Multiple Sclerosis

Multiple sclerosis (MS) is a condition that can affect the brain and spinal cord causing a wide range of potential symptoms, including problems with vision, arm or leg movement, sensation or balance.

It's a lifelong condition that can sometimes cause serious disability, although it can occasionally be mild.

In many cases, it's possible to treat symptoms but there is no cure. Average life expectancy is slightly reduced for people with MS.

It's most commonly diagnosed in people in their 20s and 30s, although it can develop at any age. It's about 2 to 3 times more common in women than men. There are approximately 100,000 people living with MS in the UK. Each year another 6,000 people will be diagnosed.

MS is one of the most common causes of disability in younger adults.

MS is an autoimmune condition. This is when something goes wrong with the immune system and it mistakenly attacks a healthy part of the body – in this case, the brain or spinal cord of the nervous system.

In MS, the immune system attacks the layer that surrounds and protects the nerves called the myelin sheath. This damages and scars the sheath, and potentially the underlying nerves, meaning that messages travelling along the nerves become slowed or disrupted.

Exactly what causes the immune system to act in this way is unclear, but most experts think a combination of genetic and environmental factors.

There are three main types of MS - relapsing, primary progressive and secondary progressive.

In relapsing remitting MS, people have distinct attacks of symptoms which then fade away either partially or completely. Around 85% of people with MS are diagnosed with this type.

Secondary progressive MS (SPMS) is a stage of MS which comes after relapsing remitting MS for many people. With this type of MS your disability gets steadily worse. You're no longer likely to have relapses, when your symptoms get worse but then get better.

Primary progressive MS affects about 10-15% of people diagnosed with MS.

It has this name because from the first (primary) symptoms it is progressive. Symptoms gradually get worse over time, rather than appearing as sudden attacks (relapses).

Below are the main symptoms of MS. They can vary from person to person depending on the type of MS they have.

Fatigue.
Difficulty walking.
Problems with eyesight such as blurred vision.
Difficulty controlling the bladder.
Numbness or tingling in different parts of the body.
Muscle stiffness and spasms.
Problems with balance and co-ordination.
Problems with thinking, learning and planning.

Depending on the type of MS you have, your symptoms may come and go in phases or get steadily worse over time.

How Can Occupational Therapy Help

Occupational therapists (OTs) can help people overcome everyday difficulties and stay independent for longer by providing advice on new techniques to continue to complete everyday activities such as dressing and meal preparation for as long as possible as the condition progresses. An OT can assess you at home or in your work place and ascertain which areas you are having difficulty with. They can then make recommendations to enable you to manage day to day tasks easier and remain independent for as long as possible.

They can:

Advise on safer ways to manage transfers around the house, for example in / out of chairs, on / off the toilet or on / off the bed.
Look at areas such as the bathroom and stair mobility and make longer term recommendations to ensure the home environment will meet both your short term and future needs. This includes considering adaptations such as wet rooms, adapted kitchens or through floor lifts.
Ensuring the correct seating, mobility aids and wheelchair are provided to maximise your function and independence. OT’s can refer onto other agencies such as a Physiotherapist for a more comprehensive mobility assessment.
Working with a client and their employer to advise on ways to remain at work for as long as feasible. This may involve looking at ways of travelling to work, how to maximise energy or investigate work place changes such as the provision of equipment and minor adaptations such as rails.
Helping manage fatigue and tiredness by identifying priorities for the day and conserving your energy for those activities whether that be preparing dinner for the children or maintaining your work role.
Recommending environmental controls which allow the control of functions in the home such as opening curtains, turning on lights or the TV to be controlled from your wheelchair, armchair or bed. An OT will work with a client to identify the most suitable environmental controls for them that will preserve your independence for as long as possible.
An OT can show you techniques and recommend equipment to help you get in and out of your car independently. The OT may also suggest adaptations to your vehicle to keep you safe while driving.
An occupational therapist can support you and your family to live positively, helping you to focus on what you can do, rather than what you can’t; for example, by assisting you to establish personal goals.

Read our case Studies

Case Study Index

Case Studies