Multiple sclerosis (MS) is a chronic autoimmune condition affecting the central nervous system – the brain and spinal cord. The immune system mistakenly attacks myelin, the protective sheath that surrounds nerve fibres. When myelin is damaged, nerve signals slow down, become distorted, or are blocked entirely, causing a wide range of neurological symptoms depending on which nerves are affected.
MS typically follows one of several patterns:
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- Relapsing-remitting MS (RRMS), the most common form, involves episodes of new or worsening symptoms followed by periods of partial or full recovery
- Primary progressive MS (PPMS) involves gradual worsening from onset without distinct relapses
- Secondary progressive MS (SPMS) develops in some people after an initial relapsing-remitting course.
There is no cure, but disease-modifying therapies can significantly reduce the frequency and severity of relapses and slow disability progression.
How common is Multiple Sclerosis?
Approximately 33,000 Australians are living with MS, making it one of the most common acquired neurological conditions affecting young adults in Australia. Women are diagnosed approximately three times more often than men. MS is most commonly diagnosed between the ages of 20 and 40, though it can develop at any age.
Australia has one of the highest rates of MS in the world. The risk of developing MS is higher in people who live further from the equator – a pattern observed globally and reflected in Australia's higher rates in southern states compared to northern regions. This is thought to be related to lower sun exposure and vitamin D levels.
MS symptoms vary widely between individuals and depend on which parts of the nervous system are affected.
Common symptoms include:
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- Fatigue – one of the most common and disabling symptoms of MS
- Numbness, tingling, or prickling sensations in the limbs or face
- Muscle weakness, stiffness, and spasms
- Difficulty with coordination and balance
- Blurred or double vision
- Dizziness
- Bladder and bowel problems
- Difficulty with concentration, memory, and attention
- Tremor
- Speech difficulties
Symptoms may come and go in episodes (relapses), or gradually worsen over time depending on the type of MS. Relapses typically develop over hours to days and may partially or fully resolve.
The exact cause of MS is not fully understood.
It is thought to result from a combination of:
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- Immune system dysfunction – the immune system mistakenly targets myelin, the protective covering around nerve fibres, triggering inflammation and damage
- Genetics – MS is not directly inherited, but having a close family member with MS increases risk. Certain genes are associated with susceptibility
- Environmental factors – lower vitamin D levels (linked to reduced sun exposure at higher latitudes), Epstein-Barr virus (EBV) infection, and smoking have all been identified as risk factors
- Sex hormones – the higher rate in women suggests hormonal influences, though the mechanism is not fully understood
There is no single test that can definitively confirm MS.
Diagnosis requires a combination of clinical assessment and investigations, guided by the Revised McDonald Criteria.
Common investigations include:
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- MRI of the brain and spinal cord – the most important diagnostic tool; detects lesions (areas of myelin damage) characteristic of MS
- Neurological examination – assessment of reflexes, coordination, vision, balance, and sensation
- Visual evoked potentials (VEP) – measure the speed of nerve signals from the eyes to the brain; can detect optic nerve involvement
- Lumbar puncture (cerebrospinal fluid analysis) – examines fluid from around the spinal cord for abnormal immune activity consistent with MS
- Blood tests – to rule out other conditions that can mimic MS
Referral to a neurologist is required for diagnosis and management. Because many symptoms overlap with other conditions, diagnosis can take time.
Treatment for MS falls into two broad categories: disease-modifying therapies (DMTs), which reduce the frequency and severity of relapses and slow disability progression; and symptomatic treatments, which address specific symptoms such as fatigue, spasticity, and bladder dysfunction.
Disease-modifying therapies (DMTs)
DMTs are the cornerstone of MS management for people with relapsing forms of MS. They are grouped broadly by efficacy:
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- Platform/moderate efficacy therapies – including interferon beta preparations (Avonex, Rebif, Plegridy, Betaferon), glatiramer acetate (Copaxone), teriflunomide (Aubagio), dimethyl fumarate (Tecfidera, Vumerity), fingolimod (Gilenya), siponimod (Mayzent), and ozanimod (Zeposia)
- High efficacy therapies – including natalizumab (Tysabri), ocrelizumab (Ocrevus), ofatumumab (Kesimpta), and cladribine (Mavenclad). These are used for highly active disease or when moderate-efficacy therapies have not provided adequate control
Treatment choice depends on MS type, disease activity, individual risk factors, and patient preference. Regular MRI monitoring is part of ongoing management.
Symptomatic management
Physiotherapy, occupational therapy, fatigue management programmes, and medications for specific symptoms (such as baclofen for spasticity or oxybutynin for bladder symptoms) are important parts of comprehensive MS care.
The following specialty medications are available at Ace, a specialty pharmacy for Multiple Sclerosis.
With Ace, you’ll benefit from:
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- Expert Support — Our dedicated team of health concierges is always available to answer your questions, provide guidance, and help you navigate your condition with confidence.
- Specialty Medication — We offer a wide range of specialty medications and support services, designed specifically for those living with chronic illnesses. Whether you’re looking for help managing a specific condition, or simply need access to the medications you need, we’ve got you covered.
- A Wide Range of Conditions — From diabetes to heart disease, and everything in between, we help manage a variety of special condition
Take control of your health and well-being, and start your journey to better health with Ace today.
MS-Specific Support
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- MS Australia – peak national organisation for MS; information, support, and advocacy
- MS Plus – MS support services in Victoria and New South Wales
- MS Queensland
- MS WA
Clinical & Research Resources
