Relapsing MS Treatment:Know Your Options

When to Call Someone about Your Symptoms

Sometimes, a symptom is urgent and you should contact a health care provider right away. Remember to check with your doctor about when you should call.

Some reasons to call include:

• You experience a new MS symptom that lasts at least 24 hours
• You experience loss of vision or blurry vision
• You have an abrupt change in bowel or bladder function
• You think you have a urinary tract infection
• You have feelings of depression or thoughts of hurting yourself

Keep in mind that this is not a complete list.

If you experience worsening depression or have thoughts of hurting yourself, contact your doctor immediately.

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Abnormal Feelings and Sensations

Many people with MS experience abnormal sensations. While frustrating, most of these symptoms don't affect physical function and can be managed or treated.

Abnormal sensations may include:

• Pins and needles/Tingling
• Itching
• Burning
• Numbness

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Bowel or Bladder Problems

The most common bowel problem in people with MS is constipation. Bladder problems can vary and may include:

• Increased need to urinate
• Hesitancy in starting urination
• Urgency to urinate right away
• Frequent nighttime urination
• Leaking Incontinence (an inability to hold urine in the bladder)

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Depression or Mood Swings

Depression is a serious condition that appears to be more common in people living with MS. If you experience symptoms of depression or have thoughts of death or suicide, contact your doctor immediately.

Symptoms of depression include:

• Sadness
• Loss of interest or pleasure in everyday activities
• Loss of or increase in appetite
• Insomnia or sleeping too much
• Agitation or slowing in behavior
• Fatigue (feeling of tiredness)
• Feelings of worthlessness or guilt
• Problems with thinking or concentration
• Ongoing thoughts of death or suicide

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Fatigue

Fatigue is one of the most common symptoms, occurring in nearly 80% of people with MS. Fatigue can feel like sleepiness or lack of physical or mental energy. It is often described as exhaustion that is not caused by activity and not relieved by rest.

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Heat Sensitivity

The symptoms of MS often worsen with increased body temperature. This can be caused by factors such as intense exercise, fever, sun exposure, or even sitting in a hot tub.

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Issues with Memory, Attention, or Problem Solving

Many people with MS experience problems with memory, attention, or problem solving. These are called "cognitive" issues. Memory loss is the most common mental change in MS.

Some examples of memory loss are:

• Forgetting names, telephone numbers, or recent conversations
• Difficulty remembering what you just learned
• Not knowing why you entered a room
• Losing or misplacing things

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Muscle Stiffness or Spasms (Spasticity)

Stiffness may feel like muscle tightness and may not be painful. Or stiffness may be severe enough to produce painful, uncontrollable spasms. Spasticity occurs most often in the upper and lower extremities.

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Pain

More than half of the people with MS say that pain is a problem. Some types of pain common in MS include:

• Trigeminal neuralgia (tri-GEM-in-uhl noor-AL-juh): a stabbing pain in the face. It can occur as an initial symptom of MS. It can also be confused with dental pain
• Lhermitte's (lair-MEETS) sign: a brief, stabbing, electric shock-like feeling that runs from the back of the head and down the spine. It can be triggered by bending the neck forward
• Pain of spasticity: tightness or aching in joints and painful muscle spasms or cramps may occur (see section on muscle pain or stiffness for more information)
• Back and other musculoskeletal pain, especially lower back pain, can have many causes. They include:
  • Spasticity
  • Pressure on the body caused by lack of movement
  • Incorrect use of mobility aids
  • Poor walking posture, unusual walking pattern, and balance problems

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Sexual Issues

In women, symptoms include:

• Reduced sensation in the genital area or painfully heightened sensation
• Vaginal dryness
• Trouble achieving orgasm
• Loss of desire

In men, symptoms include:

• Difficulty achieving or maintaining an erection (the most common problem)
• Reduced sensation in the penis
• Difficulty achieving orgasm or ejaculation
• Loss of desire

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Vision Problems

Vision problems are common in people with MS, but are usually temporary.

Some types of vision problems are:

• Optic neuritis: inflammation of the optic nerve, which may result in blurring or graying of vision, a dark spot in the center of your visual field, or rarely, blindness in one eye
• Nystagmus (nuh-STAG-miss): uncontrolled horizontal or vertical eye movements, which may result in impaired vision
• Double vision: occurs when the muscles that control a particular eye movement are weak

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Walking and Balance Problems

Problems with walking (also known as gait) are fairly common in MS.

Some examples include:

• Foot drop: difficulty turning the ankle and toes upward, resulting in the foot slapping the floor
• Toe drag: weakness or inability to extend or flex the toes
• Ataxia: swaying, unsteady gait caused by loss of balance
• Numbness can occur in the feet. Numbness can make you unable to feel the floor or know where your feet are

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Weakness

In MS, weakness can be a result of a problem with a nerve signal. You may also experience weakness from lack of activity. Sometimes you may be less active because of fatigue, stiffness, or a relapse. The longer you are inactive, the weaker your muscles can become.

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