Ask Dr Trisha: Multiple Sclerosis

Ask Dr Trisha: Multiple Sclerosis

Multiple Sclerosis or MS is an autoimmune disease that affects your central nervous system (your brain and spinal cord). Like other autoimmune diseases, in MS the immune system attacks the body’s own tissues.

We don’t know what causes it,
but something triggers cells called
T lymphocytes to attack a fatty tissue (myelin), which normally forms a protective insulating sheath around nerve cells. As a result the nerves become inflamed and damaged and their signals travel more slowly or do not transmit at all, disrupting messages to and from your brain.

Symptoms vary from person to person depending on which nerves or areas of the brain are damaged. You may experience loss of muscle control and strength, with difficulty walking or controlling movement. Dizzy spells and balance problems are common, as are changes in sensation such as patchy numbness affecting the face, body and limbs.

Your vision may be affected because your optic nerve may become inflamed. Most people with MS develop fatigue, which can make daily life difficult. Chronic pain is also common, affecting more than half of those with MS. 

Symptoms of a flare-up typically last at least 24 hours and then settle partially or completely over days or weeks, until another attack occurs. With each attack or flare, further damage to the nerves leaves increasing areas
of scar tissue called sclerosis. So, ‘multiple sclerosis’ develops.

MS can appear at any age but usually in early adulthood, between 20 and 40. Women are twice as likely to develop it as men. In Europe MS becomes more common as you travel south to north, leading some researchers to look for clues about the cause in the weather, exposure
to sunshine and Vitamin D levels,
or to infections more common in
colder climates.  

Several different drug treatments are used in MS, including steroids to reduce inflammation during a relapse. Other drugs are given for specific symptoms, such as stiffness and rigidity in your muscles, tremor, bladder and bowel dysfunction, pain, vertigo, nausea and fatigue.

In recent years, Disease-Modifying Drugs (DMDs) have become available. These treatments work by changing the activity of the immune system, and reducing inflammation. They don’t cure the condition but may help to prevent relapses. It’s a good development, but it’s not yet clear whether they slow the development of disability. Exercise, a good diet and complementary therapies are all important in helping a person with MS to keep as healthy as possible, despite what their disease throws at them.

Q. I have night cramps, what can I do?

Dr Trisha says: This problem affects at least one in three people over 60. Although in most cases the cause is not clear, there are plenty of practical things you can do to improve things. First, try to bear in mind that despite the intense discomfort, they are rarely anything to worry about. Stress can make the painful cramps worse, so try to relax. Get some regular gentle exercise such as a short walk or yoga. Learning to stretch and massage your muscles helps not only to prevent cramps but also relieves a spasm. Dehydration can trigger cramps so drink plenty of water. Very rarely they’re caused by medical conditions such as an underactive thyroid gland.If they persist, see your GP.

  • Dr Trisha writes a column every fortnight in Yours magazine. Ask Dr Trisha about your health problems by emailing