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Multiple Sclerosis

Our Approach to Treating Multiple Sclerosis

At Pacific Neuroscience Institute, care of persons with Multiple Sclerosis combines state of the art diagnostics and treatments with evidence-based recommendations for lifestyle practices.

At Pacific Neuroscience Institute, care of persons with Multiple Sclerosis combines state of the art diagnostics and treatments with evidence-based recommendations for lifestyle practices.

This comprehensive strategy treats the whole person, with the goals of controlling disease activity while optimizing function and quality of life.

The person with MS is an important partner in all treatment decisions.  The MS clinic at PNI is recognized as a “Partner in Care” of the National MS Society.

Conditions We Treat

  • Multiple Sclerosis
  • Clinically Isolated syndrome
  • Neuromyelitis Optica
  • Transverse myelitis

What Is Multiple Sclerosis?

Multiple Sclerosis is generally believed to be an autoimmune disease. Normally, the immune system, which is composed of different types of immune cells and proteins, recognizes an individual’s body as “Self’ and protects it from outside or “non-self” entities, such as germs. The central nervous system or CNS ( brain, optic nerve, and spinal cord) usually does not allow most immune cells and proteins to enter. In MS, the immune system no longer recognizes parts of the central nervous system as “Self’ and gains the ability to get into the CNS and to attack the nerves. 

What Causes MS?

The trigger that causes the immune system to attack the CNS is currently unknown. It is thought that  MS develops in an individual as a combination of genetic susceptibility and environmental influences. 

These precise genes and environmental factors have yet to be conclusively identified.

MS Risk Factors:

  • Adolescent obesity,
  • Smoking
  • Low Vitamin D levels in early life
  • Having a close family member with MS

Who Gets MS?

MS is the second most common cause of neurologic disability in young persons and usually presents between ages 20-50. It affects women almost 3 times as often as men and is more common in Caucasians.

What Causes Symptoms in MS?

Nerves are very similar to electrical cables and communicate by transmitting electrical & chemical signals. Many of them are coated with an insulating material, myelin, which helps the electrical signal be conducted in a swift and efficient manner. 

In MS, the myelin insulation is damaged or destroyed, and scar tissue or “sclerosis” occurs, leading to slowed or blocked transmission of electrical information.

In addition to myelin damage, the nerve wire or “Axon” is damaged as well. These areas of nerve damage can be seen on MRI  and are referred to as “plaques”.

Brain Imaging in Multiple Sclerosis | Source: Medscape

What Are The Symptoms Of MS?

Because MS attacks multiple parts of the CNS, it can produce many different symptoms.

Common MS symptoms include:

  • Fatigue
  • Numbness or tingling
  • Weakness
  • Incoordination
  • Visual disturbances
  • Muscle spasms
  • Change in bladder, bowel or sexual dysfunction
  • Problems with mood and memory and thinking

How Is MS Treated?

There are two categories of treatment for persons with MS.

Disease Modifying Therapies (DMT)

DMT are medications that interfere with the immune system’s ability to attack the nerves.

They help prevent future areas of nerve damage, and slow disease progression. They do not reverse existing scars or treat symptoms.

Symptoms Management

 Most symptoms of MS can be greatly relieved or ameliorated.

This usually involves a combination of appropriate medications and other treatment modalities such as rehabilitative therapies, equipment, lifestyle practices and alternative and complementary therapies where appropriate.

Exercise for People with Multiple Sclerosis

For people with MS, exercise and physical activity can be variously challenging. However, being physically active is one of the most beneficial adaptations to a lifestyle with MS.

Symptoms improved by exercise can include

  • Fatigue
  • Spasticity
  • Depression
  • Weakness and balance issues
  • Cognitive impairment

It is important that regardless of where they are in the course of the disease, research shows that people with MS should move for at least 150 minutes per week.

Activities can be adapted for each individual, with tiered recommendations that accommodate all physical condition and ability levels. For example, activities can range from running and assisted range-of-motion activities for the physically capable, to lifting weights, to muscle stimulation and breathing exercises for those who are unable to get out of bed.

Consider integrating exercise into your regimen to improve and maintain quality of daily life.

Aerobic Activity

Schedule 20-60 minutes of aerobic activity a day to work major muscles and increase heart rate. Exercise time can be split across the day and among different structured and unstructured activities. For example, unstructured activity could include taking a walk or run with the dog, cycling, swimming, climbing the stairs, dancing, playing with children, or cleaning the house. Structured exercise can involve doing an online or studio workout class.

Mindful Movement

Mind-body exercise such as tai chi, yoga, dance, or other therapeutic movement help stretch out tight muscles and increase flexibility, reduce stress, and help improve cognitive and psychological well-being. This movement can be added two to three times a week, either instead of, or in addition to, higher-intensity aerobic exercise.

Strength Training

Adding resistance training such as lifting weights to your exercise routine, can help build and maintain muscle strength and bone density. A mix of 10 to 30 minutes of aerobic and 10 to 30 minutes of resistance training daily is a good option for variety.

Cognitive Stimulation

Learning something new not only benefits physical well-being, but also stimulates brain health. As you master a new movement, you pay more attention to your coordination which adds novelty while making cognitive and physical demands on your brain and body. Examples can include dancing, boxing, or even a new sport move like a tennis or golf swing. These can be integrated into your current routine or allocated a specific time during the week, for example 30 minutes of dance on a Wednesday.

Temperature Control

To avoid flare-ups, it is important to keep your body temperature regulated as many people with MS are sensitive to heat. Using a fan or keeping a cold wet towel or some ice chips close at hand during your workout, can help prevent overheating.

Paying Attention to Your Body

It is recommended that you adjust your routine as your cognitive and physical condition fluctuates. On good days, more strenuous exercise can be invigorating while on challenging days, gentle movement can be helpful.

Additional MS Resources

MS Gym
Above MS
ChairFit with Nancy
Evergreen Health
Multiple Sclerosis Trust
Our Blog Articles About Multiple Sclerosis


Multiple Sclerosis Specialist

Barbara Giesser MD

The Pacific Brain Health Center is dedicated to providing comprehensive and holistic care to patients with multiple sclerosis.

Dr. Barbara S. Giesser, FAAN, FANA, is an internationally recognized clinician and award-winning educator who has specialized in the care of persons with Multiple Sclerosis since 1982.

For more information or to schedule an appointment, contact us at 310-582-7613.

Schedule a Multiple Sclerosis Consultation

Contact our clinic at: 310-582-7613

Schedule A Consultation – Multiple Sclerosis