Seven Complications of MS

 

Multiple sclerosis (MS) is an autoimmune disease that disrupts the communication between your brain and the rest of your body. MS can affect each person differently. You may have one or more symptoms while someone else could have many more.

You also can develop complications along with your MS. They can range from mild to severe. The problems may differ from person to person.

Muscle Stiffness and Spasticity

It’s quite common to feel tightness and soreness in your larger muscles. Spasticity may make your muscles so stiff that you can’t easily unclench your fist or bend your wrist. You also may get painful spasms. Stiffness and spasms can happen anywhere on your body. But leg muscles are affected most often. Your joints and low back also may hurt.

Medications can help ease your spasticity. So can treatments that relax your muscles, including exercises, stretches, physiotherapy, and occupational therapy.

Bladder and Bowel Problems

MS can disrupt the electrical signals to the muscles that control how you pee and poop. As many as nine out of 10 people with MS have problems with their bladder. The issues vary from person to person but may include:

• Trouble controlling when you pee
• Feeling the need to go right away
• Changes in often you may need to pee
• Difficulty urinating

About two out of three people have issues with bowel movements. The most common complaint is constipation, which is having trouble pooping or having fewer than three bowel movements a week. Some people may have trouble controlling when they need to poop.

Physical activity, diet changes, medication adjustments, and timed routines for bowel movements can help you gain more control over your life.

Vision Problems

Most people with MS will have issues with their eyes at some point. Some common vision problems include:

Optic neuritis. This can cause pain in your eye as well as dim or blurry vision. Optic neuritis also can take away your ability to see colors. You might even lose your vision temporarily. Usually, your vision returns after some time.

Nystagmus. This is also called “dancing eyes.” It’s when you lack control over your eye movements. This can happen consistently in some people with MS. For others, nystagmus can come and go.

Diplopia. This means double vision. It happens because MS can disrupt the nerves that control eye movement and weaken or damage them. You may see two of the same images side by side or one on top of the other. For some people, diplopia may be temporary, but others may have it for long periods of time. Medication and special eyeglasses can help you if your symptoms persist.

Balance Issues

Muscle weakness, spasms, and vision problems all can affect your balance and walking form. Treatments such as physical therapy can help you gain more control over your muscle spasms. Canes, crutches, walkers, and wheelchairs also can help you move around more easily.

Mental Health

Living with a lifelong disease can affect you mentally and emotionally. It’s common and normal to feel overwhelmed sometimes.

It’s important to talk to your doctor or health care provider if you feel depressed or anxious and it affects your daily life. Antidepressants, talk therapy, counseling, and other services can help.

Exercises, hobbies, getting outside, and connecting with loved ones also can boost your mood.

Sexual Dysfunction

The faulty nerve signals that happen with MS can affect the sex drive for women and men. It can make it harder to reach orgasm or get an erection. MS complications such as bladder and bowel problems, fatigue, and depression also may affect your sexual health. Side effects from MS medications can play a part too.

Talk to your doctor if you have issues with arousal or find sex painful or uncomfortable. Aids like vibrators and lubricants can heighten sexual sensation. Certain sexual positions may be easier. You also can learn ways to stay intimate with cuddling and other acts.

Epilepsy

MS raises your chances of epilepsy, a brain disorder that causes seizures. The episodes may be mild and temporary. Antiepileptic drugs can help. Sometimes, you may not need any treatments for seizures.

 

Spasticity and MS: How to Control Your Muscles

 

From WebMD Editorial Contributors

Many people with multiple sclerosis have stiff muscles and spasms, a condition called spasticity. It happens mostly in the muscles of the legs and arms, and it may keep you from moving your limbs freely.

You might feel spasticity either as stiffness that doesn’t go away or as movements you can’t control that come and go, especially at night. It can feel like a muscle tightening, or it can be very painful. Spasticity also can make you ache or feel tight in and around your joints and low back. How you feel can vary depending on your position, posture, and how relaxed you are.

What Causes Spasticity?

Spasticity happens because of an imbalance in the electrical signals coming from the brain and spinal cord, often when multiple sclerosis has damaged the nerves there. This unevenness makes your muscles contract on their own and makes them tense.

The condition can get worse when it’s too hot or cold, when you have an infection, or if you’re wearing tight clothing.

Treatment for MS Spasticity

Physical therapy, medications, surgery, or a mix of these treatments can ease spasticity when you have MS. To decide the best way to help you, your doctors will think about your overall health, how severe your symptoms are, and:

Does the condition keep you from doing everyday tasks?

Are you in pain?

Which treatments have you tried, and how well did they work?

How much will it cost?

What are the side effects?

Will the benefits outweigh the risks?

Physical and Occupational Therapy for Spasticity

Most of the time, a physical therapist will start treating MS spasticity with a basic physical therapy stretching program. The goal is to lengthen your muscles to ease the condition.

An occupational therapist may recommend different tools, like splints, casts, or braces, to keep up your range of motion and flexibility.

If physical and occupational therapy don’t help, your doctor may want you to try medications.

Medications for Spasticity

Doctors can choose from among several kinds of medications to treat MS-related spasticity. They include:

Skeletal muscle relaxants. These drugs relieve the muscle tension of spasticity. Some work directly on your muscles, and others act through your nervous system. One of the most common medications for spasticity is the muscle relaxant baclofen (Ozobax). Doctors also sometimes prescribe dantrolene (Dantrium). If pills don’t work, your doctor might be able to put a pump inside your body to deliver the medication directly to your spinal fluid (such as the baclofen pump).

Benzodiazepines. These are nervous system depressants, which means they slow down messages in your nervous system. They include diazepam (Valium) and clonazepam (Klonopin). They can also help you sleep if nighttime spasms keep you awake. You might also hear them called tranquilizers. They aren’t FDA-approved for treating MS symptoms. So they’re usually prescribed along with another medication, or if other drugs haven’t worked.

Botulinum toxin. You can also get shots of botulinum toxin (such as Botox or Myobloc) to relax your muscles. It blocks the nerve messages that tell your muscles to tighten up. It’s not suitable for use in large areas, so it’s best for spasticity that’s limited to one part of your body. It’s also temporary. Each shot lasts 3-4 months.

Alpha2-adrenergic agonists.Tizanidine (Zanaflex) works through your central nervous system to ease spasticity. It relaxes your muscles by decreasing nerve stimulation. Its effects are similar to those of baclofen, and it’s sometimes prescribed along with baclofen.

Your doctor might prescribe other medicines to treat some of the effects of spasticity. For some people, spasticity can lead to symptoms like pain or restless legs syndrome.

Some studies have shown that products made from cannabis (marijuana) can ease spasticity, though we need more research into this. Smoking marijuana has not been shown to have the same effect and could be harmful to people with MS. Ask your doctor if cannabis products might help you.

When Does Surgery Help?

When other treatments don't work, there are two types of surgery that can treat spasticity.

In one type, a surgeon cuts away part of the spinal nerve. The operation is called rhizotomy. The goal is to relieve pain or ease muscle tension.

Tendon release, also called a tenotomy, is the second type. A surgeon cuts severely tight tendons away from the muscles. It may make spasticity happen less often and make it less severe, depending on how old you are. Over time, you may need to have the surgery again.

These surgeries can help, but they’re usually only for extreme cases of spasticity and are rarely performed in patients with MS..