Multiple sclerosis (MS) treatment

The cost of multiple sclerosis treatment depends on your individual circumstances. At the time of your appointment your consultant will discuss all options with you and ensure all your questions are answered.

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you.

There are three main forms of MS:

Relapsing-remitting multiple sclerosis (RRMS)

Relapsing-remitting multiple sclerosis, or RRMS, is the most common type of MS in the early stages of the disease. It involves periods of your symptoms getting worse, known as flare-ups or relapses, followed by periods of remission, where your symptoms get better. RRMS often develops into secondary progressive multiple sclerosis (SPMS) over time.

Secondary progressive multiple sclerosis (SPMS)

In secondary progressions multiple sclerosis (SPMS), damage to your nerves builds up and your symptoms get gradually worse. Periods of remission may stop or become less frequent.

Primary progressive multiple sclerosis (PPMS)

Primary progressive multiple sclerosis (PPMS) is a less common type of MS, where your symptoms get gradually worse over time without any clear relapses or periods of remission.

The symptoms of MS vary from person to person, and everyone experiences the condition differently. Symptoms may come and go, but often get worse over time.

Common symptoms of MS include:

• Fatigue
• Numbness, weakness or tingling, often on one side of your body
• Poor coordination, dizziness or an unsteady gait/difficulty walking
• Muscle stiffness, cramps or spasms
• Memory problems
• Difficulty concentrating
• Problems with your vision, such as blurred vision, double vision or loss of vision
• Eye pain
• Problems with bladder or bowel function
• Sexual problems, including vaginal dryness or erection problems
• Electric shock sensations when you move your neck in a certain way such as bending your neck forward
• Vertigo
• Slurred speech
• Mood changes

Multiple sclerosis is an autoimmune disease that occurs when your immune system mistakenly attacks its own cells.

In the case of MS, your immune system attacks a fatty substance called myelin that coats and protects the nerve cells in your brain and spinal cord. Destruction of myelin is a process known as demyelination.

Demyelination means that messages can't pass as easily between your nerve cells, causing symptoms of MS.

What are the risk factors for MS?

Anyone can get MS, but you may have a higher risk if you:

• Are female
• Are white
• Are between 20 and 40 years of age
• Are from a part of the world with a temperate climate such as Northern Europe, Canada and the Northern United States
• Have a family history of MS
• Smoke
• Have been exposed to certain toxins
• Have low levels of vitamin D
• Have another autoimmune disorder such as thyroid disease, type 1 diabetes, pernicious anaemia or inflammatory bowel disease (IBD)
• Have been exposed to certain viruses, such as the Epstein-Barr virus that causes infectious mononucleosis
• Are obese or were obese as a child or adolescent

At your first consultation, you will be seen by a consultant neurologist, a doctor specialising in conditions affecting the nervous system.

Your consultant will ask you about your symptoms, general health, medical and family history and any medication you take regularly. They'll then perform a physical examination including assessing your movement, coordination, balance, reflexes and vision.

Will I need tests or scans?

There is no definitive test to diagnose multiple sclerosis. If your consultant suspects that you may have MS, they may order tests to rule out other conditions that could be causing your symptoms.

These may include:

• Blood and urine tests — to check for any underlying medical conditions
• MRI scan — to check for damage to your brain and spinal cord
• Lumbar puncture — to rule out infections and other conditions that could be causing your symptoms
• Evoked potential tests — to measure the speed at which messages travel from your eyes or ears to your brain
• Optical coherence tomography (OCT) — to check for eye conditions such as glaucoma and Age-related macular degeneration (AMD)

How is a diagnosis made?

Since there is no specific test for MS, your consultant will make what is known as a differential diagnosis using a combination of your symptoms, physical examination and the results of any tests or scans.

Why is this first consultation so important?

At Circle Health Group, your first appointment is very important as it's where you meet your consultant, the doctor responsible for your care.

Your consultant will spend time getting to know you, including asking about how your symptoms affect your day-to-day life, mental health and relationships. They will also discuss your expectations for treatment and encourage you to ask any questions you may have about your condition and treatment options.

It is important to us that you are as well-informed and comfortable as possible during your MS treatment, so please discuss any questions or concerns with your consultant during your appointment.

At the end of your appointment, your consultant will explain your treatment options and work with you to create an individualised treatment plan that is best suited to your needs.

While there is currently no cure for multiple sclerosis, a range of treatments are available that can help relieve your symptoms, speed up your recovery from relapses and slow the progression of the disease.

Your consultant will recommend a treatment plan tailored to your individual needs based on your symptoms and the type of MS you have. Your treatment plan will likely change over time.

Medication

Medications for multiple sclerosis are aimed at managing symptoms, treating relapses, and slowing the progression of the disease.

Medications for MS may include:

Disease-modifying therapies (DMTs)

Disease-modifying therapies (DMTs), or disease-modifying drugs (DMDs) are drugs used to treat people with relapsing-remitting MS, although there are some that are used by people with progressive MS.

There are various types of DMTs available for use in the UK, with each DMT option coming with their own set of benefits and risks. Before prescribing DMTs, your consultant will discuss the potential side effects with you and weigh up the risks and benefits of each medication before writing a prescription.

Depending on the disease-modifying drug prescribed, you can take DMDs in the form of tablets, injections, or IV infusion, where the medication is delivered directly to your vein through a drip.

As well as managing the symptoms of multiple sclerosis, early treatment with DMT can help reduce the number of relapses you have and slow the progression of the disease.

Steroids

Otherwise known as corticosteroids, steroids work by suppressing your immune system to reduce inflammation and swelling, helping your nerves work better as a result.

You may be given steroids during a relapse to reduce your symptoms and speed up your recovery. Steroids can also slow down damage to the myelin sheath that covers and protects your nerve cells.

Plasma exchange (plasmapheresis)

Plasma exchange is a procedure where your plasma – the liquid part of your blood – is removed and separated from your blood cells and mixed with plasma from a donor or a protein solution (albumin) before being put back into your body.

If you have MS, the proteins attacking your body tissue are present in blood plasma, so removing these proteins can help stop a relapse and improve your symptoms.

Plasma exchange may be recommended if your symptoms are new, severe and haven't improved with steroid medications.

Other medications

Depending on your symptoms, your consultant may prescribe other medications such as:

• Muscle relaxants
• Painkillers
• Anti-seizure medications
• Medications to treat problems with your vision, cognitive ability, bowel, bladder or sexual function

Haematopoietic stem cell transplantation (HSCT)

HSCT is a relatively new treatment for MS that uses intense chemotherapy to wipe out harmful cells and “reboot” your immune system using stem cells from your bone marrow.

Therapies

Depending on your symptoms, supportive therapies can help with mobility, and speech problems and help you cope with the psychological impact of having MS.

Supportive therapies include:

• Physiotherapy — can help with problems such as muscle pain and mobility problems, and recommend mobility aids such as walking sticks, frames, and wheelchairs
• Occupational therapy — offers advice and teaches skills to make day-to-day activities easier
• Speech and language therapy — can help with speech and swallowing problems
• Cognitive behavioural therapy —aims to change thought patterns and behaviour, helping with mental health conditions such as anxiety and depression
• Cognitive rehabilitation therapy — involves activities to improve your cognitive function such as concentration, memory, thought processes and mood
• Psychosexual therapy — offers advice and treatment for sexual problems such as erectile dysfunction, low libido (sex drive) and vaginal dryness

Self-care for multiple sclerosis

In addition to the above treatments, adopting a healthy lifestyle can improve your overall health and quality of life and may reduce relapses and slow the progression of MS.

To ensure you are as healthy as possible:

• Get sufficient sleep
• Take regular exercise
• Avoid getting too hot, as overheating can make MS symptoms worse
• Eat a balanced diet
• Quit smoking
• Reduce stress

Multiple sclerosis symptoms are different for everyone, and the impact MS has on your life varies from person to person and may change over time.

Some people experience mild symptoms while others have symptoms that significantly impact their life and make it difficult to carry out day-to-day activities without help.

Remember that help is available and reach out for support from loved ones and health professionals when needed. Although there is no cure for MS, modern treatments are effective in managing symptoms, reducing relapses, and slowing the progression of the disease.

There are also many emerging treatments on the horizon and people with MS are living longer, more fulfilling lives than ever before.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about multiple sclerosis treatment, book your appointment online or call a member of our team today.

1. Multiple sclerosis NHS
2. MS treatments and therapies MS Society
3. Multiple Sclerosis National Institute for Neurological Disorders and Stroke  
4. MS drugs and treatments Multiple Sclerosis Trust