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MS Myths: Separating Fact from Fiction

Information on MS is rife with old stereotypes and outdated opinions.  Make sure you work with doctors who are up-to-date on the latest research and stay up-to-date yourself so you make your personal choices based on the best information we have to date.

Here are a few of the most common MS Myths:

  • You can't have children.
  • Stress causes MS.
  • You shouldn't exercise.
  • Nothing else could possibly go wrong with my body.
  • "But you look so good!" You can't possibly have multiple sclerosis.

1) Fiction: You can’t have children.

Fact: While there is no good evidence that daily stress or trauma affects the course of MS, there is data on the influence of pregnancy. Since MS generally strikes during childbearing years, a common concern among women with the disease is whether or not to have a baby. Studies on the subject have shown that MS has no adverse effects on the course of pregnancy, labor, or delivery; in fact symptoms often stabilize or remit during pregnancy. This temporary improvement is thought to relate to changes in a woman's immune system that allow her body to carry a baby. Because every fetus has genetic material from the father as well as the mother, the mother's body should identify the growing fetus as foreign tissue and try to reject it in much the same way the body seeks to reject a transplanted organ. To prevent this from happening, a natural process takes place to suppress the mother's immune system in the uterus during pregnancy.

However, women with MS who are considering pregnancy need to be aware that certain drugs used to treat MS should be avoided during pregnancy and while breast feeding. These drugs can cause birth defects and can be passed to the fetus via blood and to an infant via breast milk. Among them are prednisone, corticotropin, azathioprine, cyclophosphamide, diazepam, phenytoin, carbamazepine, and baclofen.

Unfortunately, between 20 and 40 percent of women with MS do have a relapse in the three months following delivery. However, there is no evidence that pregnancy and childbirth affect the overall course of the disease one way or the other. Also, while MS is not in itself a reason to avoid pregnancy and poses no significant risks to the fetus, physical limitations can make child care more difficult. It is therefore important that MS patients planning families discuss these issues with both their partner and physician.

2) Fiction: Stress causes MS.

Fact: No definitive evidence has been found to link daily stress to MS attacks, although there is evidence that the risk of worsening is greater after acute viral illnesses.

3) Fiction: You shouldn’t exercise.

Fact: People with multiple sclerosis can enhance the functioning and health of their heart, lungs, muscles and bones in most cases through regular physical activity. Flexibility, mobility and coordination can be improved, lessening the negative effects of some conditions or slowing the progression of others. Besides, participation in physical activity can be fun and provide a chance to meet people and make new

Balance and Coordination. Some people with multiple sclerosis hesitate to be active for fear of falling. Anyone can fall and activity actually improves balance and coordination to the extent that injury is less likely among people who exercise on a daily basis.

Cardiovascular fitness. Individuals with progressive neuromuscular disorders such as multiple sclerosis may fatigue easily and thus may not reach the Target Heart Rate (THR). They should be carefully monitored in order to avoid exhaustion.

Resistance Training. Research has shown that for some neuromuscular conditions, strength training can be beneficial in maintaining strength and cardio-respiratory function if:

1) The degree of weakness is not severe
2) The rate or progression of the disease is relatively slow
3) Consideration is given to the individual's total daily activity demands
4) The rate of increasing the intensity of the exercise is slow and supervised.
Strength training should be approached very cautiously and only after medical consultation for individuals who have conditions that directly effect the muscle.
The development of muscular strength is considerably important for individuals who use wheelchairs or other assistive devices. Circumventing architectural barriers requires up to 15 times the energy expenditure for persons with disabilities when compared with persons without disabilities.

Special Considerations and Safety. There are some special considerations for resistance training by people with multiple sclerosis. Safety is, of course, a primary factor with anyone using weight training as a form of exercise. It is even more critical for individuals who may have poor posture, limited range of motion in joints or problems with joint stability. All who lift weights using a barbell should use a spotter. People with problems of joint stability or managing the barbell should definitely use a spotter.

Muscle Development Should Be Balanced. Exercise both sides of the joint when using weights. People who use wheelchairs should develop the musculature that counter-balances the anterior muscles used for daily ambulation. Spasticity from multiple sclerosis can also cause muscle imbalance. Stretch and strengthen the opposing muscles being careful not to increase abnormal muscle tone.

Machines vs. Free Weights. A person's coordination, control and strength should determine whether he or she should use machines or free weights. While machines move in only a predetermined path, they tend to be safer.

Free weights can provide a wider range of resistance, since they can be obtained in less than one pound up through hundreds, in many increments. They do, however, require balance and control of the weight, a good grip or special gloves to keep the weight in the hand and the availability of equipment in increments that are appropriate for any given person. Free weights can also be used in different ways such as in gravity-reduced exercise training. This technique utilizes gravity to reduce the effects of gravity of the weight and exercising limb by doing the exercise in a position in which gravity aids the movement.

Another method used with individuals with very limited strength as in multiple sclerosis, is manual resistance. This method, often used in a rehabilitation setting, calls for another person to provide the resistance. It, of course, cannot be calibrated like free weights or a weight machine, but working with the same person all the time is beneficial in that they can tell when they are giving more resistance than previously. Positioning and strapping is also useful for stabilizing the trunk and extremities to assure an aligned, secure and stabile position for performing exercises.

Since physical activity contributes to the maintenance of health, by exercising, people actually build stamina that makes the demands of daily living easier thus leaving extra energy at the end of the day for additional social activities. While there may be some minor discomfort by anyone at the beginning of a physical activity program after being sedentary, there is no evidence that appropriate activity, done correctly will aggravate most conditions. It is important to know how one's body responds to different conditions and to plan activities accordingly. (Source: The President’s Council on Physical Fitness and Sports)

4) Fiction: Nothing else could possibly go wrong with your body.

Fact: A diagnosis of MS should not be a reason to forget about your general health and wellbeing. With all the doctor appointments that will come along with a diagnosis of MS it may seem like a hassle to keep up with general health appointments and screenings. But, that does not diminish their importance.
 

5)  Fiction: “But you look so good! You can’t possibly have multiple sclerosis."

Fact: If your symptoms are mild and/or not obvious to others (such as numbness, pain, blindness) your diagnosis may not add up to them. They might say, “But you look so good. You don’t look sick.” Symptoms of MS may be mild or severe, of long duration or short, and may appear in various combinations, depending on the area of the nervous system affected. Complete or partial remission of symptoms, especially in the early stages of the disease, occurs in approximately 70 percent of MS patients.

For more on the Myths of MS, click here.

 

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