Multiple Sclerosis (MS) is a degenerative disease that attacks the sheath around the nerves of the central nervous system known as myelin.

When the myelin is damaged, the transmission of the nerve involved slows down and can eventually stop communicating all together. The true cause of this disease is unknown and there currently is no cure for any type of MS, of which there are many. Because this condition is progressive, activities that people have to complete on a daily basis eventually become very difficult and tiring. The treatment of MS requires a diverse medical team including a primary care physician, neurologists, occupational therapists, speech and language pathologists, and many others. Physical therapy’s major role in MS focuses on the daily function that becomes difficult over time. This is an area that can be treated in a multitude of ways.

Because the nerves are damaged, muscles become weak due to interruption of communication from the central nervous system to the muscle.

It is not that the muscle isn’t being used, it is that the muscle cannot work without the nerves communicating to the tissue. This makes function on a day to day basis difficult and cumbersome. The muscle weakness further complicates the issue by not allowing the joints to move which causes tightness in the joints and the surrounding tissues. Without the strength, endurance, and mobility to complete daily tasks, patients with MS may rely on other people and/or equipment to help them. The reliance on these things can be pushed further into the disease process if strength and mobility issues are addressed. The amount of function lost depends on the type of MS, but working on maintaining and improving strength and mobility can keep patients as functional and independent as possible for as long as possible.

The changes in activity that arise from the progression of the disease also tend to lead to postural changes. These are very similar to those found in people without MS that may struggle with neck, back, or shoulder pain, and muscle imbalances. The muscle imbalances, faulty joint positions, and pain that can develop effect the person’s ability to function; these things can be addressed and improved upon. The strength and mobility deficits seen may not be from just the disease process. The main focus of PT for individuals with MS is to improve and maintain functional independence. However, if the disease is looked at from a movement and manual therapy perspective, there are activities and functions that people with MS can improve upon through manual therapy and exercise. This is no different than anyone else who presents with similar musculoskeletal imbalances.

Physical therapy can also aid people suffering from MS by helping them stay comfortable and pain free when they are using certain pieces of equipment needed to complete their daily tasks.

Some types of MS may require people to become wheelchair bound, use lifts to move from surface to surface, and use frames to stand up. All of these pieces of equipment are necessary for people with MS to function through their day and PT can facilitate that function.

Unfortunately, people suffering from MS will never fully recover strength, full function, or mobility due to the progressive nature of the disease. However, maintaining function and allowing patients to stay as independent as possible while also preventing or eliminating pain they may feel due to the lack of movement they have, or poor postures they may maintain, is the primary focus of the physical therapy treatment of MS. If you have further questions regarding the treatment and diagnosis of this condition or want to know more about how PT can help, feel free to contact me at [email protected]. And don’t forget to take advantage of a free pain consultation at one of our 3 clinics. There are many great resources out there and we are always happy to help in any way possible.

Mitch Sturgeon has been a patient at Back in Motion® Physical Therapy since 2015 and is being treated for MS. He has this to say of his experience.

“Because I have advanced multiple sclerosis, I decided to try out a local Back in Motion physical therapy clinic. At my first visit, I noticed a lot of PTs, a lot of PTAs, matching corporate shirts, and a huge facility. I thought this might be a good place to hide out for a couple hours a week, a place to go through the motions. I mean, there isn’t much anyone can do about something as powerful as MS, right?

Wrong.

At Back in Motion, I have a dedicated team. I’ve worked with no fewer than four different physical therapists and at least half a dozen PTAs, and each one of them is energized and engaged every day. Perhaps most importantly, they gently nudge me in that direction too. Sessions with the PT don’t begin until we’ve had a discussion about the effects of the last session and how things have gone for me in between. Only then does the therapist begin manipulations.

Similarly, when the PT hands me off to the physical therapy assistant, I don’t simply start my exercises from a list. There is a discussion between the PT, PTA, and myself. We emphasize certain exercises, deemphasize others, and introduce new ones. Often, the team has considered my case in meetings and comes out with innovative treatment strategies.

Back in Motion is not a place for me to hide from my troubles. It’s a place for me to push back on this disease, a place for me to engage in physical activity, a place for me to work with dedicated clinicians who all share my goal—keep me moving as long as we can.

And I have the results to show for it.”

By Phil Finemore, DPT

Back in Motion® Physical Therapy – South Portland, Maine