Multiple Sclerosis (MS) is an inflammatory, neurological condition. Doctors have yet to identify the cause of inflammation but attribute it to a complex link between genetic, lifestyle, and environmental factors. About 2.8 million people in the world were affected by MS in 2020, the number continues to increase worldwide. The condition can lead to loss of vision, immobility, chronic pain, muscle weakness, and other complications.

How does MS develop?
The function of the nerve cells in the body is to send and receive signals from the brain. Each nerve cell has three parts: the soma or cell body, the axon or the cell trunk, and the dendrites. Together they transport the nutrients necessary for the nerve cells, convert signals into electric impulses, and send them throughout the body. The organs and limbs receive these signals, make changes, and respond accordingly. A myelin sheath is a sleeve or a protective covering around nerve cells made of lipids, proteins, and fats. Multiple sclerosis occurs when our immune system becomes faulty and mistakenly attacks the myelin sheath in the brain and spinal cord. This damages the myelin or causes lesions, plaque, or sclerosis, disrupting the process of transferring a message from the nervous system. So, the communication from and to the nervous system breaks down. The messages from the cells now may be slow or inaccurate, or the recipient’s body parts may ignore them completely.

Warning signs
MS is a progressive condition more likely to affect women than men. Here, the damage to the nervous system gradually worsens. While some may experience one or two major symptoms, others may experience more. The severity of the symptoms also fluctuates from mild to severe, with periods of remission in between. Though there is no cure yet, with proper treatment, rehabilitation therapies, and lifestyle changes, one can manage the symptoms and live an active life. Recognizing the sudden and abnormal changes can help in the early identification of MS. Early treatment can prevent serious health complications like high blood sugar, bone loss, fractures, kidney problems, frequent bruising, and reduced adrenal gland function. A few early signs are:

Muscles stiffness and spasticity
Spasticity is when the muscle tone increases abnormally. It causes stiffness and pain and makes movement difficult. It can also lead to sudden spasms and jerks in the arms and legs. Other symptoms include the involuntary crossing of legs, muscle fatigue, and sudden development of deformities.

Problems with vision
MS is an inflammatory condition that can affect any nerve cell. If it affects the eye’s optic nerve, the inflammation may cause pain and redness. It typically affects only one eye; one can experience blurred or cloudy vision, double or poor vision, or an inability to see color. If untreated, the eyesight can deteriorate, leading to early cataracts or vision loss.

Pain
People with MS may feel aches associated with muscle stiffness and spasms and experience pain while moving an eye. Each person may experience different forms of mild or severe pain, interfering with their ability to carry out daily activities. The pain may be dull for some, while others may feel a squeezing, crushing, stabbing, or shocking sensation. Pins and needles or a tingling sensation are also common signs. Some may feel pain in their muscles and joints caused by muscle stiffness.

Lack of balance
The disruption in the communication process may cause a delay in the way messages are sent, processed, and received. Some messages may be incomplete or inaccurate. Consequently, different body parts may not be able to work together in sync. This causes a loss of balance, swaying gait, and inability to maintain posture. Some may not be able to feel the floor and misjudge their steps. Lack of balance can lead to frequent trips and falls, even while walking on even grounds.

Fatigue
Mild or severe fatigue without an apparent cause can be an early sign of MS. Fatigue may worsen through the day and affect the ability to carry out daily activities. Lack of bladder control is another symptom of MS, which may keep one from having a good night’s sleep. Symptoms like pain, confusion, and mood changes may also lead to depression, preventing them from sleeping and adding to fatigue.

Relapsing multiple sclerosis
New treatments have improved the prognosis for people with MS, improving their quality of life and helping them manage the symptoms. For some patients, the symptoms may flare up or recur after treatment. Between the episodes of flare-ups, one can go through periods of remission without experiencing any of the typical MS symptoms. This type of MS is called relapsing-remitting multiple sclerosis (RRMS). Most people initially experience relapsing multiple sclerosis, and it may take quite some time, a decade or more, for the pattern of symptoms to change. Doctors diagnose the condition as RRMS if the symptoms last for at least 24 hours, during which they also worsen. The relapses are followed by a period of remission where some or most symptoms completely disappear. The symptoms of RRMS include sensitivity to heat and humidity, vision problems, numbness and tingling in the feet, weakness, fatigue, confusion, frequent urination, incontinence, and balance issues leading to falls.

Diagnosis and management
A neurologist will recommend multiple tests to rule out other diseases before confirming MS. They will conduct a detailed physical examination to check for vision and balance problems. They may also ask for brain and spine MRIs to locate the damage and functions affected. In a technique called “visual evoked potentials”, painless electrodes are attached to the scalp to measure the brain’s response to the objects one sees. Doctors may also do a spinal tap to check for abnormalities in the spinal fluid.

The goal of treatment for regular or relapsing multiple sclerosis is to reduce inflammation and the severity of symptoms and slow the disease progression, for which doctors may recommend prescription options. They may also recommend plasmapheresis—a procedure to cleanse the blood. Mobility devices like canes or walkers to maintain balance can also help.