7 Things a Neurologist Wants You to Know About Multiple Sclerosis

Bust the myths—and get the truth—about MS.

Medically reviewed in June 2020

Updated on April 7, 2022

A young MS patient talks to her neurologist.
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Multiple sclerosis (MS) is a complex autoimmune condition that may affect up to 1 million people in the United States, according to the National Multiple Sclerosis Society. Because it can look so different from person to person, myths about MS abound, from whether or not it’s treatable to what the future holds for someone with the condition.

Neurologist Ellen Lathi, MD, director of the Elliot Lewis Center for MS Care in Wellesley, Massachusetts, helps clear up some of the most common misunderstandings about MS and what the outlook is for patients.

Two pairs of infant feet.
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MYTH: One thing causes MS

Although having a close family member with MS can slightly increase a person’s risk for it, the genetic component is only a piece of the puzzle of factors leading to the condition. Dr. Lathi says that between identical twins, if one has MS, the other has a 20 to 30 percent chance of also developing it. For close family members, the risk increase is much smaller, at under 5 percent. That leaves considerable room for environmental factors. So what are they?

“The best example is probably vitamin D,” says Dr. Lathi. This hormone “plays a role in the risk of MS, perhaps dating back to in utero and certainly in childhood, adolescence and young adulthood,” she says, referring to a possible link between reduced levels and MS risk.

MS risk differs by geography, as well. Though it's been questioned, it's widely believed that distance from the equator is a factor—that the further away you live, the higher your likelihood of developing the condition.

Dr. Lathi also cites smoking as another environmental factor. She notes that although birth month has been tied to MS risk, the association might trace back to vitamin D and the mother’s reduced exposure to vitamin D-triggering sunlight during a winter pregnancy. Women who have concerns about vitamin D levels in pregnancy should talk with their healthcare practitioner.

Group of people with their arms around each other.
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MYTH: It's mostly older people who develop MS

"This is an old wives' tale,” says Dr. Lathi. The group MS affects most is women of childbearing age, although it can strike any age group and men or women, she says. “People are often diagnosed in the prime of their lives,” in their 20s to 40s, she says.

MS can follow different patterns, Dr. Lathi says. The most common disease course involves relapses and remissions and tends to strike younger women more than older people or men. Another MS pattern, one that affects about 15 percent of people with MS, is a more consistently progressive course. This type tends to have an older average age of onset and affect men and women equally.

Many patients experience both, starting with the relapsing–remitting pattern and then shifting to a progressive pattern that still involves detectable disease flares, says Dr. Lathi. Still another patient group may have only one episode of MS-like symptoms and until another one occurs, will be described as having a “clinically isolated syndrome” rather than MS.

Elderly woman and caregiver walking down hallway.
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MYTH: You'll end up in a wheelchair

Patients with MS tend to visualize a life of “severe disability,” says Dr. Lathi. But that outcome is not inevitable.

From onset of the condition, the median time to severe disability is about 23 years, Dr. Lathi says. While some with MS end up in a wheelchair, about two-thirds will be capable of walking, though they may need an aid, like a cane, to get around. Others, due to weakness or balance issues, may need a wheelchair or scooter to manage.

Pregnant woman is cradled by her partner.
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MYTH: Getting pregnant isn't safe

Dr. Lathi calls this idea “nonsense” and says it’s a concept “left over from years and years ago.” Having the MS diagnosis “should not affect a patient’s decisions about family planning,” she says. “Women with a disability can have a normal pregnancy if they choose to have a family. Pregnancy is not a bad thing for MS.” In fact, some women find their MS symptoms ease during pregnancy.

Other women may be affected, depending on the status of the MS. They may have a greater risk for a small-for-gestational-age baby, or difficulty walking in late-stage pregnancy due to gait problems. Women also may experience more relapses than usual in the six months after delivery.

Have concerns?

  • If you're considering pregnancy or are already pregnant, talk with your healthcare practitioner about what special steps, if any, to consider, including questions about your MS therapies.
  • Online support groups are also available for parents or impending parents with MS. MSConnection is a good place to start looking.
Group exercises while sitting in chairs.
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Myth: Exercise is bad for MS

“We recommend an individualized exercise plan for everyone with MS,” says Dr. Lathi. Patients will sometimes say that they can’t exercise because of their fatigue, but “a consistent exercise plan is one of the best ways to combat fatigue,” she says. It also may help keep disability delayed or at bay.

Some people with MS do feel a transient worsening or flare of their symptoms when they get hot during exercise, Dr. Lathi notes. Although the effect is temporary and does not cause progression or nerve damage, people with MS whom heat affects negatively should use strategies to stay cool, she says. These tactics can include sticking around an air conditioning on hot, humid days or even buying a cooling vest.

Happy elderly couple on beach.
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MYTH: MS progresses quickly

The idea that MS is swiftly fatal “couldn’t be farther from the truth,” says Dr. Lathi. While life expectancy for people with MS is seven years shorter than average, it's improved significantly over time. "We believe this is due to treatment breakthroughs, improved healthcare and lifestyle changes," she adds.

Because some MS-related complications can be managed or even prevented, it's important to live healthfully and get necessary care, including screenings for diseases like cancer.

In rare cases, MS can be fatal in patients who have a rapidly progressing form of the condition.

Closeup of an intravenous drip.
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MYTH: MS can't be treated

The form of MS that flares and then shows remission is treatable, says Dr. Lathi. The goal with MS drug therapy is to reduce the flares, or relapses, and slow progression of disease. A variety of these disease-modifying drugs are available, and patients should speak to their healthcare practitioners about their choices, including side effects, she says.

But the therapies aren’t failsafe. “Even with these medicines, people with (relapsing) MS continue to experience disease activity and worsening disability,” says Dr. Lathi. For people with the progressive pattern of disease, the first-ever U.S. Food and Drug Administration (FDA)-approved drug became available only in March 2017, she says. Patients with relapsing or progressive MS can receive the drug, called Ocrevus, in infusions delivered every six months. It is the 15th FDA-approved disease-modifying drug for MS, says Dr. Lathi.

Slideshow sources open slideshow sources

National Multiple Sclerosis Society. MS Prevalence. 2022. Accessed April 7, 2022.
Willer CJ, Dyment DA, et al. Twin concordance and sibling recurrence rates in multiple sclerosis. Proceedings of the National Academy of Sciences of the United States of America. 2003 Oct 28;100(22):12877-82.
Hansen T, Skytthe A, et al. Concordance for multiple sclerosis in Danish twins: an update of a nationwide study. Multiple Sclerosis Journal. 2005;11(5):504-510.
USCF Multiple Sclerosis and Neuroinflammation Center. About Multiple Sclerosis. 2022. Accessed April 7, 2022.
National Multiple Sclerosis Society. Who Gets MS? (Epidemiology). 2022. Accessed April 7, 2022.
National Multiple Sclerosis Society. Vitamin D. 2022. Accessed April 7, 2022.
MS Society (UK). New research - vitamin D in pregnancy. December 2, 2016. Accessed April 7, 2022.
Baylor Medicine. Multiple Sclerosis. 2022. Accessed April 7, 2022.
Centers for Disease Control and Prevention. The Prevalence of Multiple Sclerosis in 3 US Communities. January 2010. Accessed April 7, 2022.
National Multiple Sclerosis Society. Primary progressive MS (PPMS). 2022. Accessed April 7, 2022.
National Multiple Sclerosis Society. Types of MS. 2022. Accessed April 7, 2022.
Confavreux C, Vukusic S, et al. Relapses and Progression of Disability in Multiple Sclerosis. New England Journal of Medicine. November 16, 2000. 343:1430-1438.
Multiple Sclerosis Trust (UK). Expanded Disability Status Scale (EDSS). January 2020. Accessed April 7, 2022.
March of Dimes. Multiple Sclerosis and Pregnancy. January 2014. Accessed April 7, 2022.
National Multiple Sclerosis Society. Pregnancy and Reproductive Issues. 2022. Accessed April 7, 2022.
Coyle PK. Management of women with multiple sclerosis through pregnancy and after childbirth. Therapeutic advances in neurological disorders. 2016. 9(3), 198–210.
National Multiple Sclerosis Society. Parenting. 2022. Accessed April 7, 2022.
National Multiple Sclerosis Society. Multiple Sclerosis: Just the Facts (brochure). 2013. Accessed April 7, 2022.
U.S. Food & Drug Administration. FDA approves new drug to treat multiple sclerosis. March 28, 2018. Accessed April 7, 2022.
U.S. Food & Drug Administration. Medication Guide: Ocrevus (ocrelizumab) injection, for intravenous use. March 2017. Accessed April 7, 2022.

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