Multiple sclerosis is a very individualized disease, and every case in every patient is unique. This means that every treatment path needs to be created specifically to meet the needs of the individual. With the damage done through the disease – attacks by the immune system on the central nervous system (CNS) that irreparably damages nerves – mobility is perhaps the number one issue MS patients face, though it can cause a variety of disabilities that are nearly endless.
What is physical therapy?
Physical therapy involves specific exercises that help strengthen portions of the body affected by illness and injury. In some cases, it prevents muscular atrophy. In others, it helps improve mobility that is lost with stiffness. In yet other instances, physical therapy can improve neural responses, activating and stimulating nerves that might otherwise atrophy or die.
How multiple sclerosis affects patients
As multiple sclerosis continues to cause damage to the central nervous system, additional symptoms can appear, existing symptoms can worsen, and quality of life can start to suffer. With each patient, the story is as different as their DNA. Some patients have aggressive forms of the disease, which progress quickly and change early on from relapsing-remitting to secondary progressive MS. Others see more mild symptoms, with long periods of time between relapses and extremely slow progression.
The most common symptoms of multiple sclerosis, especially in the early stages, include:
- Difficulty with mobility, especially stiffness and weakness
- Balance and dizziness
- Extreme fatigue
- Numbness and tingling in the limbs and face
- Muscle pain or spasms
- Vision problems, including pain when moving the eyes
While not every symptom can be treated through physical therapy, many can be alleviated or at least somewhat relieved as an extension of the exercise itself.
Symptoms physical therapy can help
Some of the MS symptoms that physical therapy, or PT, can help are:
- Weakness – Many exercises strengthen muscles, so even at the worst of times, weakness is minimized.
- Stamina and Fatigue – Core training exercises and aerobic workouts (under careful supervision to avoid exacerbating symptoms) can help build more stamina and reduce overall fatigue, especially since exercise releases endorphins that give extra energy.
- Muscle Pain – Physical exercise helps reduce stiffness, increase oxygen and blood flow to muscles, and even stimulates nerve growth, all of which can help reduce the symptoms experienced by MS patients.
- Recover from Relapse – After a relapse, it’s extremely difficult to return to a status quo, and PT can help patients get through the worst of that recovery phase.
Physical therapy through the stages
With PT and multiple sclerosis, it’s important to consider the stage of the progressive disease before creating a routine that suits each patient. For example, someone who is starting physical therapy at the time of diagnosis will have a different combination of exercises and a different frequency of appointments than someone already in progressive stages.
- When first diagnosed with MS, a patient should schedule an appointment with a physical therapist. This will result in an examination that allows the therapist to understand what the patient’s body can and cannot do as a baseline. They will assess what symptoms need the most attention and keep track of progress, both positive and negative, as a program is developed for the specific needs of the patient. Knowing the physical limitations and abilities from the start can also assist with changing things should the disease progress.
- When the patient is in the midst of a relapse, a therapist working with the MS patient will know the patient’s history and be able to tailor appointments to better serve the patient’s level of pain and the effects of the flare up. The therapist can also help after the flare up to employ specific strategies to get back in control of everyday life.
- Primary progressive multiple sclerosis is diagnosed from the start without any relapses or hopes of remission. It is aggressive, with no let up of the symptoms, which rapidly worsen over time. For these patients, physical therapy is essential from the start, allowing them to build up as much strength and mobility as possible. PT can also help these patients learn coping mechanisms for lost abilities and how to implement tools that assist with mobility.
- Once a patient reaches advanced stages of MS, it’s likely they are confined to a wheelchair. They are also more likely to develop other conditions due to the progression of the disease and the lack of mobility, including epilepsy and osteoporosis. Partaking in PT can help these people keep up strength in other muscle groups, work with their legs to reduce muscle atrophy, and learn how to utilize existing muscles, bones, and tendons, developing upper body strength to help compensate for the lack of ability to walk.
Physical therapy sessions are typically held in a facility with the proper machines and tools to help patients train for current and future complications based on the progression of the disease. However, most therapists also prescribe exercises to be done at home for continued therapy. For patients in the early stages, all exercises may be done at home, with check ins several times a year. For advanced MS patients, there are other options, including having a PT expert coming to the house to assist with therapy, as well as entering into an MS treatment facility for inpatient care.