneumonia to the mycoplasma.

Vitamin D deficiency: MS is more common in people with reduced access to bright sunlight, which the body requires to produce vitamin D. Some experts think low vitamin D levels can influence how the immune system functions.

Deficiency of vitamin B12: The body uses vitamin B in the development of myelin. A deficiency of this vitamin, such as MS, may increase the risk of neurological illness.

Previous theories involved exposure to canine distemper, physical damage, or aspartame, an artificial sweetener.

MS probably does not have a single cause but multiple factors may contribute.

Diagnosis

The doctor will conduct a physical and neurological exam, inquire about the symptoms and consider the medical background of the person.

No single test can confirm a diagnosis so a doctor will use several strategies to decide if a person meets the diagnostic criteria.

These include:

  • MRI scans of the brain and spinal cord, which may reveal lesions
  • spinal fluid analysis, which may identify antibodies that suggest a previous infection
  • an evoked potential test, which measures electrical activity in response to stimuli

Other disorders have similar symptoms to those of MS, and a doctor can recommend further testing to determine other potential causes.

If MS is treated by the doctor, they may need to determine what type it is, and if it is active. In the future, the individual will need further testing to evaluate for more modifications.

Treatment

A doctor can help the individual find treatment to suit them.
A doctor can help the individual find treatment to suit them.

There is no cure for MS, but treatment is available that can:

  • slow the progression and reduce the number and severity of relapses
  • relieve symptoms

Some people also use complementary and alternative therapies but the usefulness of these is not always confirmed by research.

Medications to slow progression

A number of disease-modifying therapies (DMTs) have Food and Drug Administration ( FDA ) approval for relapsing forms of MS. These work by changing the way the immune system works.

Some of these can be given by a doctor by mouth, some by injection and some as an infusion. It will depend on the drug how often the person needs to take them and whether or not they can do this at home.

The following DMTs currently have approval:

Injectable medications

  • interferon beta 1-a (Avonex and Rebif)
  • interferon beta-1b (Betaseron and Extavia)
  • glatiramer acetate: (Copaxone and Glatopa)
  • peginterferon beta-1a) (Plegridy)

Oral medications

  • teriflunomide (Aubagio)
  • fingolimod (Gilenya)
  • dimethyl fumarate (Tecfidera)
  • mavenclad (cladribine)
  • mayzent (siponimod)

Infused medications

  • alemtuzumab (Lemtrada)
  • mitoxantrone (Novantrone)
  • ocrelizumab (Ocrevus)
  • natalizumab (Tysabri)

Current guidelines recommend the use of these drugs from the early stages, as there is a good chance that they can slow the progression of MS, especially when the person is taking them when symptoms are not yet serious.

At certain times certain medications are more effective. In a later, more severe stage of MS, for example , a doctor may prescribe mitoxantrone.

A doctor should track how well a drug performs, because adverse effects will occur and the same medications don’t suit everyone. New product solutions entering the market are proving safer and more effective than any current ones.

Adverse effects of immunosuppressive medicines include increased risk of infection. Some medications may also harm the liver.

If an individual notices adverse effects or their symptoms are getting worse, they should seek medical advice.

Medicines used to relieve symptoms during flare

Many medications are helpful when a person is experiencing symptoms worsening, during a flare. We are not going to use those medications all the time.

Corticosteroids: reduce inflammation and eliminate the immune system. In certain types of MS, they can treat an acute flare-up of the symptoms. Examples include Solu-Medrol (methylprednisolone) and Deltasone (prednisone). When a person uses them too much, steroids may have negative effects, and they are unlikely to have any long-term benefit.

Changes in behaviour: If vision problems occur, a doctor may recommend that the eyes be rested from time to time or that screen time be reduced. A person with MS may need to learn to rest when fatigue sets in and take pace to complete activities.

Mobility and balance problems: Physical therapy and walking equipment, such as a cane, may help. This can also prove useful for the medication dalfampridine (Ampyra).

Tremor: A person can use assistive devices to minimize shaking or add weights to the limbs. Also drugs can help with tremors.

Fatigue: It will help you get enough rest and escape sun. Physical and physical therapy can help teach the people how to do it more comfortably. Assistive devices, such as a mobility scooter, can aid in energy conservation. By improving sleep, medicine or therapy may help improve the strength.

Pain: A doctor may prescribe anticonvulsant or antispasmodic drugs or injections of alcohol to alleviate trigeminal neuralgia, which is a sharp pain affecting the face. Medications for pain relief, including gabapentin, can help with body pain. Medications may also be used to relieve muscle pain and cramping in MS.

Problems with the bladder and bowel: Some medicines and dietary changes can help solve these problems.

Depression: A doctor may prescribe a selective serotonin reuptake inhibitor (SSRI), as these are less likely than other antidepressant drugs to trigger fatigue.

Cognitive changes: Donepezil, an Alzheimer’s drug, can be of benefit to others.

Complementary and alternative therapies

The following may help with different aspects of MS:

  • heat and massage treatment for pain
  • acupuncture for pain and gait
  • stress management to boost mood
  • exercise to maintain strength and flexibility, reduce stiffness, and boost mood
  • a healthful diet with plenty of fresh fruits, vegetables, and fiber
  • quitting or avoiding smoking

Medical marijuana

Research have shown that cannabis can help alleviate pain , stiffness of the muscles and insomnia. There’s not enough proof to prove that though.

People should also note that:

  • There is a difference between using street cannabis and medical cannabis.
  • Not all forms of cannabis are legal in all states.

Before using cannabis a person should ask their doctor for advice, as certain types may have adverse effects. Smoking cannabis is unlikely to be beneficial, and can exacerbate symptoms.

Some people have suggested that biotin may help. 

Rehabilitation and physical therapy

Physical therapy can help with strength and flexibility.
Physical therapy can help with strength and flexibility.

Rehabilitation may help enhance or sustain an individual’s ability to successfully function at home and at work.

Programs generally include:

Physical therapy: It is aimed at delivering the skills needed to sustain and regain full mobility and functional ability.

Occupational therapy: the use of work , self-care and play as a therapy can help to maintain mental and physical function.

Speech and swallowing therapy: Advanced instruction for those who need it is carried out by a speech and language therapist.

Cognitive rehabilitation: It helps people control complex thought and perception disorders.

Vocational rehabilitation: This helps a person whose life with MS has changed in making career plans, learning work skills, finding and maintaining a work.

Plasma exchange

Exchanging plasma involves removing blood from the individual, removing the plasma, replacing it with new plasma, and transfusing it back into the individual.

This procedure eliminates the blood antibodies that target parts of the person’s body but it is unknown if it will benefit people with MS. Studies have produced results which are mixed.

Typically, plasma exchange only suits severe MS attacks.

Stem cell therapy

Scientists are investigating the use of stem cell therapy to rebuild different body cells, and to restore function to those who have lost it due to health.

Researchers hope that stem cell therapy techniques may one day be able to reverse MS damage and restore functionality within the nervous system.

Outlook

MS is a potentially severe state of health which affects the nervous system. MS development is different for each person, so it’s hard to predict what’s going to happen but most people won’t experience serious impairment.

Scientists have made rapid progress in the development of drugs and treatments for MS in recent years . New drugs are safer and more effective, and offer significant hope for slowing progression of disease.

As researchers learn more about the genetic characteristics and changes that occur with MS, there is also hope that they can more easily predict what type of MS a person will have and establish the most effective treatment from the earliest stage.

A person who is treated properly and follows a healthy lifestyle can expect to live the same number of years as a person without MS.

It is important that people who understand what it is like to get a diagnosis of and live with MS have support.

Immune System / Vaccines

Concussion in adolescents linked to an increased chance of developing MS later in life

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A recent study finds that people who get a concussion as teenagers are more likely to acquire multiple sclerosis later in life.

A concussion is a type of traumatic brain injury (TBI) that is caused by a quick impact or shock to the head and can impair brain function.

Loss of consciousness, dizziness, impaired balance and coordination, changes in behavior and mood, memory issues, and confusion are all signs and symptoms of a concussion. Symptoms usually occur within a few days of a head injury, although they might take up to a week.

While concussion symptoms are generally temporary, research has recently revealed that head trauma can have long-term consequences for brain health.

brain concussion

Researchers have now discovered a relationship between adolescent concussion and the chance of developing multiple sclerosis (MS) later in life.

Prof. Scott Montgomery of Sweden’s Oerebro University and colleagues published their findings in the Annals of Neurology recently.

MS is a neurological disease that affects around 2.3 million people worldwide.

An aberrant immune reaction is thought to be the cause of the condition, in which the immune system assaults and destroys myelin, a fatty material that protects nerve fibers in the central nervous system.

Prof. Montgomery and colleagues identified 7,292 MS patients using data from the national Swedish Patient and Multiple Sclerosis registries. All of the participants were born between 1964 and 2012, and MS diagnoses were made between 1964 and 2012.

Each MS patient was matched with ten people who did not have MS on the basis of sex, year of birth, age at MS diagnosis, and location of residence. In all, 80,212 people took part in the survey.

The researchers also looked for any concussion diagnoses among the subjects during childhood (between the ages of birth and ten years) and adolescence using data from the Swedish Patient Register (between the ages of 11 and 20 years).

MS risk increased more than twofold

The researchers discovered no link between childhood concussions and the chance of developing MS later in life.

Participants who had one concussion in adolescence were 22 percent more likely to get an MS diagnosis later in life, whereas those who had more than one concussion were more than twice more likely to have MS later in life.

According to previous study, head trauma can trigger an aberrant immune response that harms the brain. This procedure, according to the authors, might explain their findings.

“Head trauma in adolescence, particularly if repeated, is associated with a raised risk of future multiple sclerosis, possibly due to initiation of an autoimmune process in the central nervous system.”

“Another reason to protect adolescents against brain damage, particularly if they are at risk of repetitive trauma, such from sports-related injuries,” adds Prof. Montgomery.

According to the Centers for Disease Control and Prevention (CDC), concussion or another type of TBI was diagnosed in roughly 329,290 people in the United States who were treated for sports or recreational injuries in 2012.

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Fibromyalgia

Why do my legs and feet feel numb?

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Due to sitting in a position that exerts too much pressure on the nerves or restricts blood flow, a person may have numbness in their legs and feet. Long-term or inexplicable numbness, on the other hand, might indicate an underlying medical condition.

Conditions including multiple sclerosis (MS), diabetes, peripheral artery disease, and fibromyalgia can cause long-term numbness or tingling in the legs and feet. The feeling might be felt across the leg, below the knee, or in various parts of the foot.

In this post, we’ll look at some of the causes of numbness in the legs and feet, as well as the symptoms and treatments available.

Symptoms

feet Numbness

Numbness is just one of the many symptoms connected with numbness, whether momentary and chronic.

Many people who have numbness in their legs and feet often have other symptoms that occur at the same time or in waves, such as:

  • tickling
  • itching
  • a crawling feeling under the skin
  • tingling
  • burning

Causes 

Because of their position, a person’s legs frequently go numb. Chronic or long-term numbness in the feet and legs, on the other hand, is usually always an indication of a medical condition.

The following are some of the conditions that might cause numbness in the feet and legs:

Posture

The most common cause of transient numbness in the legs and feet is poor posture that puts pressure on nerves or reduces blood flow in the lower limbs. The medical word for transitory (temporary) paresthesia is what many people refer to when their leg “falls asleep.”

The following habits might lead the feet and legs to fall asleep:

  • sitting on the feet
  • wearing pants, socks, or shoes that are too tight
  • sitting or kneeling for long periods
  • crossing the legs for too long

Multiple sclerosis

Sensory nerve loss causes numbness in a small area of the body or across the limbs in people with multiple sclerosis (MS). Although MS-related numbness usually only lasts a short time, it can be severe enough to be debilitating.

Stokes and mini-strokes

Strokes and mini-strokes can harm the brain, altering how the mind perceives and processes nerve impulses. A stroke or mini-stroke can result in numbness in various parts of the body, which can be brief or long-term.

Diabetes

Diabetic neuropathy is a kind of nerve injury that occurs in some people. Diabetic neuropathy can result in numbness, tingling, and discomfort in the feet, as well as the legs if the condition is severe.

Injury

Nerves in the trunk, spine, hips, legs, ankles, and feet can be compressed, causing numbness in the feet and legs.

Tarsal tunnel syndrome

Tarsal tunnel syndrome is caused by a compressed, pinched, or injured nerve that goes down the back of the leg, along the inside of the ankle, and into the foot.

On the inside of the ankle, the tarsal tunnel is a tiny space. Numbness, burning, tingling, and shooting pain in the ankles, heels, and feet are common people of tarsal tunnel syndrome.

Lower back issues and sciatica

Compression of the nerves leading to the legs can be caused by problems in the lower back, such as a breakdown or herniation of spinal discs, resulting in numbness or sensory difficulties.

Sciatica is a condition in which the sciatic nerve, which travels from the lower back to the legs, is irritated. A person may have numbness or tingling in their legs or feet if this nerve becomes inflamed or constricted.

Tumors and other non-cancerous growths

Tumors, cysts, abscesses, and benign (non-cancerous) growths can push against the brain, spinal cord, or any part of the legs or feet. This pressure can cause numbness in the legs and feet by restricting blood flow.

Peripheral artery disease

The peripheral blood arteries in the legs, arms, and stomach constrict as a result of peripheral arterial disease (PAD), limiting the volume of blood they can pump and lowering blood flow. One of the most prevalent parts of the body affected by PAD is the legs.

When walking or moving upstairs, most people with PAD suffer discomfort and tightness in their legs and hips. Leg numbness and weakness are also common people of PAD.

PAD symptoms usually subside after a few minutes of relaxation.

Fibromyalgia

Fibromyalgia is a chronic or long-term condition that causes widespread pain, aching, and soreness throughout the body. Numbness and tingling in the hands and feet are also common people of fibromyalgia.

The majority of people who have fibromyalgia have a range of symptoms, including:

  • memory problems and difficulty thinking clearly, sometimes called fibro-fog
  • restless leg syndrome
  • stiffness and soreness for no apparent reason, especially in the morning or after sleeping
  • chronic exhaustion

For at least 3 months, almost everyone with fibromyalgia has symptoms in more than one section of their body. Fibromyalgia is unlikely to be the cause of numbness in the legs and feet if it is not accompanied by other symptoms or is not long-term.

Use of alcoholic beverages

Alcohol’s toxins can induce nerve damage, which can lead to numbness, especially in the feet.

Nerve damage caused by chronic or heavy alcohol intake can also induce numbness. Reduced levels of B vitamins, such as B-1 (thiamine), B-9 (folate), and B-12, are connected to nerve damage induced by heavy alcohol consumption.

Treatment

The best way to treat numb legs and feet is to figure out what’s causing them.

Medication

Long-term numbness in the legs and feet can be treated with the following medications:

  • Gabapentin and pregabalin. Medications that block or modify nerve signals may assist to alleviate numbness caused by fibromyalgia, MS, and diabetic neuropathy.
  • Corticosteroids. Some corticosteroids can assist with persistent inflammation and numbness caused by diseases like MS.
  • Antidepressants. Duloxetine and milnacipran are two antidepressants that have been authorized for the treatment of fibromyalgia.

Home remedies

The following are some home treatments for numbness in the legs and feet that may help:

  • Epsom salt baths. Magnesium, a component found in Epsom salts, is believed to improve blood flow and circulation. Epsom salts may be purchased over the internet.
  • Stress management and mental strategies. People with persistent numbness, such as MS and fibromyalgia, should attempt to concentrate on the fact that the numbness is typically transient and will go away on its own. The symptoms of central nervous system disorders are also exacerbated by stress.
  • Rest. Nerve pressure is one of the most common causes of leg and foot numbness, and usually improves with rest.
    Ice. Ice can aid in the reduction of edema that puts pressure on nerves. Several times a day, apply cold compresses or wrapped icepacks to numb legs and feet for 15 minutes at a time.
    Heat. Heat can assist release tight, painful, or strained muscles that might produce numbness by putting pressure on nerves. Overheating numb legs and feet, on the other hand, can exacerbate inflammation and produce discomfort and numbness.
  • Sleep. Many chronic illnesses that cause numbness in the legs and feet have been shown to worsen when people don’t get enough sleep.
  • A nutritious and well-balanced diet. Nerve damage caused by malnutrition, particularly vitamin B deficiency, can result in numbness. Chronic inflammation and discomfort, which can produce numbness, can be reduced by getting adequate vitamins and other minerals.
  • Reduced or complete abstinence from alcohol. Toxins found in alcohol can induce nerve damage and numbness. Alcohol can also exacerbate the symptoms of chronic pain and inflammatory disorders, as well as create flare-ups.
  • Massage. Massage can assist enhance blood flow and alleviate discomfort in numb legs and feet.
  • Exercise. A lack of activity can cause the heart and blood arteries to weaken, limiting their capacity to pump blood to the lower limbs. Yoga, Pilates, and tai chi are examples of activities that help improve blood flow and relieve chronic inflammation or discomfort.
  • Supportive devices. Nerve pressure caused by injuries, tarsal tunnel syndrome, or flat feet can be relieved using braces and specially tailored footwear.

Alternative therapies

Alternative remedies have been demonstrated to help alleviate the symptoms of numbness in the legs and feet caused by several diseases. The following therapies are available:

  • hydrotherapy
  • mindfulness meditation
  • guided imagery
  • vitamin B supplementation (especially B-3, B-6, and B-12)
  • massage
  • reflexology
  • acupuncture
  • biofeedback

When to see a doctor

Consult a doctor if you have numbness in your legs or feet that:

  • lasts for long periods
  • is accompanied by permanent or long-term changes in the color, shape, or temperature of the legs and feet
  • is not related to postural habits or lifestyle factors, such as tight clothing and footwear
  • is accompanied by any other chronic symptoms

Conclusion

Numbness in the legs and feet is a frequent problem, but if it persists, it might indicate an underlying medical condition.

Anyone who has unexplained numbness that is persistent, frequent, severe, debilitating, or accompanied by other chronic symptoms should consult a physician for a diagnosis and treatment options.

Sources:

  • https://www.foundationforpn.org/what-is-peripheral-neuropathy/causes/alcohol/
  • https://www.msfocusmagazine.org/Magazine/Magazine-Items/13-Points-about-Paresthesia
  • https://www.niams.nih.gov/health-topics/fibromyalgia/advanced#tab-symptoms
  • https://www.medicalnewstoday.com/articles/321560
  • https://www.ninds.nih.gov/Disorders/All-Disorders/Paresthesia-Information-Page

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Bones / Orthopedics

What you should know about MS-related walking issues, including how to test and treat them

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Multiple sclerosis (MS) is a central nervous system illness that affects people. It can restrict mobility, making it difficult to walk.

According to the National MS Society, the disease affects around 1 million people in the United States. One of the most prevalent mobility-related symptoms is difficulty walking.

This post discusses how MS can damage one’s ability to walk, the mobility tests used by physical therapists, and the many therapies available.

MS walking difficulties

MS walking difficulties

The central nervous system, which includes the brain, spinal cord, and optic nerves, is affected by MS. Damage to this system, which controls how a person moves and reacts to stimulus, might result in mobility issues.

An immune system problem in a person with MS causes the immune system to attack healthy tissue, in this case myelin.

A fatty substance that covers and insulates nerve fibers is known as myelin. It also aids in the rapid transmission of signals via the neurons.

If myelin is injured or destroyed, the nerve it protects may lose its ability to receive impulses correctly. This means that messages traveling through the nerve may be disrupted or never reach their destination.

MS-related movement difficulties are thought to be caused by myelin loss in the cerebellum, according to experts. The cerebellum is a part of the brain that aids with movement and coordination.

These mobility issues may include:

  • muscle tightness, stiffness, or spasms
  • problems with balance
  • severe numbness in the feet
  • loss of position sense, which involves knowing where the feet are when walking
  • fatigue
  • muscle weakness
  • trouble with vision
  • cognitive issues
  • unstable walking

Gait changes due to MS

The gait of a person is their walking pattern. According to a 2018 study, 50–80 percent of people with MS suffer balance and gait problems.

Other research from 2018 reports a range of gait alterations, including:

  • a slow walking speed
  • a reduced range of motion in the leg joints
  • a smaller step length
  • reduced stability
  • difficulty lifting the front part of the foot, which is called “foot drop”

Gait issues can increase the risk of falling. According to the National MS Society, 50–70% of people with MS experienced falls in the two–six months before to taking the survey.

MS walking tests

A person with MS may be asked to take a walking test by a physical therapist. This entails walking a predetermined distance while the therapist assesses their gait.

The findings may aid physical therapists in more successfully treating gait disorders.

Timed 25-foot walk

This requires a 25-foot walk (ft). A person should walk as swiftly as they feel comfortable, and assistive aids such as a cane may be used.

The person’s physical therapist will time them while they walk to a distance marker and, possibly, as they return. The purpose is to assess the person’s gait speed, which is a useful indicator of walking ability.

Ambulation index

This is comparable to the timed 25-foot walk test, which has mostly supplanted it.

Walking 25 feet as quickly as possible while being timed is also part of the ambulation index. The purpose is to quantify mobility rather than gait speed in this case.

A person’s score ranges from 0 to 10. They have a score of 0 if they are totally active, and a score of 10 if they are unable to get out of bed.

Dynamic gait index

This entails assessing a person’s walking style, as well as their balance and potential for falling.

To complete this test, a person must walk and perform additional activities, such as:

  • changing speed
  • turning their head left and right or up and down
  • avoiding obstacles
  • turning on the spot
  • climbing stairs

The 12-item MS walking scale

This questionnaire, often known as the MSWS-12, contains 12 statements about how MS affects one’s ability to walk.

The person being tested will be asked to rate each statement on a scale of 1 to 5 by the healthcare expert administering the test.

A “1” indicates that the person has not had the experience described in the statement. A score of 5 indicates that they have had a particularly bad experience with it.

Timed up-and-go test

This is how physical therapists time how long it takes a person to get out of a chair, walk 10 ft, and then return to the chair.

According to the Centers for Disease Control and Prevention (CDC), if it takes more than 12 seconds, the person is at risk of falling.

Treatment options and self-management techniques

Physical treatment, according to the National MS Society, can help with a variety of gait issues.

To assist a person adapt, a physical therapist may propose vestibular activities that cause imbalance. These activities could include:

  • head or eye movements
  • altering visual input
  • walking on different kinds of surfaces

They may also encourage a person to do stretching exercises to improve:

  • flexibility
  • strength
  • cardiovascular fitness
  • balance
  • coordination
  • relaxation

Some prescription drugs can enhance a person’s gait by reducing muscular stiffness and speeding up walking.

People with MS may benefit from a variety of assistive equipment, such as canes, crutches, or braces.

Anyone who has difficulty walking should get medical advice on how to lessen their risk of falling. This could entail:

  • not wearing high heels
  • avoiding slippery surfaces
  • removing obstacles and trip hazards from the home
  • keeping walking areas well lit, especially at night

Conclusion

MS can make it difficult for nerves to transmit electrical signals as they should. This can lead to mobility issues, such as difficulty walking.

Physical therapists employ a variety of tests to determine how MS affects a person’s gait and to improve treatment options.

Stretching and exercising, as well as utilizing assistive equipment and maybe taking drugs, can all help with mobility issues. Anyone with MS who is having trouble walking should speak with a member of their medical team.

Sources

  • https://www.sralab.org/rehabilitation-measures/12-item-multiple-sclerosis-walking-scale
  • https://www.nationalmssociety.org/For-Professionals/Researchers/Resources-for-MS-Researchers/Research-Tools/Clinical-Study-Measures/Ambulation-Index-(AI)
  • https://www.medicalnewstoday.com/articles/ms-walking
  • https://www.sciencedirect.com/science/article/abs/pii/B978044463916500015X?via%3Dihub
  • https://www.nationalmssociety.org/What-is-MS/Definition-of-MS
  • https://www.sralab.org/rehabilitation-measures/dynamic-gait-index
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862880/
  • https://nmsscdn.azureedge.net/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure-GaitOrWalkingProblems-TheBasicFacts_FINAL.pdf
  • https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure-Stretching-for-People-with-MS.pdf
  • https://www.nationalmssociety.org/What-is-MS/How-Many-People
  • https://www.msif.org/about-ms/symptoms-of-ms/movement-and-coordination-problems/
  • https://www.nationalmssociety.org/For-Professionals/Researchers/Resources-for-MS-Researchers/Research-Tools/Clinical-Study-Measures/Timed-25-Foot-Walk-(T25-FW)
  • https://www.cdc.gov/steadi/pdf/TUG_test-print.pdf
  • https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Walking-Gait-Balance-Coordination
  • https://www.msif.org/about-ms/what-is-ms/

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