MS is a progressive disease characterized by demyelination of nerve fibres of the brain and spinal cord. It begins with an inflammatory process followed by loss of myelin that surrounds the nerve axon and eventually scar tissue develops causing a disruption of nerve transmissions. As the scar tissue increases, symptoms become more severe.
No two clients will have the same presentation because symptoms will vary according to the location and extent of the lesions in the central nervous system. And, because symptoms can change from treatment to treatment, the therapist needs to get a clear picture of the clients current health status. Time is taken to assess the client during every visit. The therapist will ask general health questions in regards to current signs and symptoms, medications and other treatments that may be received. Some examples of assessment include palpation, range of motion testing, strength and sensory testing. Sometimes orthopedic tests are performed in order to detect any secondary conditions.
The therapist will always aim to decrease nervous system firing, avoid inducing fatigue and provide a caring touch and supportive environment for the client. Treatment is performed in the context of a relaxation massage and only mild to moderate pressure is used throughout. Specific treatment goals include maintaining and improving both soft tissue and joint health, maintaining and improving joint range of motion, limiting contractures and also decreasing swelling and muscle spasticity. Treatment will also address postural changes and any secondary conditions that may be occurring.
There will also be an individual self care plan designed to encourage relaxation, improve functional ability and educate the client about maintaining tissue health. Moderate exercises have been found to be beneficial. Yoga and tai chi will improve flexibility, balance and coordination.