Spinal Injuries in Multiple Sclerosis: Your Guide | MyMSTeam (2023)

causes|How it causes the symptoms|Spinal injuries versus brain injuries|recognition|Other conditions|prevention|Support

Spinal Injuries in Multiple Sclerosis: Your Guide | MyMSTeam (1)

Lesions occur in multiple sclerosis (MS) as a result of damage to nerve cells in the central nervous system (CNS). It'sThe lesions can be found in the brain.and the spinal cord, dependingType and severity of MS.

Adiagnose MSrequires the identification of at least two lesions in different areas of the CNS with damage that occurred at different times. Any other diagnosis must be ruled out before a diagnosis of MS can be made. Not all spinal injuries are caused by MS.

Other conditions to exclude are:

  • Other demyelinating disorders, such as neuromyelitis optica
  • Brain or spinal cord tumors
  • CNS infections, such as Lyme disease or HIV
  • Other autoimmune diseases, such as Sjögren's syndrome
  • Vitamin B12 or copper deficiency
  • Structural damage to the brain or spinal cord

What causes spinal injuries?

In MS, the immune system attacks the protective covering on the outside of nerve cells (myelin). This damage leaves scar tissue that develops into lesions in the brain or spinal cord called plaques.

(Video) Multiple Sclerosis and the Spinal Cord

Spinal injuries are common in people with MS. One study found that 104 people newly diagnosed with MS83 percentHe had spinal injuries.

new wound? Learn how powerful DMTs can behelp slow the progression of MS.

Other causes of spinal injuries can include:

  • Neuromyelitis optica spectrum disorder (a neurological disorder that causes demyelination of the optic nerves, brain stem, and spinal cord)
  • Dural arteriovenous fistulas (abnormal connections between veins and arteries around the brain or spinal cord)
  • Neurosarcoidosis (an inflammatory disease of the CNS)
  • Krebs
  • infections
  • Trauma
  • birth defects

location of spinal injuries

The vertebral column contains 33 individual bones divided into five regions. Spinal lesions in MS are typically found in the cervical region, beginning at the base of the head and continuing down the neck. They are also occasionally found in the thoracic region, which extends from the base of the neck to the middle of the back. Onelearnfound that people with MS who have whiplash injuries are more likely to also have thoracic spine injuries.

How do spinal injuries cause MS symptoms?

Spinal injuries can cause nerve damage leading to motor and sensory dysfunction. Loss of myelin around nerve cells in the spinal cord slows down electrical signals sent from the CNS, which can disrupt communication between nerves. Loss of the spinal cord (atrophy) or loss of white matter tissue (neurons and myelin) in the spinal cord can also cause symptoms.

Nerve damage caused by MS can also cause altered sensations, a type of nerve pain. This is because the damaged nerves cannot properly send signals to the CNS. The brain tries to associate this nerve pain with other sensations, including:

  • Tingle
  • combustion
  • chop
  • Drag
  • deafness
  • electric shocks
  • needles and pins

Some MyMSTeam members also experience a shooting sensation in the cervical spine, which may be related to spinal injuries. One member asked, "This may sound strange, but I have two cord injuries, one at C2 and one at C3. Sometimes I get a 'throbbing' feeling. It comes and goes. Does anyone else have something like this?" Other members agreed that they had experienced this as well and described vibrating sensations similar to that of a tuning fork.

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How are spinal injuries and brain injuries different?

EM ischaracterized bythe presence of lesions in the brain and spinal cord. People with primary progressive MS tend to have more spinal cord injuries than brain injuries.

Brain and spinal injuries also cause different symptoms. In MS, the symptoms depend on the location of the lesion. For example, brain injuries can cause symptoms such as impaired coordination or vision problems. Conversely, spinal cord injuries can cause muscle weakness, numbness, tingling, and pain.

How do doctors recognize spinal injuries?

The most common method for detecting lesions is MRI. This is a highly sensitive imaging process that can take detailed images of organs and tissues in the body. MRIs use radio waves and magnetic fields to measure the water content in tissues.

Myelin is a fatty substance that repels water. Areas affected by MS lack myelin. As a result, these areas fill with water and look abnormal on an MRI, showing damage to the spinal cord. It is important to note that, unlike an X-ray, an MRI does not involve radiation.

MRI techniques

Radiologists sometimes use gadolinium (a contrast agent) to highlight new areas of inflammation in the spine. Under normal conditions, the blood-brain barrier protects the brain and spinal cord from contaminants. Large molecules like gadolinium could not cross this barrier. However, during periods of active inflammation, the blood-brain barrier is compromised. This inflammation allows gadolinium to enter the CNS, and the scan shows areas of inflammation.

During an MRI, your radiologist and neurologist look at different sequences of images to determine the extent of the damage. Some common imaging sequences used to detect MS lesions and other abnormalities are:

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  • T-1 weighted sequence without gadolinium
  • T-1-weighted sequence with gadolinium
  • T-2 weighted sequences
  • FLAIR-Sequenz (fluid-attenuated inversion recovery).

T-1-weighted sequence without gadolinium shows darker areas where nerves are permanently destroyed (areas with lesions and little or no myelin). Gadolinium T-1-weighted sequence shows brighter areas of gadolinium where there is active inflammation (lesion enhancement).

The T-2 weighted sequence shows the global effect of the disease and the total number of lesions. This sequence can show old and new lesions at the same time. FLAIR sequence can reduce image "noise" from the surrounding cerebrospinal fluid, providing a clearer image of lesions.

Other diseases with spinal injuries

All demyelinating diseases share common signs and symptoms caused by inflammation of the CNS. This can make it difficult to diagnose these diseases. Doctors use the concept ofdifferential diagnosisto rule out other diseases before MS is diagnosed. Some diseases that have symptoms similar to those of MS are neuromyelitis optica spectrum disorder and transverse myelitis.

Neuromyelitis optic spectrum disorder

optic neuromyeliteSpectrum disorder is a rare neurological disorder characterized by demyelination of the optic nerves, spinal cord, and brain stem. It can cause optic neuritis (swelling and inflammation of the optic nerve), leading to blurred vision.

The spinal cord can also be damaged, leading to muscle weakness, muscle spasms, and bladder and bowel dysfunction. These symptoms are very similar to those of MS. However, MRIs show mainly spinal cord injuries with few brain lesions.

transversal mind

Transverse myelitis (TM) is a demyelinating disease caused by inflammation on both sides of a segment of the spinal cord. This causes symptoms similar to those of MS because the inflammation interferes with the transmission of signals between the spinal nerves and other parts of the body.

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A person with TM who has an abnormal brain scan that shows more than two lesions has a higher risk of developing MS (up to 90 percent). TM is a relatively rare condition.

Prevention of new or worsening MS lesions

currently existsthere is no cure for MS. The US Food and Drug Administration has approved manydisease modifying therapies (DMT)It can slow the progression of MS, reducing the number and severity of flare-ups.

Other MS medicines are designed to relieve symptoms rather than stop the progress of the disease. DMTs work in a number of ways, including:

  • Reduce the number of certain immune cells involved in MS attacks
  • regulation of immune cell function
  • Reduction of inflammation and demyelination.

Talk to other people who understand

MiMSTeamis the social network for people with multiple sclerosis and their families. MyMSTeam brings together more than 187,000 members to ask questions, offer advice and share their stories with others who understand life with MS.

Do you live with multiple sclerosis? Do you have MS spinal injuries? Share your experiences in the comments below or start a conversation by posting on yourActivitiespage of book.


  1. Other Ruling Rules - National Multiple Sclerosis Society
  2. Spinal cord abnormalities in patients with newly diagnosed MS - Neurology
  3. Sinais e sintomas - Multiple Sclerosis Trust
  4. Anatomia da Coluna Vertebral - Mayfield Brain and Spine
  5. Advances in Spinal Cord Imaging in Multiple Sclerosis - Therapeutic Advances in Neurological Disorders
  6. Thoracic spinal cord injuries are influenced by the degree of involvement of the cervical spine in multiple sclerosis - spinal cord
  7. Spinal cord atrophy in multiple sclerosis due to loss of white matter volume – JAMA Neurology
  8. Altered Sensations - Confidence in Multiple Sclerosis
  9. MRI lesions of the brain and spinal cord in primary progressive versus relapsing multiple sclerosis - eNeurologicalSci
  10. Brain Injuries – Cleveland Clinic
  11. Magnetic Resonance Imaging (MRI) – National Multiple Sclerosis Society
  12. FLAIR*: a combined MR contrast technique for the visualization of white matter lesions and parenchymal veins - radiology
  13. McDonald Criteria - Multiple Sclerosis Fund
  14. Differential Diagnosis – National Multiple Sclerosis Society
  15. Optikusneuritis – Mayo Clinic
  16. Neuromyelitis Optic Spectrum Disorder - National Organization for Rare Disorders
  17. Transverse Myelitis and MS – National Multiple Sclerosis Society
  18. Disease Modifying Therapies for MS - National Multiple Sclerosis Society
(Video) Multiple Sclerosis (M.S.) Pathophysiology, Treatment, Nursing Care RN & LPN NCLEX


What happens when MS attacks the spine? ›

Many with spinal cord problems and MS have numbness on one side of the body and weakness on the opposite side. They may lose standing balance or have a gait problem characterized by ataxia, such as the inability to walk a straight line. Paralysis and loss of sensation of part of the body are common.

What part of spine does MS affect? ›

The cervical region is the upper part of the spine found in the neck. MS lesions on the cervical spine can cause similar symptoms to when they appear in other areas, such as numbness, weakness, and balance issues. In addition, they can cause loss of sensation in both the shoulders and arms.

What percentage of MS patients have spinal lesions? ›

Spinal cord lesions are common in MS. They're found in about 80 percent of people newly diagnosed with MS. Sometimes the number of spinal lesions identified from an MRI can provide the doctor with an idea of the severity of the MS and the likelihood of a more serious episode of demyelination occurring in the future.

Where are MS spinal lesions located? ›

Characteristic lesions are located in the periventricular and juxtacortical regions, in addition to the brainstem, cerebellum, spinal cord, and optic nerve. Disease localized to the spinal cord may cause partial or complete transverse myelitis, involving sensory or motor changes involving 1 or both sides of the body.

Does MS show up on spine MRI? ›

Magnetic resonance imaging (MRI) is a reliable diagnostic tool and readily identifies MS involvement of both the brain and the spinal cord [9].

Can nerve damage from MS be repaired? ›

Myelin is repaired or replaced by special cells in the brain called oligodendrocytes. These cells are made from a type of stem cell found in the brain, called oligodendrocyte precursor cells (OPCs). And then the damage can be repaired.

What is the spinal test for MS? ›

A lumbar puncture is a diagnostic test for multiple sclerosis that involves removing and analysing a sample of cerebrospinal fluid (CSF), the fluid that surrounds the brain and spinal cord within the skull and backbone. It is sometimes referred to as a spinal tap.

What do spinal lesions feel like? ›

Among the possible symptoms of a spinal cord lesion are: Pain. Numbness. Tingling, prickly, or burning sensation.

How often should MS patients have MRIs? ›

New lesions might occur in patients with progressive MS and adjusting therapy can be considered. Patients with untreated CIS should be scanned every 1–3 months for the initial 6 months and if stable repeating MRIs every 6–12 months is recommended, unless new clinical symptoms occur.

Why do you have to tap your spine for multiple sclerosis? ›

In MS, damage to myelin causes certain types of proteins to be released into the spinal fluid. When these proteins are identified in the spinal fluid, but not in the blood, MS is thought to be one of the possible diagnoses. Spinal fluid is obtained through a lumbar puncture (also known as a spinal tap).

Does MS always progress to disability? ›

The truth is that 15 years after the onset of MS, only about 20% of patients are bedridden or institutionalized. Another 20% may require a wheelchair, or use crutches, or a cane to ambulate, but fully 60% will be ambulatory without assistance and some will have little deficit at all.

How many lesions is alot for MS? ›

An “average” number of lesions on the initial brain MRI is between 10 and 15. However, even a few lesions are considered significant because even this small number of spots allows us to predict a diagnosis of MS and start treatment.

How long do MS lesions show on MRI? ›

The pattern of gadolinium-enhancement in multiple sclerosis lesions is variable but almost always transient (2–8 weeks, although typically <4 weeks).

Do MS lesions go away on MRI? ›

Conclusions: Brainstem lesions in MS patients can disappear on subsequent imaging. Disappearing MRI lesions may delay the diagnosis. These results suggest that more weight should be given to the reported clinical brainstem events, especially in the initial diagnosis of MS.

Can spinal lesions from MS cause back pain? ›

MS breaks down the layer of myelin and leaves patients with unprotected nerves that do not work as well as they should. As a result, patients may experience a number of uncomfortable symptoms, including spine pain.

Can MS affect your teeth? ›

MS patients are all at higher risk for dental issues because of the complications of MS. The disease itself affects the teeth and gums on a biochemical level. The medicine that is used to treat MS can also lead to problems.

Does MS show up in blood work? ›

Blood Tests: Currently, there are no definitive blood tests for diagnosing MS, but they can be used to rule out other conditions that may mimic MS symptoms, including Lyme disease, collagen-vascular diseases, rare hereditary disorders and acquired immune deficiency syndrome (AIDS).

Can MS be mistaken for spinal stenosis? ›

A variety of neurologic signs and symptoms are associated with MS and include myelopathy, extremity weakness, low back pain, sciatica and paresthesias. Many of these signs and symptoms are identical to those experienced by patients with spondylosis (e.g. spinal stenosis, disc herniations).

Why is Benadryl great for multiple sclerosis? ›

Diphenhydramine, sold as Benadryl, is a type of antihistamine that can help reduce the likelihood or severity of an allergic reaction to a multiple sclerosis (MS) infusion treatment. Antihistamines block histamines, chemicals made by white blood cells that cause allergy symptoms such as itchy skin, rash, and hives.

What is the new MS drug that repairs myelin? ›

Treatment with medrysone, a glucocorticoid approved in the U.S. as a topical treatment for certain inflammatory eye diseases, improved repair of myelin in a mouse model of demyelination, a new study shows.

What vitamins should you avoid with MS? ›

High doses of other vitamins can antagonize your immune-modulating, immunosuppressive therapies used to manage MS. Supplements that stimulate the immune system should be avoided in high doses. Those include selenium, zinc, B1, B2, folic acid, B6, vitamin A, biotin, magnesium, copper, and manganese.

Can you feel MS in your spine? ›

Spinal cord wasting (atrophy), or the loss of white matter tissue (neurons and myelin) in the spinal cord, can also cause symptoms. Nerve damage caused by MS can also cause altered sensations, a type of nerve pain. These occur because damaged nerves cannot properly send signals in the CNS.

Do spinal lesions mean MS? ›

Spinal cord lesions are more commonly seen in progressive forms of multiple sclerosis, and they can result in an increased risk of disability.

Can you drive with MS? ›

One of the first questions many people have when they're diagnosed with MS is: “Will I still be able to drive?” The good news is that most people with MS continue to drive as normal.

What do MS spinal lesions look like on MRI? ›

T2 sequences can be used to count the total number of MS lesions, which look like bright white spots on T2 sequences, and can be called “hyperintense”. To help identify new or active areas of disease, a special contrast dye can be given by IV during the MRI.

What diseases are similar to MS? ›

Conditions That Can Seem Like MS
  • Epstein-Barr Virus.
  • Vitamin B12 Deficiency.
  • Diabetes.
  • Nerve Damage.
  • Eye Problems.
  • Stroke.
  • Lupus and Other Autoimmune Diseases.
  • Parkinson's Disease.
Dec 21, 2022

What is late onset of MS? ›

Late-onset multiple sclerosis (LOMS) is defined as symptoms initiating after the age of 50. Misdiagnosis and a remarkable gap in diagnosis of LOMS is a challenge of the elderly population so in this article we described the proportion of LOMS and the clinical features and phenotype of the disease in this age group.

What is the best MRI for multiple sclerosis? ›

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. We can now use a technique called FLAIR to make 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.

How often do MS patients see their neurologist? ›

“When MS is diagnosed, the neurologist may see the patient once or twice a year vs. the patient's more frequent office visits and calls to the primary doctor. “PCPs are the constant on the team, particularly when it comes to preventing or controlling high cholesterol, high blood pressure, diabetes,” she adds.

How often should MS patient see neurologist? ›

Ongoing monitoring is an essential part of living with MS, too. Even when your disease is stable and your medication is controlling your symptoms, Dr. Cohan recommends that you see your neurologist every six months—and make an appointment immediately if your symptoms change.

How painful is a spinal tap? ›

A lumbar puncture is where a thin needle is inserted between the bones in your lower spine. It should not be painful, but you may have a headache and some back pain for a few days.

Is spinal tap for MS painful? ›

“Spinal taps are usually uncomfortable but seldom extremely painful,” notes Giesser. When the needle used to remove spinal fluid is inserted through your spinal membrane and into the spinal canal, you may feel pressure in your back, but this part of the procedure is usually painless.

How much does a spinal tap cost? ›

How Much Does a Lumbar Puncture (spinal tap) Cost? On MDsave, the cost of a Lumbar Puncture (spinal tap) ranges from $848 to $1523. Those on high deductible health plans or without insurance can shop, compare prices and save.

Is sclerosis of the spine serious? ›

Sclerosis can affect any of the bones in the body, including the spinal vertebrae. These lesions can be indicative of a more serious underlying condition. For this reason these types of lesions should be investigated by a qualified physician to make sure there is nothing more serious lurking beneath the surface.

Does MS make you paralyzed? ›

Muscle weakness, stiffness, and spasms may be severe enough to affect walking or standing. In some cases, MS leads to partial or complete paralysis and the use of a wheelchair is not uncommon, particularly in individuals who are untreated or have advanced disease.

What does MS back pain feel like? ›

Neck and back pain: Some people with MS can experience neck and back pain. This may be due to immobility, or to the same type of wear and tear that many people without MS experience. This type of pain is often an aching, stiff sensation that can be moderately severe.

What is the treatment for sclerosis of the spine? ›

Unfortunately, there is no medical treatment for spinal sclerosis that will make it go away. What occurs if you have this condition is the bones are going to thicken. The thickening is the result of excessive amounts of calcium deposits.

What is the worse stage of MS? ›

Secondary progressive MS (SPMS) is a stage of MS which comes after relapsing remitting MS for many people. With this type of MS your disability gets steadily worse.

What happens in the last stages of multiple sclerosis? ›

More severe symptoms and complications that may develop during the final stages of multiple sclerosis include: Difficulty breathing. Limited mobility/paralysis. Speech complications.

What can trigger MS flare ups? ›

What Causes an MS Flare-Up?
  • Stress.
  • Fatigue.
  • Heat.
  • Infections.
  • Diet.
  • Medications.
  • Smoking.
Jun 7, 2021

Is walking good for MS patients? ›

Diana: The best MS exercises are aerobic exercises, stretching, and progressive strength training. Aerobic exercise is any activity that increases your heart rate, like walking, jogging, or swimming. You just don't want to overdo it—it should be done at a moderate level.

What triggers MS? ›

Multiple sclerosis is caused by your immune system mistakenly attacking the brain and nerves. It's not clear why this happens but it may be a combination of genetic and environmental factors.


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