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6 Empowering Ways to Manage Your MS

By Beth W. Orenstein
Reviewed by Jonathan Howard, M.D.
April 01, 2024

Having multiple sclerosis (MS) can make some people feel a bit helpless. For people with progressive forms of MS, there’s the unknown of how the disease will progress or whether it will cause disability. And for people with relapsing-remitting MS (RRMS), it's difficult to know when the next flare or relapse is coming—and the unpredictability of these flare-ups is one of the most difficult aspects of living with RRMS, says David Irani, M.D., a board-certified neurologist and director of the Multiple Sclerosis Clinic at University of Michigan Health in Ann Arbor.

But you don’t have to feel powerless in managing your MS, no matter which type you’re living with. These proactive steps can help you take charge of your health and well‑being.

1. Seek and Stick to Treatment

It’s important to visit your neurologist regularly. With their help, you’re more likely to notice any changes in your condition and to address them earlier rather than later, when the damage could have a greater impact on your life.

Starting treatment as early as possible helps many people with MS feel that they're taking control of their condition. “Current MS treatments suppress disease relapses quite effectively—in some people, up to 80% [of relapses],” Irani says.

If your doctor prescribes a disease-modifying drug, staying on that drug and taking it as prescribed is essential, says Michael D. Kornberg, M.D., a board-certified neurologist at Johns Hopkins Medicine, in Baltimore. You can follow up with your doctor to monitor your condition and make sure the prescription you have works for you, Kornberg says. “Generally, that [follow-up] means an MRI once a year and lab tests as needed.”

2. Be Active

Some MS symptoms, such as fatigue, weakness, and poor coordination, can make the idea of physical activity seem out of reach. “But we know that people with MS who get moderate aerobic exercise tend to do better over time,” Kornberg says.

According to the National Multiple Sclerosis Society (NMSS), stretching and aerobic exercises can help reduce symptoms like bladder and bowel dysfunction, fatigue, mood issues, and spasticity. And a 2018 study in Multiple Sclerosis Journal suggests that resistance training (such as weight training or body weight exercises) may actually help prevent increasing disability in people with RRMS, though more research is needed. Regular exercise may also help reduce the risks of cardiovascular disease, a leading cause of death in the United States.

To reap the benefits of exercise, aim for at least 30 minutes of physical activity at least three days a week. Just be sure to check with your doctor before starting any exercise program.

A physical therapist or a fitness instructor who knows about MS can help you design a routine that you can do without overexerting yourself. A physical medicine and rehabilitation specialist can do the same, says Kornberg, who also recommends that people with MS try aerobic exercise in a swimming pool. “You can exercise for longer without having worsening symptoms caused by overheating or exerting yourself too much,” he says.

3. Get Good Sleep

Quality sleep is another key to managing your MS, Kornberg says. That’s because poor sleep can contribute to fatigue and brain fog (problems with mental clarity) and cause some people’s symptoms to feel worse.

Some symptoms and medications can affect your ability to sleep soundly at night. It’s important to talk to your doctor about these issues if you experience persistent problems with sleep, but lifestyle changes are also a good place to start.

Here’s what you can do to help improve your sleep:

  • Establish a routine. Go to bed and get up about the same time every day regardless of whether it’s a weekday or weekend—this can help your body wind down for sleep and wake up when it needs to.
  • Avoid caffeine, a stimulant, after noon. Likewise, don’t consume alcohol, which can disrupt sleep, within six hours of bedtime.
  • Sip only small amounts of liquids before bedtime. That way, you don’t have to get up to go to the bathroom frequently.
  • Keep your bedroom cool, quiet, and dark. These are optimal sleeping conditions.
  • Reserve your bed for just two activities: sleeping and sex. If you read, watch television, or check your phone in bed, it may be too stimulating. Avoid using screens at least 30 minutes before bed, too.
  • Clear your head before you turn in. Keep a paper and pencil on your nightstand to write down anything you must remember, which may help you rid those to-dos from your mind.

4. Eat Healthy Food

According to the NMSS, there is no single “MS diet” to improve symptoms or treat the disease. However, healthy eating habits have many benefits for people with multiple sclerosis, including helping you establish or maintain a body weight that’s healthy for you. With this, you may experience a lower risk of MS-related disease activity.

Your diet can also affect the good and bad bacteria in your gut, which is an important part of your immune system. Keeping the bacteria in a healthy balance through diet may help make MS symptoms more manageable, some research suggests.

Try preparing your meals at home as much as possible so you know what’s in the food you’re eating—that way, you can avoid excess sugar, sodium, or additives that may contribute to inflammation. You can also follow recommendations such as:

  • Using fresh, natural ingredients
  • Incorporating a variety of colorful fruits and vegetables
  • Opting for whole grains over refined grains
  • Limiting your consumption of foods that are highly processed

5. Stay Social

To maintain a good quality of life, it’s important to stay active socially and avoid isolating yourself. Social and emotional support can be key in helping you navigate any ups and downs of living with MS.

6. Set a Timer on Your Worries

Meghan Beier, Ph.D., a board-certified rehabilitation psychologist who works with people with MS at Johns Hopkins Medicine, encourages people to “feel their grief, but not to live there.” If you start feeling sad about a symptom you now have to live with, for example, spend about five minutes acknowledging your feelings, Beier says. Then, gently, without judgment, switch your attention to something that’s more hopeful.

In cognitive behavioral therapy, there’s something called “worry time”—scheduled time to reengage with worries you’ve noticed, so that they’re contained rather than allowed to run free. Beier explains that when those worrying thoughts pop up at other moments during the week, you can say to yourself, “Not now—I’m going to save that for my worry time.” Having this worry time can help you gently disengage from unhelpful thoughts but also give them the needed time and space, Beier says.

Ultimately, it's important to remember that living with multiple sclerosis still leaves you with opportunities to seize the reins. If you take steps to manage your MS through treatment and lifestyle, and also care for your mental health along the way, you’ll likely feel better for it.

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