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Beginning Treatment
Starting treatment early and staying on that treatment is very important. All of the current multiple sclerosis (MS) treatments have been shown to reduce the risk of relapses and slow the progression of disability. The exact effectiveness of each treatment varies for each person. Choosing the treatment that is best for each person must be an informed decision between the patient and doctor. Specific medications can be found in our section entitled Medications.

The importance of early treatment can't be overstated. MS experts recommend that anyone who has been diagnosed with a relapsing form of MS should consider beginning treatment as soon as possible. Because of their associated risks, Lemtrada and Zinbryta are generally recommended for people who have already had an inadequate response to two other disease-modifying treatments (DMTs). Novantrone is also generally reserved for people diagnosed with secondary-progressive MS (SPMS) or those who have had an inadequate response to other treatments.

Which ever treatment is decided upon, the goal of each MS therapy includes:
• Reducing the number of relapses
• Slowing down physical disability
• Reducing the number of brain lesions
• Reducing the rate of brain shrinkage
• Improving mental and physical function
• Improving quality of life by helping make everyday activities more manageable
• Helping people live independently

Maintain High Expectations for Your MS Treatment

It's important to remember that no MS therapy can cure MS, and symptoms may still be experienced while on treatment. However, with MS, slowing of the disease, or having no disease progression, is considered successful treatment. Even though symptoms may be present, staying on treatment is important to slowing the progression of MS.

It's important that symptoms are regularly noted so one can be sure that the current MS treatment is meeting set goals. If those goals are not being achieved, then it's important to talk to one's doctor about the possibility of switching MS treatments.

Achieving Treatment Goals

There are 3 considerations for reaching the MS treatment goals:

 1  Treating MS early - At the first sign of MS symptoms, treatment can help minimize nerve damage and slow MS progression. Studies have shown that treatment works best when it's used early.
 2  Staying on treatment - Even if one can't see a difference and feel that they don't need treatment, the MS therapy may be working to slow the progress of their MS.
 3  Evaluating one's treatment - Evaluation can help when considering the effectiveness of one's current MS therapy and whether it may be time for a change.

Everyone with MS is unique, and there is no test or crystal ball that can predict how well a specific treatment may or may not work for each person. However, the ongoing results of MRI and other tests can give an idea about how well a treatment is working. Generally, if the MRI results and examinations over time are good, and the person is feeling well, then their MS is probably being managed well.

Treating MS Early

MS treatment needs to be started as soon as possible. Most studies have shown that permanent nerve damage can happen early in MS, and that treatment is more effective in the early stages of the disease. Even if MS symptoms are mild, it's still very important to begin a therapy once a diagnosis has been made. The greater the delay in beginning a treatment, the greater the chance of additional or more severe damage to the central nervous system (CNS).

MS typically causes physical symptoms that can impact one's quality of life. Some people experience problems with balance and coordination; fatigue; muscle tension, pain, and weakness. As MS progresses, these symptoms may become worse. Some people with MS may require the use of a cane, walker, or wheelchair at some point. However, when MS is treated early, it can help slow down physical disability—a key factor in living well with MS.

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Just as MS causes physical symptoms, it may also cause mental function symptoms involving one's memory; attention and concentration; and your ability to finish sentences or find the right words to express yourself. Early treatment can significantly delay the progression of these symptoms.

It's important to note that many times there can be symptoms of MS that are invisible. Damage may occur to the CNS that may not have any appearance of symptoms. Therefore, the harmful changes that occur in one's brain and spinal cord as a result of MS may affect their ability to do certain things, now or even in the future, and they may not even realize it.

Staying on Treatment

Since there is no cure for MS, staying on prescription therapy is the most important way to manage one's MS. Since damage to the CNS may occur with or without causing symptoms, it's necessary that any MS treatment be maintained so damage may be limited. So, even if one can't see or feel a difference, their MS therapy may be working to slow or maintain the progress of the disease.

Treating MS is a long-term commitment and one's guard can never be let down. It's very important to avoid any gaps in therapy because this is all it may take for one's MS to worsen.

It's important to remember that even if one feels better at times, they still have MS - they are not cured. Most people with MS typically feel better at times and worse at others. The degree of what hurts, how badly, how long, and so on will vary with each and every person with MS. The simple fact that MS treatments only modify the course of the disease, one may not be able to feel them working at all.

As long as treatment is continued, the chance of slowing the progress of the disease in greatly increased.

If, however, it's felt that there are too many relapses, or too many symptoms or side effects are being experienced, then it's very important to talk to one's doctor about possibly changing their treatment. Just because one treatment works well for one person doesn't mean that it will work well for another, there are other choices or options that can help.

Since every person reacts differently with every medication, remember that some MS treatments may take weeks or months to begin working in your system. It will probably take even longer to show its full potential. When switching MS treatments, be sure to give your new treatment time to take effect before reevaluating.

Being Patient

Now it's important to understand that you can't expect any medication to work as fast as an aspirin does on a headache or a decongestant for a stopped up nose. The dosage amount of disease modifying drugs is very small in relation to many other drugs. As with many other diseases, treatments are not tracked by the hour or day, but rather by the month and year. You have to become a "patient" patient, yet always be ready to act quickly if needed.

It usually takes time for a disease modifying medication to stabilize symptoms and will usually be at such a gradual rate, that it may not even be noticed till things are a bit better one day. A sudden realization that symptoms may show some easing up or improvement can happen at any time. Take note of what is lost and what comes back, and then to what degree of a return.

Physical disability is one way to mark the progression of this disease; however, MS can progress silently through the loss of axons. The brain can compensate for some level of damage, so symptoms may be hidden for quite some time and yet you may feel perfectly healthy.

Like an iceberg, the progression of MS can lie concealed beneath the surface and can progress silently. What can actually be seen is just the tip of the iceberg, and everything else is truly under the surface. The physical signs that someone has MS are so few compared to the signs that can never be seen. It’s essential to keep up with your MS treatment, what ever that may end up being. While there is no cure for MS, treatment can reduce relapses, and some treatments have been proven to slow the progression of physical disability.

If you don't go into remission or stabilize within a reasonable amount of time, then talk to your doctor again. Should you give it longer or could it be time to talk about switching treatments? It's also very important to know that just because a specific treatment works well on lot of other people, doesn't mean that it will be the best treatment for you. Just like with the many over-the-counter pain killers, some brands work better for some people while other brands work better for others, it just might take a bit of trial and error.

As long as your treatment is working to everyone's satisfaction, it's important to stick with it. Don't skip a day and stay in a routine, make it a habit. All that MS might need to get another foot in the door is a small window of opportunity, and if given the opportunity, imagine what more it can do to you. Don't give it the satisfaction of winning.