Multiple sclerosis (MS) is a condition that affects your body’s central nervous system (your brain and spinal cord). It is estimated that over 2.8 million people worldwide have MS, with evidence that is becoming more common. It is known that it is 2-3 times more common in females than males, but the reasons are not yet fully understood.
In order to help you best manage your symptoms, it helps to understand how MS works. MS is complex, and research is giving us new information all the time, so treatment needs a comprehensive and flexible approach.
If you take a look at our diagram, you can see that in a healthy state, many of your nerve fibers are protected by a fatty material called myelin. Myelin wraps around your nerve fibres creating an outer shell which shields and supports them. Their normal function is to increase the speed of nerve signal transmission. In MS, your immune system mistakenly attacks the myelin sheath, with the result that the damaged nerves may not be able to send the correct signals throughout your body.
‘Sclerosis’ means scarring, and people with MS develop multiple areas of scarring as a result of this nerve damage. Different areas of damage can cause different MS symptoms, such as problems with balance, speech, vision or muscle control.
A simple inflammatory response — the innate immune system — is your body's first line of defence. Your immune system is a network of organs, cells and tissues. Infection-fighting white blood cells (leukocytes) find and destroy substances and organisms that the body recognises as a threat.
MS is considered to be an auto-immune disorder, where the body’s immune system mistakenly considers itself to be a threat, and mounts an inflammatory attack against the target tissue. There are many auto-immune conditions affecting many different parts of the body. For example, rheumatoid arthritis is an attack against the lining of some joints, psoriasis affects the skin, lupus may involve the kidneys etc.
In order to attack nerves in MS, the white cells cross a layer of cells called the blood-brain barrier (BBB) which is designed to prevent toxins and white blood cells from entering the brain and spinal cord. But in MS, the white cells are able to pass through the barrier and attack the myelin sheaths. Research is currently trying to understand why the barrier becomes “leaky”, and to focus future treatments.
2. Demyelination in multiple sclerosis
Demyelination in multiple sclerosis refers to the loss of myelin from nerve cells that occurs from inflammation. These areas are called lesions or plaques. With the myelin removed or damaged, the electrical messages that the nerves transmit can be altered or not passed on, like a bad signal on a radio.
The MS symptoms that result from this depend on the location and extent of the damage, as well as the ability of the brain to “re-route” the signal around areas of damage (neuroplasticity).
3. Continual damage from the white cells
For people with MS, this becomes a vicious circle, as more and more white cells arrive. Once the white cells have crossed into the central nervous system, they are triggered to continually treat the protective myelin as a target threat. It is therefore vital that the management of MS aims to reduce inflammation, and all aspects of the OMS program are focused on this.
4. Remission of multiple sclerosis
If you have relapsing remitting MS, you can have periods of remission, when an attack of symptoms is followed by a period with no new symptoms, and perhaps minimal old symptoms or none at all.
There is an “iceberg” phenomenon with MS however, meaning that the disease can be active below the surface, and while you may not be aware of symptoms, the condition may still be causing damage. On average it is felt that it can take up to 10 new lesions before experiencing a clinical relapse.
5. Result of damage & treatment
As you can see from the diagram, the damage results in impulses either travelling along the nerve poorly — or not at all. As a result of this, you may experience symptoms like:
There are a number of treatments that can reduce the severity and frequency of MS attacks. These treatments can also result in less damage to the spinal cord and brain over time.
✔Exercise to ease fatigue, balance, stiffness and other symptoms
✔Occupational therapy can help you make adaptations to make everyday tasks easier.
✔A speech therapist to help you if you have trouble talking
✔ Vitamin D — when the sun's UVB rays hit the skin, they produce vitamin D, which dampens overactive immune responses and also protects brain cells
You could also try the OMS program, which combines all these treatments for a holistic approach. The effects of MS are different for everyone, but thanks to effective therapies, medication and assistive devices, people with MS are able to live full lives.