Featuring Barry A. Hendin, MD
MSAA’s Chief Medical Officer
Question: How is weakness in MS best treated?
Answer: Weakness in multiple sclerosis can be divided into “primary weakness,” due to injuries from lesions of the spinal cord and brain; or “secondary weakness,” which comes from issues such as inactivity, fatigue, pain, or medications used to treat multiple sclerosis and its symptoms.
Whether weakness is primary, or secondary, the strategies to treat that weakness are quite similar. Maintaining a regular exercise program remains a central ingredient in the treatment of weakness, no matter what the cause. Ideally, the exercise program will be regular and moderate, rather than infrequent and excessive.
Specialists in physical therapy and occupational therapy are often helpful in guiding specific exercise programs to deal with specific localized weakness. And please keep in mind that although fatigue may be a barrier to creating an exercise program, paradoxically, regular exercise reduces fatigue!
Medications may help with specific problems due to weakness: Provigil® (modafinil) and Nuvigil® (armodafinil) may be beneficial in reducing fatigue, which is often perceived as weakness; Ampyra® (dalfampridine) may be beneficial for walking difficulties due to lower-extremity weakness. Assistive devices, such as braces, may be helpful for dealing with isolated weakness in the arms and legs.
Treating weakness while optimizing strength is multi-dimensional: a healthy diet, regular exercise, and managing other medical issues, is the best strategy. Your professional team is a great asset, but much of the treatment and benefit are self-directed. Optimize your strengths, prioritize tasks to conserve energy, focus on wellness, and call upon your professional team when needed.
Barry A. Hendin, MD, is a neurologist and Director of the Arizona Integrated Neurology MS Center. He is also Director of the Multiple Sclerosis Clinic at Banner University Medical Center and Clinical Professor of Neurology at the University of Arizona Medical School.
MSAA’s Ask the Expert series received a Merit Award from the 26th Annual Digital Health Awards!
