Multiple sclerosis (MS) Overview

Multiple sclerosis is a condition which affects the brain and spinal cord, which causes a variety of symptoms such as difficulty with balance, movement of limbs and vision. The degree to which multiple sclerosis affects someone can range from severely disabling to mild. It is up to three times more common in women, with over 100,000 people in the UK living with the condition overall.

What are the signs and symptoms of multiple sclerosis?

People with multiple sclerosis can see their symptoms fluctuate, or worsen progressively over time. Bouts of symptoms are called relapses, whereas symptom-free periods are referred to as remissions. Some typical symptoms include:

  • Cognitive difficulties – with planning, concentrating and learning
  • Muscles spasms and stiffness or weakness
  • Vision problems
  • Tiredness
  • Sexual problems
  • Mobility issues
  • Pain
  • Incontinence issues
  • Speech and swallowing difficulties

How does multiple sclerosis get diagnosed and treated?

Currently, there is no cure for multiple sclerosis, but there are treatments to enable people with multiple sclerosis to live relatively free from its effects. Patterns of several of the symptoms associated with multiple sclerosis can help a doctor refer a patient to a neurologist (specialist doctor of the nervous system) for assessment.

No single test can lead to a certain diagnosis, so a neurologist will work to eliminate the likelihood of other conditions first. MRI scans can help identify nerve damage and a lumbar puncture can also be used to take a sample of spinal fluid which can then be tested for evidence of antibodies. These would highlight potential multiple sclerosis-related infection levels.

Treatment varies according to the individual patient’s needs. For example, steroids can be used to treat relapses, whereas other drugs can be administered more regularly to reduce the number and severity of relapses.

Some people with multiple sclerosis will also benefit from seeing a physiotherapist or a speech therapist, if their movement or their speech is particularly impacted.

There are a few ways to determine whether an employee has multiple sclerosis, or to confirm a multiple sclerosis diagnosis which requires reasonable adjustments:

  • An employee is legally obliged to disclose their multiple sclerosis if their work is as a member of the armed forces, or involves the operation of machinery or vehicles which may then become a health and safety concern as a result of certain multiple sclerosis symptoms, i.e. muscle stiffness.
  • Even if the employee does not wish to, or have to, disclose their multiple sclerosis, an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
  • Given that multiple sclerosis can evolve over time, with certain symptoms worsening as the person ages, it is important to maintain regular communication with the employee who has multiple sclerosis so that the reasonable adjustments remain appropriate.

What reasonable adjustments are possible with multiple sclerosis?

Employers have a legal duty to make reasonable adjustments for employees with multiple sclerosis if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has multiple sclerosis. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of multiple sclerosis:

  • Accommodating home or remote working: this can help if the employee has significant mobility issues, including vision problems limiting their ability to drive, which affect their ability to commute into the office.
  • Making assistive technology available and training on how to use it: such as expanded keyboards and forearm supports, as well as dictation devices, to enable easier use of a computer for employees with spasticity or speech difficulties.
  • Making sure there is a flexible break schedule and easy bathroom access: for employees with multiple sclerosis who may have decreased bladder or bowel control, or who have increased levels of fatigue.
  • Adjusting deadlines: to accommodate any cognitive difficulties that the employee may have as a result of their multiple sclerosis.
  • Giving written instructions: to help the employee with planning and organisation if this is impacted by their condition.
  • Raise awareness: for the employees with multiple sclerosis to be better understood in the workplace, and to make employees feel comfortable with asking for help related to their multiple sclerosis.

Multiple sclerosis Signposting

Multiple Sclerosis (MS) Society – charity researching and campaigning for better treatment and understanding of the condition in the UK, including making day-to-day support available across the country for people with MS (0808 800 8000).

Multiple Sclerosis (MS) Trust – charity providing information to people living with MS, training to health professionals on how to diagnose and treat the condition, and funding for specially-trained nurses in the areas where they are most needed (01462 476700).

MS UK – charity empowering people with MS to live healthier and happier lives, whose knowledge and advice is led by those with first-hand experience (0800 783 0518).

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