Multiple sclerosis treatment options

Last updated July 7, 2025, by Marisa Wexler, MS
Fact-checked by Inês Martins, PhD

While there’s currently no cure for multiple sclerosis (MS), several treatments are available to manage the disease, improve long-term outcomes, and support a better quality of life.

MS treatment options range from disease-modifying therapies that reduce disease activity and slow MS progression, to treatments that target specific symptoms or help manage acute MS relapses.

In addition to medications, a comprehensive approach to MS care often includes complementary interventions like physical therapy and lifestyle modifications such as exercising and eating a well-balanced diet.

Research is ongoing, and many experimental treatments are being tested in MS clinical trials. The goal is to develop safer and more effective treatment options that maximize MS life expectancy — and, ultimately, find an MS cure.

How is MS treated?

Approved treatments for MS fall under three broad categories:

• Disease-modifying therapies: Medications that can alter the course of MS, reducing the frequency of relapses and slowing the progression of disability
• Relapse management therapies: Treatments that help reduce the severity and duration of disease relapses
• Symptomatic treatments: Interventions that address specific symptoms, such as spasticity, pain, fatigue, and bladder problems.

Because MS affects everyone differently, treatment plans are uniquely tailored to each person’s symptoms, disease type, lifestyle habits, and preferences. A safe and effective plan should be developed in collaboration with a person’s healthcare team.

The National MS Society recommends a comprehensive care approach involving several healthcare specialties, including primary care, neurology, urology, mental health, and rehabilitation.

Treatments to modify disease progression

Disease-modifying therapies (DMTs) for MS are medications that alter the course of the disease, mostly by suppressing or modulating the immune system. All have been shown to lower the frequency of relapses, reduce the development of new lesions, and/or delay the progression of disability.

The vast majority of DMTs are approved in the U.S. for relapsing forms of MS, but fewer options exist for people with progressive forms of the disease. Thus, selecting the best treatment depends on a person’s MS type, in addition to other factors such as overall health and administration preferences.

As there is no one DMT that is best for everyone, people with MS should work closely with their healthcare team to determine the most appropriate DMT for their individual needs.

In some cases, a doctor may choose to treat the disease with therapies that are approved for indications other than MS — this is known as off-label use. Rituximab, approved for certain blood cancers and autoimmune conditions, is an example of a medication that is commonly used off-label in MS.

Treatments for MS attacks

An MS attack, also called an MS relapse or flare-up, is an episode in which new symptoms appear or existing ones suddenly worsen due to active inflammation in the central nervous system (the brain and spinal cord).

These episodes can vary in severity and duration, and not all require treatment. Whether a relapse is treated depends on how much it interferes with a person’s daily life and function.

When treatment is needed, MS relapse management therapies are used to reduce inflammation and speed recovery. The most common options include:

• Corticosteroids, such as prednisone and methylprednisolone, which are typically the first-line treatment for severe relapses. These medications mimic a natural hormone called cortisol that has anti-inflammatory properties.
• Adrenocorticotropic hormone (ACTH)-based therapies, such as Acthar Gel and Cortrophin Gel. These are generally used if corticosteroids are not effective or cannot be tolerated well. ACTH products stimulate the production of cortisol and other hormones that help manage inflammation.
• Plasmapheresis (plasma exchange), a procedure that replaces a person’s plasma – the liquid portion of blood — to remove pro-inflammatory proteins and antibodies. This approach is usually reserved for patients who fail to respond to corticosteroids.

Treatments for MS symptoms

While DMTs can prevent symptoms from getting worse, those drugs do not generally alleviate everyday symptoms such as gait and vision problems, spasticity, fatigue, and mental health issues. Thus, treatment plans for people with MS often include therapies for managing MS symptoms.

Several symptomatic treatments for MS are available. Importantly, apart from pharmaceutical interventions, symptom management also commonly involves rehabilitation approaches — including physical and occupational therapy — and lifestyle changes.

Complementary therapies for MS

In addition to MS medications, many people incorporate MS complementary therapies into their care plan to help manage symptoms and improve overall well-being. These non-drug therapies are generally tailored to the person’s needs and preferences, and may include physical therapy, exercise, emotional support, acupuncture, and dietary adjustments.

Physical therapy

Physical therapy can help maintain or improve strength, balance, coordination, and mobility in people with MS. A physical therapist will work with patients to develop a personalized exercise program focused on a specific area of the body or on a specific problem. They may also recommend certain mobility aids and assistive devices and train patients to use them appropriately.

Beyond mobility, physical therapy also can aid with bladder issues and help make daily activities like dressing and personal care easier to manage.

Exercise

Regular exercise is generally recommended for MS patients. It can ease symptoms such as fatigue, muscle stiffness, and bowel issues while supporting cardiovascular health, strength, and mood.

There’s not one activity that’s recommended for people with MS, so patients should try exercises that feel comfortable based on their abilities and energy levels. Activities like walking, swimming, cycling, range-of-motion exercises, yoga, and Pilates can all be of benefit.

Diet

While no specific MS diet is recommended, patients should adopt healthy eating habits as part of their care plan. A balanced diet includes a variety of fruits and vegetables, lean proteins, legumes, nuts, and whole grains, while limiting highly refined foods, added sugars, salt, and saturated fats. Some people may benefit from working with a dietitian to address individual nutritional needs.

When to start MS treatment

Even in its earliest stages, MS can cause ongoing, silent damage to the brain and spinal cord. This occurs even when symptoms are mild or not yet noticeable.

While no available treatment can reverse nerve damage once it happens, DMTs for MS can help reduce that damage, slowing or stopping the progression of the disease before it causes serious disability.

For this reason, starting MS treatment early is considered the best therapeutic approach. Acting before irreversible damage takes place may improve outcomes and overall well-being in the long run.

The American Academy of Neurology released guidelines in 2018, which were endorsed by several MS organizations, recommending initiating treatment as soon as a diagnosis is confirmed in most cases.

When to stop MS treatment

There are several reasons why someone with MS might stop their current treatment and switch to a different one. For example, a medication may no longer be effective, cause intolerable side effects, or need to be paused for specific life events, such as pregnancy or breastfeeding. In other cases, a newer or more appropriate MS therapy may become available.

Some people may also consider stopping treatment if their disease seems stable and they are not experiencing signs of disease activity. However, increasing evidence indicates that stopping MS therapies can cause disease activity to reemerge and result in worse long-term disability.

Ultimately, any decision about pausing, stopping, or starting a new treatment should always be made in close collaboration with a person’s care team. The potential benefits and risks must be carefully assessed to ensure the best outcomes for the patient.

Stem cell therapy for MS

Stem cell therapy for MS, more formally known as autologous hematopoietic stem cell transplant (aHSCT), is an experimental treatment that aims to reset a person’s immune system to stop it from attacking the nervous system.

While not formally approved by the U.S. Food and Drug Administration for MS, the medications and procedures used in a stem cell transplant are already approved by the regulatory agency for other uses.

The procedure involves first collecting a person’s own stem cells, which are able to grow and differentiate into all kinds of blood cells, from the bone marrow or blood. The patient then undergoes an intensive course of chemotherapy to destroy their existing immune system, after which the previously harvested stem cells are infused back into the patient.

After a few weeks, the infused stem cells will rebuild a new immune system that’s no longer primed to cause MS-related inflammation and damage. In theory, this can prevent relapses and possibly slow progression. Some promising results with HSCT have been reported in MS patients, particularly in those with early disease.

Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.