Multiple Sclerosis Treatment
There's no cure for multiple sclerosis (MS).
Still, being diagnosed with MS is not a death sentence — in fact, far from it.
In addition to there being several types of MS drug treatments that can reduce the number and intensity ofrelapses和slow the progression of the disease overall, there are also numerous types of rehabilitative therapies that can help people maintain their mobility and independence and manage theirMS symptoms。
Manypeople with MSalso try one or more complementary therapies to address symptoms,relieve stress, and improve quality of life.
MS Drug Therapies
People diagnosed with复发缓解MS(RRMS)疾病改良的疗法数量最多 - 那些可以降低复发的频率和严重性并减缓MS的进展的疗法。
However, those options are not all equally effective, so each person with RRMS should discuss the best choice of MS drug with their doctor. Increasingly, many MS doctors believe — and evidence from research supports this belief — that starting MS treatment with a highly effective drug leads to less disability in the long run than starting with a less effective drug with fewer side effects.
RELATED:Early, Aggressive MS Treatment Superior to Escalation Approach, Study Shows
During relapses, people with RRMS may be treated with皮质类固醇to help shorten the relapse. For those people who can’t take or don’t respond to皮质类固醇, several other treatments can be tried to reduce inflammation and relieve symptoms during relapses.
In recent years, the number of drugs approved to treat “active”secondary-progressive MS (SPMS)have increased. SPMS is a stage of MS that follows RRMS, and typically, people with SPMS see a steady progression ofMS symptoms很少或没有复发。具有“活跃” SPMS的人仍然经历一些复发。
For people withprimary-progressive MS (PPMS), there is only one approved disease-modifying therapy, namelyOcrevus (ocrelizumab)。
That being said, some doctors prescribe the drugRituxan (rituximab)off-label in place ofOcrevusfor people with either RRMS orPPMS。两种药物的作用机理非常相似,但是Rituxanis much less expensive and may be an option for people for whom Ocrevus is unavailable or unaffordable.
In addition to disease-modifying therapies, people at any stage of MS may be prescribed other drugs that target specific symptoms and health problems related to MS.
Rehabilitation for MS
Multiple sclerosis can affect a person’s ability to walk, speak, swallow, perform daily tasks — such astaking a shower或者preparing meals— and even think.
In most cases, help is available to find alternative ways to perform these functions, sometimes by using assistive devices, and sometimes by retraining the muscles or establishing new habits.
Physical TherapyA physical therapist (PT) can help with problems of physical functioning, such aswalking and balance problems和lack of manual dexterity (the ability to do things with your hands). A PT may design anindividualized exercise programfor you, advise you onstretching and strengtheningyour muscles, prescribebalance exercises, and teach you how to use an辅助设备,例如拐杖或步行者。A PT with specialized training can help with膀胱再培训。
Occupational TherapyOccupational therapists (OTs) look for ways to enable persons with MS to perform the tasks and engage in the activities that are important to them. This can include activities at home, school, in the workplace, or elsewhere. It can also include driving or learning to use public transportation. An OT may advise you on home modifications to keep you safer and more comfortable, as well as on the use of assistive devices.
Speech-Language Therapy如果你有trouble speaking或者swallowing, a speech-language pathologist is the expert you want to see to determine what’s going wrong and how best to deal with it. A speech-language pathologist may prescribe oral strengthening exercises or exercises to improve articulation, or the way sounds are produced.
认知康复MS can affect your memory as well as your ability to learn new information and remember it, retrieve the word you want to say, plan and organize tasks, and multitask, or focus on more than one thing at a time. Cognitive rehabilitation therapy may focus on improving these functions or finding ways to compensate for orminimize the effects of cognitive impairments。
Learn More About Rehabilitation for People With Multiple Sclerosis
Psychosocial Help for MS
Adiagnosis of multiple sclerosisdeals an emotional blow, and while not everyone feels the same, it’s common to experience sadness,grief, anxiety, and often沮丧when first receiving the diagnosis or at some later point while living with the disease.
负面情绪可能主要是在损失时发生的 - 身体或认知能力,人际关系,就业或曾经被爱的活动 - 但不必有特定的损失或事件来引发情绪困扰。MS的不可预测性以及疾病本身对大脑的影响,可能导致anxiety and depression。
For all of these reasons, finding emotionalsupportis crucial for individuals living with MS and their close family members and friends.
这种支持可能的病人pport group or a mental healthcare professional. It can also help to find awellness programgeared toward people with MS. Wellness programs are typically exercise or activity groups offered through an organization like the National多发性硬化社会或者through a specialized MS treatment center.
在得到朋友,家人和其他与MS的其他人的支持时,在缓冲患有慢性疾病的情感压力方面有很长的路要走,请记住if you or a loved one is depressed, it’s important to seek professional help.
Alternative Medicine for MS
Many people with MS turn to natural remedies — also called complementary and alternative medicine, or CAM therapies — to manage symptoms.
But most natural treatments for multiple sclerosis haven't been thoroughly studied by medical researchers.
In general, the AAN found that while some of these approaches seemed to be somewhat helpful, more clinical data is needed before they can be deemed truly safe and effective.
Here is what the AAN concluded regarding the complementary therapies for which it found enough evidence to make practice recommendations:
- Cannabinoids, or marijuana products, may reduce symptoms of痉挛和pain.
- Ginkgo biloba is possibly effective at alleviating fatigue but not cognitive function.
- Magnetic therapy is probably effective for reducing fatigue.
- Reflexology is possibly effective at relieving paresthesia (burning or prickling sensations).
Marijuana for MS
The use of marijuana to treat MS is a controversial issue that's still undergoing long-term study.
根据AAN,码头(Dronabinol), which is syntheticmedical marijuanain pill form, may reduce spasticity and the pain it causes.
Mind-Body Therapies for MS
Mind-body therapies are practices that take advantage of the connection between mind and body.
Some, such as yoga and tai chi, involve moving the body but are noted to have positive effects on mood as well as身体素质, while others, such as meditation, involve using primarily the mind but can have positive physical effects such as reduced pain in addition to reduced psychological stress.
练习yogaon a regular basis has been found to help reduce fatigue and improve quality of life for people living with MS.
If you're interested in trying yoga, look for a class that suits your abilities. Many yoga studios offerchair yoga,例如,如果您难以站立,这可能会有所帮助。您还可以寻找“自适应”瑜伽课,这些课程通常针对残疾人。
Doingtai chican improve balance and reduce stress for people with MS. Tai chi usually involves moving your weight slowly from one side to the other using flowing movements. While advanced tai chi practitioners may perform deep bends or squats, beginner routines typically remain more upright. Chair tai chi is also an option if standing is difficult.
TheFeldenkrais Method, which uses slow repetitions of movements to teach the body easier ways to perform physical tasks, has been shown to increase physical comfort and mobility in those with MS.
许多患有MS的人使用按摩疗法放松,缓解肌肉张力,减轻压力和抑郁。
Although there's no hard evidence that massage can relieve MS symptoms, it's generally considered a safe therapy to pursue, especially if it makes you feel better.
Acupuncture, which involves inserting very thin needles into specific points on the body, is a popular pain-relief strategy among people with MS.
有些人认为针灸也有助于肌肉痉挛和膀胱问题,尽管科学证据尚未证实这些联系。
Exercise can be helpful if you have MS.
Walking and wateraerobicsare particularly helpful for people with MS, because these exercises are less likely to cause fatigue or heat exhaustion than a higher-impact workout.
Reflexology involves putting pressure manually on certain points on your feet, hands, or ears that are believed to connect to the body's organs.
The evidence supporting this treatment for MS is weak, but it suggests that reflexology may help treat tingling, numbness, and other skin sensations associated with the disease.
But it's unlikely that music alone will be effective in controlling these symptoms.
Editorial Sources and Fact-Checking
- Yadav V, Bever C, Bowen J, et al. Summary of Evidence-Based Guideline: Complementary and Alternative Medicine in Multiple Sclerosis.Neurology。2014年3月。
- Abo Youssef N, Schneider MP, Mordasini L, et al. Cannabinoids for Treating Neurogenic Lower Urinary Tract Dysfunction in Patients With Multiple Sclerosis: a Systematic Review and Meta-Analysis.BJU International。April 2017.
- Lanza G, Ferri R, Bella R, Ferini-Strambi L. The Impact of Drugs for Multiple Sclerosis on Sleep.Multiple Sclerosis。January 2017.
- Hill KP, Palastro MD. Medical Cannabis for the Treatment of Chronic Pain and Other Disorders: Misconceptions and Facts.Polish Archives of Internal Medicine。November 2017.
- Brenton JN, Schreiner T, Karoscik K, et al. Attitudes, Perceptions, and Use of Marijuana in Youth With Multiple Sclerosis.神经学期刊。December 2017.
- Simpson R, Booth J, Lawrence M, et al. Mindfulness-Based Interventions in Multiple Sclerosis — a Systematic Review.BMC Neurology。January 2014.
- Boiko EA, Ivanchuk EV, Gunchenko MM, Batysheva TT. The Potential of Music Therapy in Neurology Using Multiple Sclerosis as an Example.Neuroscience and Behavioral Physiology。June 2017.
- Treating MS.National Multiple Sclerosis Society。
- Multiple Sclerosis Diagnosis & Treatment.Mayo Clinic。
- Treating Multiple Sclerosis (MS).Johns Hopkins Medicine。
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