Health Care Quarterly:

A multiple sclerosis journey: The path to achieve wellness

Physicians define wellness as the process of obtaining optimal health, a journey involving education, planning and action. For the more than 2,500 Southern Nevada residents living with multiple sclerosis, this journey is often filled with day-to-day obstacles. MS is an autoimmune disease in which the body’s immune system mistakenly attacks tissues, causing life-altering and debilitating symptoms. The team at the Mellen Program for MS at Cleveland Clinic Lou Ruvo Center for Brain Health strives to meet the ever-changing needs of patients by encouraging them to make health and wellness a priority.

MS is a lifelong disease with far-reaching implications causing fatigue and problems with flexibility and movement as a result of spasticity and weakness. With an MS diagnosis, the risk for becoming physically disabled increases; and factoring in poor lifestyle choices, as well as additional health disorders, can make that risk for disability even greater.

Multiple research studies have indicated that maintaining a healthy lifestyle can help improve the quality of life in patients with MS. There are many variables, including exercise, nutrition, lifestyle choices, health maintenance, sleep pattern, mental health awareness and occupational/social/intellectual health.

Exercise: Several investigations have shown that patients with MS are less physically active than the general population. This could be a result of pain or weakness, which are common symptoms, but the lack of physical activity can have wide-ranging and negative effects. Originally, exercise was thought to be unsafe in patients with MS, especially for those living in hot climates like Las Vegas, as increased heat and overexertion can temporarily increase MS-related symptoms as the core body temperature rises. However, unlike previously thought, exercise is considered safe in MS and should be implemented in weekly routines. Aerobics and muscle strengthening are recommended, as these can prevent and even improve accumulation of disability, symptoms and overall quality of life. For those living with MS in warmer climates, consider exercising in an air-conditioned room, having cold water and hand-held fans readily available, include frequent rest breaks, and employ aquatic therapy if available.

Nutrition: Those with MS should avoid food that is processed and high in saturated fats, refined sugars and salt. Instead, focus on an anti-inflammatory, plant-based diet that includes fruits and vegetables, whole grains and lean proteins. It is also important to incorporate food that is high in fiber to minimize constipation, a common symptom of MS. Additionally, several studies have shown that vitamin D deficiency is a huge risk factor for MS, which is why we recommend that those living with MS should take a vitamin D3 supplement on a daily basis. Vitamin D dosages are highly variable, so it’s important to discuss how much vitamin D3 one should take with an MS doctor and routinely monitor blood levels.

Smoking and drinking: Smoking is harmful overall and should specifically be avoided in those with MS. One important study indicated that 20 percent of patients with MS smoke tobacco. It is crucial for patients with MS to refrain from smoking, as it is associated with increased risk of progression of disability. The effects of alcohol on MS are less well studied, but it should be used in moderation, especially in combination with medications that are used to treat this disorder.

Health maintenance: There is a complex relationship between MS and other medical conditions, specifically those of the vascular system such as obesity, Type II diabetes and hypertension. It is important to routinely see a primary care provider that is sensitive and reactionary to the needs of MS in order to avoid further complications.

Sleep pattern: Sleep is vital to everyone’s well being, but is especially important in MS. Adults should strive to get eight hours of sleep per night. Regularity is also key in good sleep hygiene- it is important to go to bed and wake up at the same time every day and to create a bed time ritual to help the body slow down.

Mental health awareness: Psychological conditions including depression, anxiety and stress are common in those living with MS and can worsen symptoms. However, there are ways to combat them. Meditation, guided imagery and mindfulness can all help reduce stress, while physical therapy, yoga, and tai chi can improve anxiety, depression and fatigue. These mind-body processes can be beneficial when balancing emotional health and wellness.

Occupational/Social/Intellectual Health: Cognitive changes are common in MS, so it’s vital to take proactive measures to help maintain a healthy brain. Having a good work-life-balance, an active social life and staying mentally sharp are all factors that can improve overall brain health. A rich social life can provide sources of support, reduce stress, combat depression and enhance intellectual stimulation, while staying mentally active with puzzles, crosswords and other card games energizes the brain. Implementing these factors on a daily basis is beneficial for everyone, especially those with MS.


In addition to these tips, those looking for further instruction on how to maintain a healthy lifestyle can make an MS wellness consultation. Unlike general neurological visits that typically focus on changes in the patient’s disease and treatment options, these wellness consultations give individuals a chance to talk to their doctor about their general well being as it relates to MS. These visits are supplemental to the standard MS visits that are provided by the Cleveland Clinic neurology team.

During these consultations, we discuss all of the ways in which to improve MS health and wellness on an individualized basis and how to routinely implement these stepping stones. These consultations are educational and provide important information that is specific to a patient’s current disease state, ultimately helping to improve function and quality of life. Wellness consultations are available by referral from CCLRCBH’s MS neurology care team, which ensures that we are able to provide the best care as we are familiar with the patient’s disease state and have spent time monitoring its progression.

Living with MS is a journey, but the physicians at CCLRCBH are here to serve as a guide to make sure folks stay on the right path. It is strongly recommended that those living with MS schedule an MS examination and wellness consultation at CCLRCBH by calling 702-483-6000 or visit

Dr. Carrie Hersh, DO, MS, is a neurologist at the Mellen Program for MS at Cleveland Clinic Lou Ruvo Center for Brain Health.