Multiple sclerosis: How to slow its progression and relieve symptoms

Of all chronic neurological diseases, multiple sclerosis affects the largest number of young people. It is estimated that approximately 2.5 million people worldwide suffer from it, with an average age of around 30 and a peak incidence between 21 and 25. The disease is characterized by the appearance of inflammatory lesions in nerve fibers and their protective layer, the myelin sheath, which is attacked by the immune system. These lesions are located in multiple areas of the brain and spinal cord, implying a direct impact on the central nervous system.

Symptoms are very broad and can vary from patient to patient and even change over time. Among the most common are visual acuity disturbances (including double vision), sensory and motor disturbances, lack of coordination, sphincter disturbances, weakness—usually in both legs or in the leg and arm on one side of the body—affecting multiple neurological functional systems, and fatigue. All of these symptoms can significantly affect patients' quality of life, especially considering that they are mostly young.

We must individually search for the ideal treatment Dr. Albert Saiz, Neurologist at the Hospital Clínic Barcelona

Although the exact causes of multiple sclerosis are still unknown, advances in research have led to significant improvements in treatment, improving patients' quality of life. Furthermore, given that symptoms vary significantly between patients, it is essential to "find the most appropriate treatment individually," emphasizes Dr. Albert Saiz, a neurologist at Hospital Clínic Barcelona . Currently, although the disease has no cure, there are treatments available to slow its progression and control symptoms.

Available treatments

First, there are pharmacological treatments to control flares or acute episodes. These are usually based on the administration of corticosteroids to reduce inflammation, or on plasma exchange procedures, which eliminate antibodies involved in the autoimmune response from the blood plasma. There are also disease-modifying treatments, whose objective "is not to relieve any symptoms, but rather to prevent the onset of new episodes," explains Dr. Ana Hernando, a nurse at Hospital Clínic Barcelona.

These treatments are classified according to their route of administration. On the one hand, there are self-injectable drugs, such as beta interferon and glatiramer acetate, which reduce the number of flares. On the other hand, there are oral treatments, including teriflunomide, dimethyl fumarate, and fingolimod. There are also intravenous treatments, administered in the hospital and sometimes based on monoclonal antibodies. In addition to these already available options, there are new drugs in development with promising short-term results, such as daclizumab and ocrelizumab.

Along with treatments that modify the course of the disease, there is also symptomatic treatment, which aims to alleviate clinical manifestations. Some symptoms can be controlled with specific medication, while others require a more comprehensive approach, which may include physical rehabilitation, psychological support, or social intervention.

Recommendations for patients

Beyond medical treatments, healthcare professionals emphasize the importance of following a series of recommendations to improve quality of life. “After the impact of a multiple sclerosis diagnosis, the person must continue to live as normally as possible,” emphasizes nurse Hernando.

Among the most common recommendations are maintaining a balanced diet—rich in vitamin D—avoiding toxic habits such as tobacco and alcohol, continuing to work whenever possible, and exercising. “Good physical fitness will allow us to counteract some symptoms that may appear in the future, such as fatigue, spasticity, or stiffness,” adds Hernando.

After the impact of a diagnosis of multiple sclerosis, the person must continue with life as normally as possible. Ana Hernando, Nurse at the Hospital Clínic Barcelona

Multiple sclerosis is an unpredictable and heterogeneous disease, making it difficult to predict how it will progress in each case. Some people present with a "benign" form, without developing significant disability, while others experience a more aggressive course, with significant sequelae.

However, therapeutic advances have significantly improved the prognosis, as the number of people who develop the disease after a first episode or isolated clinical syndrome has been reduced by half. Furthermore, life expectancy and average survival have improved substantially: today they are almost 2.5 times higher than they were 50 years ago. To increase the chances of a favorable prognosis , experts agree that it is key to start treatment in the earliest stages of the disease.