Getting treatment for MS | MS Society

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You have the right to ask about getting treatment for your MS. This is true no matter what kind of MS you have – or how long you’ve had it.

Some treatments help with the symptoms of MS, while others control MS itself. With these treatments you can get fewer and less serious relapses, and disability progression may slow down.

First questions about MS treatments

Who do I ask about treating my MS?

It’s best you speak to an MS specialist, like a neurologist who has many patients with MS. An MS nurse can also talk about treatments in general. Only an MS specialist can give you advice on treating your MS and prescribe drugs for you.

To see your specialist you don’t have to wait for your next appointment to come round. You can ask to see them before then. Ask your GP or MS nurse to book one for you.

If you don’t already have an MS specialist, ask your GP to refer you to one.

> Find out who’s who in the health care system

When should I ask about treatment?

Official guidelines say everyone with MS should be offered an appointment with a specialist at least once a year to talk about their care. This is true no matter what kind of MS you have and whether you’re already on treatment or not. This is a chance to talk about how your MS might be treated.

If you haven’t seen a specialist for quite a long time you have the right to ask for an appointment. And if your yearly review doesn’t happen, you should ask your GP, MS nurse or neurologist about getting one scheduled. It’s never too late to think about treatment.

If you’ve just been told you have MS, guidelines say your neurologist should have spoken to you about treatment and given you information on it when you were diagnosed. Within six weeks of this you should get a follow-up appointment where you can talk about your treatment choices.

I have relapsing MS.

What are my options?

If you have relapses with your MS, over a dozen drugs can now slow down this sort of MS and reduce relapses. They’re called disease modifying therapies (DMTs). Talk to your specialist about them if they haven’t already mentioned them.

DMTs won’t cure MS but they can slow it down and mean you get fewer relapses. They range from less hard hitting drugs with fewer side effects to stronger ones with more serious side effects.

There’s a wide range of drugs and other therapies that can help with specific MS symptoms. And steroids can help you get over a relapse sooner. Talk to your specialist, MS nurse or GP about these.

I’ve got relapsing MS and I don’t think drugs are working

There are a number of very effective DMTs for relapsing MS.

If you don’t feel the drug you’re taking is controlling your relapses well enough, talk over other possible MS relapse treatments with your neurologist or MS nurse. This might include the stem cell therapy HSCT. In the UK HSCT is only an option if two DMTs haven’t worked for you.

My MS is progressive. Is there a treatment for me?

For most people with progressive MS DMTs don’t work. The exception is if your MS is progressive but is classed as ‘active’. This means you still get relapses, or doctors see inflammation on your MRI scans. If you have secondary progressive MS and it’s ‘active’ then two DMTs might help you – Extavia (which is one of the beta interferons) or siponimod (Mayzent).

A new DMT called ocrelizumab (Ocrevus) can work against primary progressive MS early on and if inflammation can be seen on your MRI scans. You also need to have a score on the Expanded Disability Status Scale (EDSS) between 3.0 and 6.5. A score of 6.5 means you need two walking aids – such as canes or crutches – to walk 20 metres without having a rest. This drug has been recommended for use on the NHS for this kind of MS since 2019 in England, Wales and Northern Ireland, and in Scotland since the start of 2020.

If your MS is progressive then HSCT isn’t likely to help you unless you have early primary progressive MS and inflammation is seen on your MRI scans.

But there are lots of treatments, therapies, lifestyle changes and devices that help with the symptoms or disability caused by progressive MS. Ask your GP, MS nurse or neurologist for help.

Our researchers are working to find treatments for progressive MS.

What to do when

I’m not happy with what my specialist says

Maybe you don’t agree with what your specialist says about treating your MS. Or perhaps you don’t understand the information they’ve given you.

It’s worth first talking to your neurologist about your concerns or if you’d like to consider a different course of treatment.

You can ask for a second opinion from another MS specialist. Discuss this with your neurologist, your GP or with the hospital or clinic where you were seen.

However, this could mean having to travel to a different hospital and your treatment could start later. Talk this through with your specialist to see what a delay might mean for you.

> Find out more about getting a second opinion on the NHS choices website

I’ve got a long wait to see my neurologist

It can be difficult to get an appointment with a neurologist and long waiting times are sometimes an issue.

Neurologists are meant to follow NICE recommendations and offer everyone with MS a comprehensive review of all aspects of their care at least once a year.

While you’re waiting to see your neurologist, we recommend speaking to your MS Nurse about your treatment options so you’re prepared when you see them.

If you’ve been waiting a long time for an appointment with a neurologist and are concerned about the impact on your MS, please get in touch with at [email protected]. Sharing your experiences helps us make the case locally for MS services and campaign for better access to treatments.

If you’ve been waiting a long time for an appointment with a neurologist and would like some information and support on what services are available to you, please contact our Helpline on 0808 800 8000 or at [email protected].

I’ve been denied an NHS treatment for my MS

When you have a diagnosis of relapsing MS, your neurologist should guide you through which treatments you’re eligible for and help you make a decision.

If you feel you’re not being prescribed a DMT you’re eligible for, this could be due to a number of different reasons. If you have a clinician who’s reluctant to prescribe you a treatment, that doesn’t mean you’re not eligible for any. It’s important to be aware of your treatment options before you see your specialist.

If you’re unclear about why you’re not being offered your preferred treatment option, we may be able to help. Contact your local Regional External Relations Officer who may be able to raise the issue with decision-makers locally.

I’ve been denied a NHS treatment that’s not currently approved for MS

Some treatments that could help you have either been rejected by your national level commissioner or haven’t been reviewed for treating MS on the NHS yet.

Whether you’ll have any success accessing these treatments will depend on how expensive they are for your local NHS to fund and whether national commissioners have explicitly recommended they shouldn’t be used.

For exceptional circumstances it is possible to receive NHS funding through applying for an individual funding request.

I want to explore Individual Funding Requests or Individual Patient Treatment Requests

To access treatments that haven’t been approved for MS on the NHS you may want to try to get an Individual Funding Request (IFR) or Individual Patient Treatment Request (IPTR) in Scotland. These are to request funding for people who are considered to have exceptional clinical circumstances. They have to be submitted by a healthcare professional.

These requests are submitted to your local commissioner. The treatments are not routinely available and it’s unlikely funding will be granted for a non-approved treatment where there are lots of people who’d like to access it for the same reason.

Your neurologist will be able to advise you on the likely success of submitting a request.

I want to get HSCT for my MS

HSCT is now being funded by the NHS for people with relapsing MS who have continued to have relapses despite taking two other DMTs. However, it’s not yet widely available.

NICE will review HSCT for the NHS in England and Wales once they have enough clinical trial evidence. This appraisal will decide whether it should be made more widely available.

> Find out more about HSCT

Find out about your rights in different parts of the UK

England and Wales

The National Institute of Health and Care Excellence (NICE) are responsible for approving DMTs for England and Wales. Once NICE approves a treatment, the NHS across England and Wales has three months to implement that guidance. Once that has happened patients are legally entitled to be prescribed the treatment (so long as they meet the eligibility criteria ).

Northern Ireland

The Department of Health, Social Service and Public safety has formal links with NICE. Once NICE approves a treatment it’s reviewed locally for applicability to Northern Ireland. Where appropriate it’s then endorsed for implementation in Health and Social Care (HSC). This process should be completed within 8 weeks.

Scotland

The Scottish Medicines Consortium (SMC) is responsible for approving DMTs in Scotland. When the SMC approves a DMT, the NHS boards in Scotland take it into account when they decide which medicines are available in their area. But they don’t have to follow the SMC decision.

Making an official complaint

Making a complaint in England and Wales

If a NICE approved treatment that you’re eligible to take is unavailable in your area, you can make an official complaint.

Officers from the Patient Advice and Liaisons Service (PALS) are available in all hospitals. They offer confidential advice, support and information on health-related matters to patients, their families and carer.

Making a complaint in Northern Ireland

If you have a complaint about your level of treatment you can contact the Patient and Client Council who support NHS patients with complaints in Northern Ireland.

> Find contact details for each health trust’s complaints department

Making a complaint in Scotland

If you have a complaint about your level of treatment you can contact the Patient Advice and Support Service (PASS) who provide free, confidential advice and support for NHS patients in Scotland.

Take political action

If you’re repeatedly denied a treatment you feel you’re eligible to take, you can contact your MP, SMP or Assembly Member to help you challenge the decision. Find out who your representatives are here.

Contact our MS Helpline on 0808 800 8000 for support and information about taking this step.

Talking about treatments – questions to ask my MS specialist

MRI and MS: 7 things you need to know

MRI plays a vital role in how we diagnose and monitor MS. In fact, over 90% of people have their MS diagnosis confirmed by MRI.

1. What is MRI?

Magnetic resonance imaging, or MRI for short, uses strong magnetic fields to see inside the body. It’s particularly useful in MS as it allows us to measure what’s happening in the brain and spinal cord.

2. Why are MRI scans important for an MS diagnosis?

In MS your immune system attacks the myelin coating surrounding nerves. MRI scans can pick up these areas of damage, called lesions, in different parts of your central nervous system.

MRI has shaped how we monitor and treat MS too. It’s used to build a picture of how someone’s MS is changing over time. This can help to decide if a treatment is working.

Research has highlighted the benefits of regular MRI scans to monitor MS and inform treatment decisions. But, there’s lots of factors to consider when deciding how often to have a scan. It’s best to discuss this with healthcare professionals

3. What’s it like to have an MRI scan?

During an MRI scan you’ll be asked to lie flat on a bed that’s then moved inside the scanner. The scan usually lasts for 15 to 90 minutes, depending on how many images are being taken.

Although the procedure is painless, the machine itself can be very noisy. You’ll also be asked to keep as still as possible during the scan, so it’s important to get comfortable before it starts. 

Read MS blogger Nicola’s tips on having an MRI scan.

4. Are there different types of MRI scans?

There are a number of different images that can be taken during a single MRI session.

A common type of MRI for MS is a T2-weighted scan, which detects all areas of myelin damage in the brain and spinal cord. Doctors may also use a type of scan called FLAIR, which makes it easier to spot the lesions.

Doctors will also use a contrast agent called gadolinium with a T1-weighted scan to focus on newer, active lesions. Gadolinium only highlights active damage because it can’t enter the brain unless there’s inflammation.

5. Can an MRI explain my symptoms?

What we can see on an MRI scan can explain the symptoms you might be experiencing. But it doesn’t always.

This is because many lesions may be in areas of the brain that don’t produce symptoms. And some areas of damage that could be causing symptoms might be too small to see on the scan.

6. How does MRI work?

MRI measures how much water there is in the body. Because different parts of the brain have different amounts of water, we can use MRI to distinguish them and build up pictures of the central nervous system.

The protective myelin coating is a fatty substance, so it repels water. This means we can measure how much myelin is present because it looks different to nerves and other cells in the brain on a scan.

7. What’s the future of MRI research?

Researchers sometimes rely on MRI scans in clinical trials to see the effect of a particular treatment. MRI scans can give us a window into the brain to see whether new treatments look promising much earlier on, before symptoms of progression even appear.

New, more powerful scanners will help us to detect even more subtle changes in the brain and spinal cord in MS. Improvements in MRI technology also mean we can run shorter trials to test the potential of new MS drugs, speeding up the whole development process.

Assign tests to students using Microsoft Teams

Microsoft Teams for Education More…Less

The Assignments feature in Microsoft Teams allows you to send quizzes created in Forms to students. It allows students to take tests right in Teams, and you to assign grades.

Assign a test to students in Teams

org/ItemList”>

1. Go to the desired class team and select Jobs .

2. Select “Create > quiz”.

3. Select “+ Create Test ” to create a test or select an existing one. Use the search bar if you don’t see the quiz you’re looking for right now.

Note: Selecting “+Create test ” will open a new web browser window on the device. Create a quiz in Forms and then switch back to Teams. The new test will now be available for students to select and assign.

After selecting the required test, it will appear in the task in section “Instructions” . Enter the rest of the job parameters and select Assign .

Students will be able to submit a quiz directly to Teams where you can grade it.

Note: Forms automatically calculate scores for queries with multiple choices . For more information about viewing and returning test results, see Teams in this article.

Evaluate and return feedback to students

1. Select “Assignments” in the desired class team, and then select the test.

   By default, assignments are displayed in order of completion and show how many students submitted each assignment.

2. org/ListItem”>

   On the Return tab, you will see that all students have been assigned a test and their work status is: Not Passed” , “ Reviewed” and “Passed” .

   Select “Enabled ” next to the student’s name to check.

   Tip: You can open multiple tests to review and grade at the same time. On the Check In tab select the Status drop-down list to sort students by assignment status. Select the checkboxes for students who turn in work, and then select the highlighted group to open it.

3. The assignment grade view opens for the student’s test scores. When reviewing, you can:

   Select “Review” next to to move from question to question when viewing a student’s test.

   See automatic replies with multiple choices. Forms will already have calculated scores, but you can change the score to receive partial or additional credit.

   leave feedback for one answer.

   Review the short answers and questions and add points.

   Select at the top of a test to provide comments for the entire test.

   When working with multiple tests that are enabled at the same time, use the drop-down menu on the People tab to navigate between students.

4. To publish a student’s grade and return the grade, select More options > grade .

   Select “Post” to submit your final feedback and scores.

5. Return to the assigned puzzle and update it. Tests that you have completed and returned will be displayed on the “Returned ” tab.

If you need to collect responses from students outside of a test scenario, you can still use assignments to distribute a form or survey completed in Forms.

1. In Microsoft Forms, select the form or survey you want to assign.

2. drop menu “Share” copy the link to the form.

   Note: Verify that the view permissions are set according to your needs in the script. With assigned to students, only members of my organization can respond to privacy requests at your school or district, and anyone with the link can be helpful in submitting forms to families.

3. Open Teams and go to the Assignments tab in the class team. Just as you would create a new assignment for a Jew, select “Create > assignment” .

4. Complete the assignment instructions and select Add Resources .

5. From the Resources menu, select the ” Link” tab, and then paste the “Form” link you copied earlier and enter the display text. Select “Connect”.

6. Fill in any remaining assignment information, and then select “ Assign”.

Additional information

Microsoft Forms for Education

Create a quiz using Microsoft Forms

Create an assignment in Microsoft Teams

Set up branching in a Microsoft Forms form or quiz

View assignment details in Microsoft Teams (for students)

Pass professional testing for free in Moscow

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