Multiple sclerosis (MS) is a chronic disease that adversely affects the brain, spinal cord, and optic nerves. Known to have a wide range of symptoms such as fatigue, sexual dysfunction, pain, mood changes, muscular changes, issues with visual sight, bladder and bowel problems, modern treatments are gradually proving effective at slowing down this disease. Let’s take a better look at Multiple Sclerosis and understand the exercises that one can do for a better life.
Understanding Multiple Sclerosis
Multiple Sclerosis means “multiple scar tissues”. It is a chronic neurological disease that affects the central nervous system. Just like a virus or bacteria, MS can attack the healthy tissue, namely, the myelin sheath around the nerve fibres. This causes inflammation, resulting in the brain not being able to communicate properly with the rest of the body.
When a myelin sheath is damaged in multiple areas, it leaves a scar. These areas are also called plaques or lesions. Development of several lesions can cause the nerve fibres to break or become damaged, thereby disabling the body from carrying out certain functions. The primary affected areas include the brain stem, cerebellum, spinal cord, optic nerves and white matter in some areas of the brain.
Signs and Symptoms of Multiple Sclerosis
Given that MS affects the brain and the spinal cord, which in turn, controls all the actions of our body, some of the earliest symptoms include:
- Muscle weakness
- Numbness and tingling in the face, body, arms, or legs
- Lhermitte’s sign (a shock-like sensation when they move their neck)
- Difficulty emptying their bladder or need to urinate frequently
- Bowel problems and constipation
- Fatigue, vertigo or hampering a person’s ability to function at work
- Sexual dysfunction
- Spasticity and muscle spasms
- Double or blurred vision, or even partial or total loss of vision
- Emotional changes or mood changes
Some of the less common symptoms include:
- Respiratory or breathing problems
- Speech disorders
- Swallowing problems
- Urinary tract infections
The symptoms, intensity, and duration may differ from person to person, and over the course of the disease. The severity of the disease can depend on the amount of nerve damage and which nerves in particular are affected. For some, it starts with a subtle sensation, and their symptoms do not progress for months or years. Sometimes, symptoms worsen rapidly, within weeks or months. In the later stages, people may experience changes in perception and thinking, as well as sensitivity to heat.
Treatments for Multiple Sclerosis
While there is no known cure for MS, treatments such as medications, physical therapy and exercise can surely help in slowing the progression of the disease, thereby reducing the number and the severity of relapses.
Primary treatment options include medications to delay the disease progression. A doctor may give some of these orally, by injection, or as an infusion. The duration and frequency of the treatment depends on the drug and its application. During treatment, the doctor monitors and determines the success of the drug, to see if there are any adverse effects. With newer drug options coming into the market, safer and more effective medicines are becoming available.
Several disease-modifying therapies (DMTs) have been approved by the European Medicine Agency (EMA) and the Food and Drug Administration (FDA) for treating the relapsing forms of MS. Some of these DMTs include interferon beta (IFNB) 1-a and 1-b, glatiramer acetate (GA), mitoxantrone, natalizumab, fingolimod, teriflunomide, dimethyl fumarate, and alemtuzumab. These therapies reduce the progression of multiple sclerosis, preventing the immune cells from attacking the brain and the spinal cord, thereby changing the way our immune system functions.
As part of their treatment, patients may also need to intensify the Physiotherapy and Occupational Therapy that they were anyway undergoing for Multiple Sclerosis. Doctors may also recommend mobility aids like walkers and wheelchairs to get around safely. In addition, autologous Stem Cell Therapy has shown considerable promise in reducing symptoms and increasing the time between MS relapses.
Some specific symptoms can be treated with other approaches, supplemented with less stressful drugs, as follows:
- Behavioral changes: A doctor might recommend resting your eyes from time to time, or limiting your screen time, especially if you already have previously existing problems with your vision. An individual with MS may need to learn to rest when fatigue sets in, and to pace themselves so they can complete the intended activities.
- Problems with mobility and balance: This set of issues can be supported by physical therapy and walk-aiding devices such as canes, crutches etc.
- Tremors: A person may use assistive devices or attach weights to their limbs to reduce shaking. Certain medications may also help with the tremors.
- Fatigue: Getting sufficient rest and avoiding the heat can definitely help. Physical and occupational therapy can help teach people more comfortable ways to do things. Assistive devices, such as a mobility scooter, can help conserve energy. Medication or counselling may help boost energy by improving sleep.
- Pain: A doctor may prescribe anticonvulsant or antispasmodic drugs or alcohol injections to relieve trigeminal neuralgia, i.e. a sharp pain that affects the face. Pain relief medication may help with body pain, while other medications can relieve the muscle pain and cramping prevalent in MS.
- Bladder and bowel problems: Some medications and dietary changes can help resolve these issues.
- Depression: A doctor may prescribe a selective serotonin reuptake inhibitor (SSRI) or other antidepressant drugs for depression.
Physical Exercises for Multiple Sclerosis
A common myth about exercise and Multiple Sclerosis, is that exercising might possibly worsen symptoms of MS. However, it has been scientifically proven that exercising actually helps ease the pain by reducing inflammation, fatigue, and improving the overall mood of individuals with Multiple Sclerosis. Exercise is not only highly recommended as a regular part of the treatment, but can also help suppress the symptoms, and slow down the progression of the disease.
Regular but moderate physical exercise can be beneficial when dealing with Multiple Sclerosis. Exercises of various kinds are known to improve the overall fitness, endurance and strengthening of muscles. It also helps to maintain a healthy heart rate and contributes to a balanced physical and emotional well-being, by reducing overall fatigue and inflammation.
For best results, it is essential to follow a complete fitness program that covers all the required aspects of exercise, some of which are:
- Aerobic exercise
Aerobic exercise, also known as cardio, improves cardiovascular health. Aerobic exercises may include walking, jogging, cycling, or swimming. Approximately 30 minutes of cardio thrice a week should help in improving cardiovascular strength. Water aerobics, i.e. working out in a pool, can also be a great form of exercise for people with chronic illnesses. Exercising in water further helps to improve aerobic capacity and strengthen the muscles.
- Strength/resistance training
Resistance and strength training helps increase the overall muscle strength. Depending on the overall level of health and fitness, one can start with basic resistance such as body weight, then move up to bands, and then to weights. Strength training bolsters the muscles by retaining muscle mass, which contributes to their healthy functioning. Strength training should be followed two-three times a week.
- Balance and core exercises
Core and balance training is one of the most fundamental forms of exercise. A strong core helps to maintain a stable body balance, and can be achieved by exercises that focus on controlling the posture and body mass. Basic exercises such as standing on one leg, planks, etc. can largely help to condition the core.
Stretching is the preferred exercise for improving flexibility and range of motion. Stretching releases muscle tension and helps to decrease spasticity, muscle tightness and stiffness, and lack of muscle control. Stretching for a minimum of 10-15 minutes a day can greatly benefit muscular stress. In fact, yoga has proven highly beneficial for MS, being a combination of various stretching exercises as well as breathing.
Pilates is a preferred form of core strengthening exercise. It helps to improve balance and condition the muscles. Pilates is known to be an effective exercise for treating medical conditions.
Dos and Don’ts for Efficient Exercising
- Follow a complete fitness program that includes all areas of exercise.
- Consult a professional, e.g. physiotherapist and/or a fitness trainer, before designing a fitness regime.
- Design a fitness plan by keeping the symptoms, fitness level and overall health in mind.
- Set a daily routine that incorporates regular exercise in moderation for maximum benefit.
- Include warm-ups as a standard routine before starting any form of exercise and make sure to cool down after exercising.
- When starting any new form of exercise, start slow and progress gradually.
- Do not overdo it. Make sure that you do not exercise beyond your level of fatigue and to an extent that it causes too much strain and pain to your muscles and body.
- Prevent the body from overheating. Since your body may be sensitive to heat, avoid exercising during the hottest part of the day and drink plenty of cool water. If your body is getting too heated, pause and let it cool down a bit before continuing again. Exercise in a cool room or a cool environment.
- Try moderations if the exercises get too difficult for you.
- Do not let fatigue take over; take breaks in-between exercises and get adequate rest. Allow your body enough recovery time on a daily basis.
What is the best exercise for Multiple Sclerosis?
All basic forms of exercise – aerobic, strength, core and flexibility – that contribute to a healthy heart rate, muscle strengthening, core conditioning, and increasing flexibility of muscles can be included in your exercise plan for Multiple Sclerosis.
Can exercise make Multiple Sclerosis worse?
This is a common myth that exercising can worsen Multiple Sclerosis. In reality, exercise does quite the opposite; it will help you strengthen your overall body, improve your health, and aid you with easing the symptoms of Multiple Sclerosis, while also slowing down the progression of the disease.
Can exercise reverse Multiple Sclerosis?
Even though exercise would not reverse Multiple Sclerosis, it may, however, help in easing the symptoms and helping your body to function in the best possible way.
Can exercise trigger Multiple Sclerosis?
Exercise would not trigger Multiple Sclerosis. Even though exercising may seem more challenging than normal, it is proven to be far more beneficial in the long run. The important thing is to not overdo it and consult a professional first.
What should I avoid while exercising with Multiple Sclerosis?
When exercising, the main thing to keep in mind is to progress gradually. The golden rule is to not overdo any form of exercise. Avoid exercises that bring severe fatigue and strain to your muscles, and make sure that your body is not overheated. It might also be a good idea to not exercise in hot temperatures.
To conclude, Multiple Sclerosis affects each person differently. If you’re looking for treatment options, it is always best to consult a professional and keep in mind your symptoms, as well as your level of fitness and health. Furthermore, exercise can surely improve your overall physical, mental and emotional well-being. It can also prove to be a fun social activity and a de-stressing part of your daily routine.