You will be offered regular appointments with an MS, and with a doctor if you are taking disease-modifying therapy, to review your symptoms and treatment plan.
Many people with MS have fatigue. This is not ordinary tiredness, but a feeling of utter exhaustion that is not related to how much you have been doing. The fatigue can be brought on by heat, overexerting yourself or stress. Sometimes it can be related to the time of day.
If you have problems with fatigue, your GP will first make sure that nothing else could be causing it, such as anxiety, depression, difficulty in sleeping or medical problems such as anaemia or thyroid disease. If you have any of these conditions you will be offered treatment for them first.
Training in mindfulness (paying attention to your present thoughts and feelings), cognitive behavioural therapy (a type of talking therapy that helps you change the way you think and behave) or special techniques to help you manage your fatigue may also help.
Aerobic balance and stretching exercises such as yoga may also help ease MS-related fatigue. The MS team can refer you to an occupational therapist for 1-on-1 or group therapy for fatigue management.
If you are having problems with mobility, access to a specialist MS physiotherapist is available.
Taking part in a supervised exercise class that combines some aerobic and strength training may help if you have problems with mobility or fatigue.
If you find it hard to balance because of dizziness, special exercises to improve your balance may also be helpful.
Spasticity is a condition that affects the muscles, making them more stiff and rigid than usual. Other conditions can make spasticity worse such as constipation or an infection and these should be assessed and treated.
You may need to try several different drugs for spasticity taken at various doses until the right one is found for you. The drugs could include baclofen, gabapentin, tizanidine, and benzodiazepines. You may even need to try a combination of drugs. Drugs that don't work for you should be stopped. Once the right drug and dose has been prescribed, your neurologist will set up an appointment to review your treatment at least once a year.
You will also be encouraged to manage your own spasticity by varying the drug dose you take within agreed limits.
If drugs do not help your spasticity, you will be referred to the specialist spasticity service.
You may have neuropathic pain. This happens when the nerves don't work properly and send the wrong signals to the brain. It can feel like stabbing, an electric shock, burning, tingling, prickling, itching, or a sensation of pins and needles anywhere in the body. If you have this, you will be offered treatment in line with NICE's guideline on neuropathic pain.
You might also get pain in your muscles, joints and bone, and this is usually caused by problems with mobility or posture. If you have this type of pain, your doctor will assess your symptoms and offer treatment or referral.