What is Multiple Sclerosis?
According to MS Australia, Multiple Sclerosis is a condition that affects the central nervous system (CNS), and interferes with nerve impulses within the brain, optic nerves and spinal cord. It is characterised by the presence of sclerosis, or scars, that appear on the CNS and may develop different symptoms depending on where they form.
Over 25,600 Australians live with MS and approximately two million people are diagnosed around the world. The majority of people diagnosed with MS are between the ages of 20-40 years old but can manifest in people outside of this age range. Women are most susceptible to developing the disease, with them being three times as likely to get the disease than men.
What are the symptoms of Multiple Sclerosis?
Symptoms of Multiple Sclerosis are varied and can differ depending on where the scarring has occurred within the CNS. The degree of severity of these symptoms will also be unique to each person with the disease.
The following is a list of the most common symptoms
One of the most common symptoms and occurs in roughly 80% of cases
Muscle stiffness and occasional spasms, most often in the legs
Caused by not using certain muscles in the body due to nerve damage
Often the first symptom arising, numbness or tingling in the face or body is common
- Difficulty walking
Related to several factors including loss of balance, weakness, spasticity and fatigue
- Vision impairment
Blurred vision, pain on eye movement, poor colour contrast are often early symptoms
- Bowel and bladder problems
Incontinence and bladder issues happen in 80% of cases and loss of control of bowels or constipation are often experienced
- Dizziness and vertigo
Feeling off-balanced or like the world is spinning all around you
- Sexual health problems
Sexual responses may be inhibited due to damage in the CNS as well as the other symptoms mentioned in this list
- Emotional changes
Can often be a reaction to life changes due to living with MS. Mood swings, episodes of uncontrollable laughing or crying, irritability and other mental health problems are often faced by those with MS.
Found to be one of the most common symptoms of MS and is more common amongst people with MS than in the general population
- Cognitive changes
Change in high-level brain function impacts 50% of those with MS and may include having difficulty processing information, organising, problem-solving, focusing their attention, memory issues and difficulty in learning
- Pain and itching
A study found that 55% of MS patients experience significant pain, and nearly half experiences chronic pain
There are some symptoms that are less common among those with Multiple Sclerosis and include:
- Speech Problems
Slurred speech or having a softened voice occurs in about 25-40% of people with MS
- Hearing loss
Some people with MS experience impaired hearing and is sometimes found to be an initial symptom of the disease
- Breathing problems
People whose chest muscles have been weakened and damaged by the nerves that control these muscles often have difficulty breathing
Seizures have been estimated to occur in 2-5% of people with MS
- Problems swallowing
Is generally a result of the damage done to the nerves and muscles around the mouth and throat
Uncontrollable shaking can occur in different parts of the body due to the damaged areas of the nervous system that are responsible for the coordination of movement
What causes Multiple Sclerosis?
It is still unknown what causes Multiple Sclerosis initially, but scientists generally believe that it can be caused by a number of factors.
Research into knowing more about how it is caused will help discover more effective ways to treat it in the future.
What is understood is that the scarring on the CNS is caused by an immunological response, where the body’s immune system attacks other parts of the body that it thinks are foreign.
Environmental factors are also believed to play a role in developing the disease. A low level of vitamin D has been linked as a risk factor for MS, as well as smoking and obesity. A higher risk of developing the disease has also been linked to living further away from the equator.
MS is not a genetically transmitted disease, meaning that it can’t be passed down from parent to child. Despite this, studies found that with identical twins, if one gets MS the possibility of the other twin developing it is a 1 in 4 chance.
There are a few unproven theories that have been discussed and researched as a possible cause of MS. Many of these don’t have substantial evidence to prove their effect on MS development. These theories include:
- Environmental allergies
- Exposure to household pets
- Exposure to heavy metals such as mercury, lead and manganese.
- Organic (chemical) solvents
Medicinal CBD for Multiple Sclerosis
Research has shown potential success in easing some symptoms of MS in patients. Less evidence has been found for the effect CBD has on eliminating the disease itself.
A study published in 2014 performed a systematic review of medical marijuana studies and clinical research, and its effectiveness and safety on symptoms of MS, epilepsy and movement disorders. This evidence-based systematic review sought to answer the following questions regarding the safety and efficacy of cannabinoids in relieving/reducing the symptoms of:
- Spasticity in patients with multiple sclerosis (MS)
- Central pain and painful spasms in MS (pain could be from any etiology, including spasticity, but excluding neuropathic pain)
- Bladder dysfunction in MS
- Involuntary movements, including tremor
The review found evidence that oral cannabis extract (OCE) was effective and tetrahydrocannabinol (THC) is probably effective at treating spasticity in MS patients in patient-centered measures. Muscle spasticity is common for around 90% of people with MS. Research also found that OCE is effective and THC and nabiximols (a form of cannabis in a pill) are probably effective in the treatment of central pain or painful spasms.
It was found that nabiximols were probably effective in treating bladder issues but TCH and OCE were found to be ineffective in treating urinary complaints in MS patients. More research will need to be done when looking into the effectiveness of cannabis on tremors, as TCH and OCE were found to be probably ineffective and nabiximols were possibly ineffective.
The risks and benefits of medical marijuana should always be weighed carefully, with the risk of serious adverse psychopathological effects found to be just under 1%. The research review could not report on the comparative effectiveness of marijuana for these symptoms when compared to alternative therapies and/or medication.
The Multiple Sclerosis and Extract of Cannabis (MUSEC) study, one of the clinical studies that was included in the systematic review of medical marijuana, reported results of whether cannabis extract eased muscle stiffness and the pain associated with it. Participants aged 18-64 who had stable MS for at least 6 months and muscle pain/stiffness for the past 3 months before enrollment were chosen to undertake this study and were evenly allocated into the cannabis group or the placebo group. The primary measure of success was an 11 point CRS to evaluate the participant’s perceived change in muscle stiffness after 12 weeks of treatment compared to before the study.
The research found substantial evidence that the group that took the cannabis extract had eased muscle pain/stiffness by double that of participants who were on a placebo. Sleep quality was also tested in this study, and participants who took cannabis reported a higher quality of sleep compared to the placebo group.
Their fundings suggested that standardised cannabis extract can be clinically useful in treating the phenomenon of spasticity in MS patients and that utilising an 11 point numerical scale of rating change throughout a study is an effective way of measuring the treatment effect of relief from muscle stiffness. Effective pain relief through the use of cannabis extract was especially common in patients that had a very high baseline pain score.
Could CBD cure Multiple Sclerosis?
MS Australia points to the success of medical marijuana when used to treat symptoms such as pain and spasticity due to many people experiencing relief when taking it and plenty of evidence from scientific studies and research. They do only suggest this as a last option for the management of these symptoms and ask that people with conditions such as psychotic or mood disorders steer clear of it due to its possible side effects.
There is further research being done into the success of CBD in the easing of bladder, ataxia, tremors, spasms and sleeping difficulties, with hope for the future for people who suffer these symptoms.
The research review found some evidence that medicinal CBD for multiple sclerosis can be beneficial in treating muscle spasticity, stiffness and pain, as well as with central pain. Some MS symptoms weren’t effectively treated with the help of medical marijuana, but it is promising to see that muscle spasticity, one of the main symptoms of MS, may be treated with cannabis.
In the MUSEC study, the overall rate of relief from pain was 15% higher in the cannabis extract group than in the placebo group. It was found that cannabis extract can be effectively used to relieve the symptoms of spasticity and muscle stiffness and pain.
As always, further research will need to be taken to find definitive evidence that cannabis can fully ease the pain of these symptoms in the majority of MS patients.
CBD may not be able to completely cure Multiple Sclerosis at this point in time. However, the evidence pointing to its capacity to ease certain symptoms is promising. Certain medical cannabis extracts are likely to help with easing muscle spasticity and body pain.