Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
How are the physical manifestations of multiple sclerosis treated?
There are numerous medications that are used to manage complications associated with MS. The following table lists common complications, examples of drug and non-drug therapies, and comments about complications and/or management. Among these, only dalfampridine (Ampyra) has been approved by the FDA as a symptomatic (non-DMD) treatment for MS.
Multiple Sclerosis Complications with Examples of Drug and Nondrug Management*
Nondrug Management and Comments
Difficulty walking (slowness)
Dalfampridine (Ampyra) was FDA-approved in 2010 to improve walking in patients with MS. Physical therapy, orthotic equipment, and walking aids also may be of benefit.
Aspirin, NSAIDs, acetaminophen, or physical therapy are used for muscle and back pain. Anticonvulsants, like carbamazepine (Tegretol) or gabapentin (Neurontin) are used for face or limb pain. Antidepressants or electrical stimulation are used for prickling pain, intense tingling, and burning. Referral to pain specialist is recommended with severe pain.
Antibiotics are used to manage infections.
Vitamin C and cranberry juice are used to prevent infections.
Catheters are used to relieve retention of urine. Oxybutynin (Ditropan, Ditropan LX, Oxytrol) or tolterodine (Detrol, Detrol LA) is used for bladder dysfunction.
For males, erectile dysfunction drugs, papaverine, penile implant, or electrostimulation are used. For females, vaginal gels or a vibrating device are used.
Often resistant to treatment. Sometimes drugs or surgery are used if tremors are severe.
*This list is not exhaustive; most of the drugs listed below are used to treat multiple sclerosis symptoms even though they have not been FDA-approved for these particular purposes.
What are the future directions for managing multiple sclerosis?
There is a great deal of ongoing research in multiple sclerosis, and there continues to be a focus on the immune system in investigational therapies. In addition, scientists are trying to develop techniques that allow brain cells to generate new myelin or that prevent the death of nerves. Other promising approaches include the use of precursor (neuronal stem or progenitor) cells that could be implanted into the brain or spinal cord to repopulate areas of missing cells. Future therapy may involve methods designed to improve impulses traveling over the damaged nerves. Scientists also are exploring the effects of diet and other environmental factors on multiple sclerosis.
Medically reviewed by Jon Glass, MD; American board of Psychiatry and Neurology