In the latest of their ‘Medical Case Book’ series, the team at Integro Medical Clinics explore living with and managing the symptoms of multiple sclerosis with cannabis medicines.
Multiple sclerosis (MS) is an autoimmune condition, which has several different forms and levels of severity.
It occurs when the body’s immune system malfunctions and attacks a healthy part of the body, in the case of MS, the brain or spinal cord of the nervous system.
The attacked layer that surrounds and protects the nerves is called the myelin sheath. This damage to the sheath and underlying nerves, means that messages travelling along the nerves become slowed or disrupted.
Exactly what causes the immune system to act in this way is unclear, but most experts think a combination of genetic and environmental factors is involved.
MS can affect the brain and spinal cord, causing a wide range of potential symptoms, including problems with vision, speech, arm or leg movement, sensation or balance. It’s a lifelong condition that can sometimes cause serious disability, although it can occasionally be mild. In many cases, it’s possible to treat symptoms.
It’s most commonly diagnosed in people in their 20s and 30s, although it can develop at any age. It’s about two to three times more common in women than men and is one of the most common causes of disability in younger adults.
The symptoms of MS vary widely from person to person and can affect any part of the body.
The main ones include fatigue, back and neck pain, difficulty walking, vision problems, problems controlling the bladder, numbness or tingling in different parts of the body, muscle stiffness and spasm, issues with balance and coordination and problems with thinking, learning and planning.
Depending on the type of MS you have, your symptoms may come and go in phases or get steadily worse over time. MS starts in one of two general ways: with individual relapses (attacks or exacerbations) or with gradual progression.
Relapsing remitting MS
More than eight out of every 10 people with MS are diagnosed with the relapsing remitting type.
Someone with relapsing remitting MS will have episodes of new or worsening symptoms, known as relapses.
These typically worsen over a few days and these relapses can last from as little as a week to many months, then slowly improve over a similar time period.
Relapses often occur without warning but are sometimes associated with a period of illness or stress. The symptoms of a relapse may disappear altogether, with or without treatment, although some symptoms often persist, with repeated attacks happening over several years.
Periods between attacks are known as periods of remission – these can last for years at a time.
After many years (usually decades), many, but not all, people with relapsing remitting MS go on to develop secondary progressive MS.
In this type of MS, symptoms gradually worsen over time without obvious attacks. Some people continue to have infrequent relapses during this stage.
Around half of people with relapsing remitting MS will develop secondary progressive MS within 15 to 20 years, and the risk of this happening increases the longer you have the condition.
Primary progressive MS
Just over one in 10 people with the condition start their MS with a gradual worsening of symptoms.
In primary progressive MS, symptoms gradually worsen and accumulate over several years, and there are no periods of remission, though people often have periods where their condition appears to stabilise.
There’s currently no cure for MS, but a number of traditional treatments can help control the condition including steroids, specific treatments for individual MS symptoms and disease-modifying therapies and medicines.
Cannabis medicines & MS symptom control
Many patients have found that using Cannabis medicines to control their MS symptoms can be incredibly helpful.
Dr Anthony Ordman, senior clinical adviser and hon. clinical director at Integro Medical Cannabis Clinics said: “Over the years I have treated many MS patients in my clinics. Whilst they generally receive excellent care for their MS, the secondary conditions such as chronic back pain can be neglected.
“Traditional pharmaceutical pain medicines often have unpleasant side effects such as brain fog and constipation and frequently stop working after a few weeks. Cannabis medicines can prove extremely helpful in the pain management of MS patients pain because they reduce muscle spasm and inflammation.”
The wholistic approach
In the overall management and improvement in quality of life for a patient, many elements need to be assessed and different approaches tried to see if they work for the individual.
Emotional support and being monitored and listened to by a trusted healthcare professional are absolutely vital. At Integro Medical Clinics specialist cannabis practise nurse, Sophie Hayes, is very experienced in dealing with MS patients and on call to support and deal with any questions they may have.
“Managing the symptoms of MS often requires a multi-disciplinary approach. Every individual’s presentation is different and benefits from a combination of pharmacological and non-pharmacological methods,” said Sophie.
“These can include physiotherapy exercises, Transcutaneous Electrical Nerve Stimulation (TENS), cooling and/or heat therapy, supportive braces, alternative therapies and CBT.
“In addition to this, cannabis medicines can be a useful prescription to help manage the pain and relax the muscles. This can enable individuals living with MS to engage with these methods and regain a greater sense of control over their symptom management.
There are several organisations in the UK that MS patients can turn to including the National Back Pain Association – BackCare, the MS Society and the MS Trust (see contact details below).
Denice Logan Rose, executive director, BackCare, commented: “BackCare can offer practical and emotional support to MS patients living with back pain through education, information, advice and a small network of UK based branches.
“Even though it can be one of many side effects of MS it should not be underestimated the distress back pain can cause. Turning to an organisation like BackCare for support can help alleviate the stress, anxiety and discomfort that arises from the added complication of back pain.”
She continued: “Back and neck pain can affect MS patients for a number of different reasons. For example, spasticity, sitting in one position for too long, incorrect use of mobility aids, struggling with mobility, or possibly the same type of wear and tear that many people without MS experience.
“These pains can often get neglected within the overall larger framework of an MS diagnosis.
“At BackCare we are constantly investigating new approaches to back pain management to try to help people living with MS to have an improved quality of life and less discomfort.”
The patient’s story
Sarah Martin is a seasoned cannabis advocate and activist for Project 21. She is 51-years-old and first began to manifest symptoms of MS in 2002.
However, it was misdiagnosed for a couple of years as Dion Beret syndrome.
“As time passed the symptoms spread from numb feet and mood swings with depression, to an absolute physical inability to get out of bed or make a cup of tea. Even swallowing and speech became a challenge,” Sarah said.
She was then correctly diagnosed with relapsing and remitting MS but refused to be treated in hospital and struggled on at home.
Sarah was at her lowest ebb, when a friend suggested to her that she try cannabis, as she had heard it could have a positive effect on MS symptoms.
“At once my leg spasms reduced and the constant ache, I felt in my body decreased,” she added.
“I was finally able to get a good night’s sleep and relax, leading to a huge elevation in my mood.”
Sarah has become a dedicated cannabis proponent and continues to use medical cannabis to improve the quality of her life and control her MS symptoms.
Dr Anthony Ordman added: “Integro Clinics Ltd always recommend remaining under the care and treatment of your GP and specialist for your condition, while using cannabis-based medicines, and the Integro clinical team would always prefer to work in collaboration with them.”
If you would like further information, or to make an appointment for a medical consultation, please contact us at Integro Clinics:
To contact BackCare: +44 (0) 208 977 5474
https://www.mssociety.org.uk/care-and-support/local-support – @mssocietyuk
https://www.ms-uk.org/ – @MSUK6
https://mstrust.org.uk/about-ms – @MSTrust
https://shift.ms/ – @shiftms
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