So How Does Multiple Sclerosis Happen?

March 15, 2021

By Karolina Stetsyuk (Kozlova), PT, DPT, board certified neurologic clinical specialist

This month I want to touch upon a neuro-degenerative disorder called multiple sclerosis (MS). Did you know that every year, approximately 400,000 people in the US are diagnosed with this disorder and 2.3 million individuals worldwide? That’s a fairly significant number of individuals! Unfortunately, it is unknown what exactly causes MS. It is thought to be a combination of genetic factors, infections (viruses), environmental, digestive, and/or autoimmune factors. There is alot of research out there looking for the potential trigger but it’s difficult to determine whether something causes a disease or is just seen alongside of it. Multiple Sclerosis affects women 2-3x more than men and every 2 out of 3 people maintains their ability to walk but may need some assistance.

So, what exactly happens? Well, researchers think that something (not exactly sure what) triggers protein (antigen) to become activated within the body and start producing autoimmune, cytotoxic brain effects. The immune system responds by producing T-lymphocytes, macrophages, and immunoglobulins. However, the blood brain barrier (which usually blocks destructive neurotransmitters from crossing into the brain) becomes ineffective in blocking myelin sensitive   (Continued from page 1) T-cells from entering and attacking myelin and as a result, the nerves, which are wrapped in myelin (a sheath that helps with nerve conduction) begins to destruct and demyelination occurs. Over time, gliosis (scar tissue) begins to form and repair of the central nervous system is impossible as the plaques keep building. Thus, signaling between nerves and muscles is impaired leading to changes in cognition and function. Some more common changes include: sensory changes, pain, visual changes, dizziness and vertigo as well as different aspects of motor dysfunction. Those can include weakness, fatigue, spasticity, balance/coordination deficits, tremors and a myriad of other changes.

So, then the question becomes – how can physical therapy help a neurodegenerative disease? Function, function, function! With a good interdisciplinary team, having medication (lots of trials out there) tailored to your needs and physical therapy, physical function and quality of life can be much improved with moderate intensity exercise and diet. With better diet, you have the likelihood of decreased co-morbidities – so intake of olive oil, avocados and nuts or even the ketogenetic diet shows reduced negative impact of disease on grey matter. Also supplements like magnesium, B12 and high doses of vitamin D help slow disease progression. For exercise, progressive strength training has shown to increase muscle strength, improve actives of daily living and increase control with walking. Aerobic exercise = increase hippocampal (learning and memory) volume, connectivity, and memory in MS.

So even though this disease can devastate someone physically and cognitively, there is hope with research being done every day and maybe one day they will find a cure.


Karolina Stetsyuk (Kozlova), PT, DPT, Board Certified Neurologic Clinical Specialist is accepting new patients. If you or a loved one is afflicted with MS and having difficulty functioning, Dr. Kozlova can help. Call today and schedule an appointment. 603.644.8334


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