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Fourth edition
November 2009
MS
Essentials
07
For people living with MS
This publication is available in large print (22 point)
Call 020 8438 0799 or email [email protected]
Managing
bladder
problems
Bladder problems can be all too familiar for people with
MS. However, you do not have to cope alone, as bladder
problems can almost always be managed effectively and
help is available.
To understand how to manage bladder problems, it helps
to know a little about how the bladder works, how it is
affected in MS, and the types of problems this can lead
to. This booklet describes a ‘first-line’ treatment route that
works well for the majority of people, particularly those with
less severe MS. The key is a proper investigation to identify
the problem, or combination of problems, to be addressed.
This first-line treatment route does not work for everyone
with MS. This booklet also outlines further options that can
help manage bladder problems effectively for people more
severely affected.
Further advice on managing bladder problems and helpful
information about products are both available from your
local continence service. You can self refer to most NHS
continence advice services. The Bladder and Bowel
Foundation can give you details of your nearest service. i
Through the booklet we refer to other organisations
which can help with particular issues – just look
for the i . Their details are listed at the back of
the booklet under ‘Useful organisations’ (page 16).
Contents
How the bladder works
Types of bladder problems
A first-line treatment route
Emerging treatments
If symptoms become more
difficult to manage
12 Further information
02
04
05
09
10
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How the
bladder
works
Page 2
If everything is working as it should, bladder control is something
most people tend to take for granted. When your bladder is getting
full, a warning system between your brain and bladder tells you
that you should go to the toilet – and you can usually ‘hold on’
until you get to one. Equally, even when your bladder isn’t full,
you can choose to go to the toilet if you know you’re not going
to get the chance to go again for a while – for example, before
going on a journey.
Two key functions
The bladder itself has two key functions: storage, which it
does most of the time, and emptying. The system works
so that at any time it is doing one or the other of these.
To store and empty urine, the bladder uses two main
muscles – the detrusor (in the bladder wall) and the sphincter
(at the outlet of the bladder). These two muscles need to work
in coordination with each other so that one is relaxed while
the other is contracted. When the bladder is storing urine, the
detrusor is relaxed and the sphincter is contracted. When
the bladder is emptying, the sphincter relaxes to open and the
detrusor contracts to expel the urine.
Two main muscles in the bladder
emptying
detrusor
storage
Managing bladder problems © MS Society 07/11
sphincter
2
The two main muscles of the bladder, detrusor and
sphincter, need to work in coordination with each other
when storing and emptying. One relaxes as the other
contracts.
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Messages from the brain
A nerve centre in the lower part of the brain switches the
bladder from storage to emptying. The success of this relies
on messages transmitting properly through the whole length
of the spinal cord. In MS, if lesions affect the nerve pathways
in the spinal cord, causing leg weakness, this is also going
to interrupt the connecting nerve pathways of the bladder.
The spinal cord
brain
This section of the
spinal cord is where
nerves travel to and
from the bladder – just
underneath the section
where nerves travel
to and from the legs.
Messages from the brain to the bladder have to travel the
whole length of the spinal cord.
Managing bladder problems © MS Society 07/11
spinal cord
This is the section in
the spinal cord where
nerves travel to and
from the legs.
3
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Types of
bladder
problems
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Page 4
There are two main types of bladder disorder that can occur in MS.
The most common is a problem with storage, and the other is a
problem with emptying. It is not known why some people get one
and not the other, or why some people get a bit of both.
Bladder problems are not unusual – perhaps as many as three
quarters of people with MS experience them.1 They may occur
or worsen during a relapse, particularly if your mobility is affected.
Similar symptoms may also be caused by a urinary tract
infection, which may itself be caused by bladder problems,
or may be completely unrelated to your MS.
Problems with storage
When the nerve pathways in the spine are interrupted, faulty
reflexes can appear so that even a small amount of urine in
the bladder causes it to contract. This is known as ‘detrusor
overactivity’, which causes a need to urinate frequently
– an effect known as frequency.
There can often also be an inability to ‘hold on’, called urgency.
If this is severe, urgency incontinence will be a problem.
Medication can be highly effective in reducing the tendency
for the bladder to contract, and this helps to relieve both
frequency and urgency.
Problems with emptying
The other main type of bladder disorder is to do with emptying.
Instead of the bladder muscles being coordinated, the sphincter
does not relax when the detrusor muscle contracts. This makes
urine flow poor and interrupted, and bladder emptying incomplete.
Managing bladder problems © MS Society 07/11
People with MS often cannot feel that their bladders are not
empty. However, by a process of deduction, they may identify
the problem – if they need to empty for a second time only
a short interval later and pass a similar volume.
4
People who think they don’t empty are usually right, but quite a
lot of people who think they do empty their bladders in fact do not,
and they have a significant volume of urine left behind. Urine left in
the bladder – this is called ‘the residual’ – stimulates further bladder
contractions and can add to problems of urgency and frequency.
Urinary tract infections (UTIs)
It is important to test for urinary tract infections (UTIs) because
symptoms of a UTI can be very similar to bladder problems
caused directly by MS (for example, needing to go very
frequently). Some people do seem to get more infections
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than others, even with exemplary hygiene. People doing
intermittent self-catheterisation to help empty the bladder are
likely to have bugs (microbes) in their urine when it is tested –
but this is different from having a real infection. An infection
causes the urine to go cloudy and smelly, and some people may
also have pain on passing urine, though not everyone. Infections
can usually be treated with antibiotics.
There is a good ‘first-line’ treatment route for managing bladder
problems in MS, as shown in the diagram on page 6.2 It works
well for the majority of people, particularly those less severely
affected by MS and people who, if they need to self-catheterise,
do that as well as take medication.
Step 1 – check for infection
As explained on page 4, if you have bladder problems it is
important to test for infection in the urine. If a UTI shows up
on tests, it needs to be investigated and treated.
Step 2 – is your bladder emptying?
It is also important to know if you are emptying your bladder fully.
Measuring the ‘residual volume’ – the amount of urine left in your
bladder after emptying – is the most important test in managing
bladder problems. Even if your problems are to do with urgency
and frequency (which do not necessarily suggest a problem with
incomplete emptying), this test should be done.3
A continence adviser or nurse can measure the residual volume
either by using a catheter to drain your bladder, or more usually,
by using an ultrasound scan on your lower abdomen – a quick,
painless and non-invasive procedure.
Record keeping, like measuring fluid intake and volume of urine
passed, will not tell you about the residual volume – you would
need to be able to establish that the residual is nil when the
record starts. In any case, you also lose fluids from your body
through sweating, for example, that record keeping does not
keep track of.
If the residual volume is low – less than 100ml – medication
can be prescribed to reduce the bladder contractions and
relieve both frequency and urgency.
If the residual volume is high – more than 100ml – you would
need to take steps to improve bladder emptying (for example by
self-catheterisation) before taking medication to reduce urgency.
Managing bladder problems © MS Society 07/11
A first-line
treatment
route
5
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First-line treatment route for managing bladder problems 2
Managing bladder problems © MS Society 07/11
TEST FOR
Urinary tract infection
6
B
C
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Drug treatments
A number of drugs can be used to treat an overactive bladder
and make bladder contractions less unpredictable. Many belong
to the same family of ‘anti-cholinergic’ drugs. There is a choice:
oxybutynin (brand name Ditropan), tolterodine (Detrusitol),
propiverine (Detrunorm), trospium chloride (Regurin), solifenacin
(Vesicare), fesoterodine (Toviaz) and darifenacin (Emselex). They
are taken as tablets once or several times a day, depending on
the duration and strength of the medication.
All of them are likely to cause a variable degree of dry mouth.
Some people have side effects with one and may then switch
to another that they find more agreeable.
The drug desmopressin (tablets, or nasal spray) may be
prescribed if other drugs don’t work well during the day,
or to allow you to sleep undisturbed if you are prone to wake
in the night with the need to empty your bladder.3 Desmopressin
must never be used more than once in 24 hours. A potential
danger is of ‘water intoxication’ (severe water retention that
causes a dangerous imbalance of sodium and water in the
body). Ask your doctor for advice about fluid intake.
Intermittent self-catheterisation
Intermittent self-catheterisation is the most effective solution
for incomplete bladder emptying and many people find it useful.
This means inserting a thin plastic tube (the catheter) into the
urinary opening to drain the bladder. For most people, this is
done two to four times a day. A specialist nurse or continence
adviser can teach you how to do this.
This sounds difficult, but most people find that actually doing
it is much easier than they expected and that it makes a huge
difference to their lives, giving them back the freedom to be out
and about without worrying about where the nearest toilet is.
There are many different types of catheters – for men and women
– including single use ones. A specialist adviser, such as an
MS nurse or continence nurse, will have up-to-date information
about the different types, and can help you choose the most
appropriate one.
The Bladder and Bowel Foundation has more information about
intermittent self-catheterisation. i
Managing bladder problems © MS Society 07/11
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Managing day to day
Drink enough
It may seem illogical, but drinking less does tend to make bladder
problems worse. When you drink less, your urine becomes more
concentrated. This can irritate your bladder, making it more likely
to contract, and you may end up going to the toilet more. It can
also make urinary tract infections (UTIs) more likely. So it helps
to keep up your fluid intake in general, up to 1.5 to 2 litres a day.
Although be careful to limit your caffeine intake, as this can make
you go to the toilet more often.
If you need to get used to drinking more, it is best to increase
your fluid intake gradually, for example on days when you are
at home or when it is easy to get to a toilet.
Problems when emptying?
If you have problems with emptying, a continence adviser may
suggest a variety of emptying techniques and bladder stimulating
devices. These include holding a small vibrating device against
your bladder when you go to the toilet. It does not work for
everyone, but this vibration technique helps some people to
empty their bladder more effectively.4 Commercially available
battery powered massagers can be effective for this.
Adjustments at home or work
If frequency or urgency causes problems, there may be practical
measures you can take to minimise their impact. Do you
have quick and easy access to a toilet at home or at work?
Perhaps a downstairs toilet or commode would help at home?
In work, most employers have a legal duty to make ‘reasonable
adjustments’ – such as moving your workspace closer to toilets
if that would help. The MS Society publication Work and MS
has further details.
Managing bladder problems © MS Society 07/11
RADAR key scheme
8
The disability charity RADAR runs a National Key Scheme to allow
access to a network of around 9,000 accessible toilets across the
UK. They also produce a guide showing the location of the toilets.
From late 2011, this will be available as an ‘app’ for smartphones. i
Pelvic floor exercises
Pelvic floor exercises can help with control by improving your
ability to ‘hold on’. Their main use in the general population is
to help with stress incontinence following childbirth, but they
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can be done by men as well as women. A ‘pelvic floor’
physiotherapist can help you to learn to exercise these muscles.
‘Can’t wait card’
Some people find it useful to carry a ‘can’t wait card’ that explains
they have MS, to show to people when they need to use a toilet
urgently. A card is available free from the MS Society.
Continence advisers
Virtually every area in the UK has a specialist continence service with
at least one adviser. Continence advisers can provide information,
for example, about products available, as well as advice that is both
understanding and confidential. You can ‘self-refer’ to most NHS
Continence Advisory Services. For details of your nearest service,
call the Bladder and Bowel Foundation helpline. Calls are confidential
and you can speak to a specialist nurse. Details are also listed on
their website. i
Cranberry
Cranberry juice and cranberry extract tablets have both been
studied in a number of research trials. But there is no conclusive
evidence that they can help prevent or treat urinary tract infections
for people with MS.3, 5, 6, 7
One recent trial suggested that cranberry extract tablets might help
prevent infections for people with neurological bladder problems.
MS causes neurological bladder problems, but the trial did not
look at people with MS in particular – so we can’t be sure of the
benefits for MS.8
If you do drink cranberry juice, remember that fruit juices are high
in sugar and can quickly add up to a lot of calories.
Research is going on constantly to discover good ‘second-line’
treatments.
Botulinum toxin (‘botox’)
A newly emerging, highly effective treatment involves injecting
botulinum toxin (also known as ‘botox’) into between 20 and
30 different sites in the bladder wall. This probably works by
partially paralysing the bladder as well as blocking sensory
mechanisms in the bladder wall, although how it works as well
as it does is not fully understood.
The treatment results in quite long-lasting benefits (generally up to
around 10 months) during which urgency and urgency incontinence
Managing bladder problems © MS Society 07/11
Emerging
treatments
9
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may be greatly reduced. At the moment, only people with MS
who can self-catheterise are using it because it is likely that
it makes any problems with bladder emptying worse.9 The
treatment is minimally invasive and has few side effects, but is
not yet licensed. A number of specialists around the UK have
learned how to carry out the procedure. If ‘first-line’ treatment
is not working for you, you can ask your GP for a referral to
the local urologist to discuss it.
Cannabis-based treatments
In recent years there has been considerable interest in
researching cannabis-based medicines to treat MS symptoms,
including bladder problems. Some research trials have
shown benefits for some people with urgency and urgency
incontinence.10, 11 However, issues over long-term safety and
possible dependency problems associated with the use of
cannabis in young, otherwise fit people, are still to be clarified.
To date, no cannabis-based medicine has been specifically
licensed for treating bladder problems in MS.
If symptoms
become more
difficult to
manage
While the first-line treatment route shown on page 6 works well
for many people, it doesn’t work for everybody. This section
summarises further options that can be effective for people
who are more severely affected by MS.
Why might symptoms change?
Bladder symptoms in MS tend to become more difficult to
manage as more lesions affect the spinal cord. As the illustration
on page 3 shows, the nerve pathways to and from the bladder
are close to the nerve pathways affecting the legs. So the level
of bladder problems you might experience is often connected
to the level of difficulty you have in walking.12
Managing bladder problems © MS Society 07/11
Continence products
10
Some people find that using protective pads can be a satisfactory
answer to bladder problems. For men, devices called ‘convene
drains’ can be helpful. These fit over the penis, and carry urine
away through a tube to a small bag attached to the leg. However,
not everyone finds pads or convene drains the best solution –
it depends on how mobile you are, how intrusive you find your
symptoms, and your overall level of disability. There are a number
of helpful publications which have details, for example, about pads,
special clothing and other protective products, such as sheets.
Information is available from Promocon and the Bladder and
Bowel Foundation. i
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Further options: indwelling catheters
Although self-catheterising can be an effective solution for
many people, not everyone can manage it. If you have problems
with dexterity – such as difficulties writing – or you have reduced
sensation in your hands, it may not be an option for you. Also if
extreme frequency is a major problem for you, self catheterisation
is not the answer, as this is due to an overactive bladder rather
than not emptying.
You might want to consider an indwelling catheter – one that is
left in place – if self-catheterisation is not possible or suitable for
you. This usually helps to manage bladder problems for people
who have moderate to severe mobility problems; it would be
exceptional for a person who can walk to have one.
Indwelling catheters have a bag attached, to collect the urine
that drains from the bladder. This is emptied regularly, through
a small tap in the bag. Bags can be quite discreet, and come
in different sizes – for example, some people use a larger one
for night time. They can be worn either strapped to the leg or
in specially made underwear.
An alternative to a bag may be a catheter with a valve, which
is opened and closed to drain the bladder, either into a toilet
or a receptacle. You would need an assessment to decide
whether this is suitable. It depends on many factors, including
bladder capacity and your dexterity to operate the valve.
There are two kinds of indwelling catheter: urethral and
supra-pubic. It is important to discuss with a urologist
(your GP can refer you) which would be more suitable for you.
Deciding to move to an indwelling catheter can be difficult,
as this is a significant transition to make in how you manage
your MS. Your MS nurse or continence adviser can help to talk
through this change – there can be a lot to take in. They can
help too with information about different products that are
available. Some people also find it helps to talk to someone
else who has an indwelling catheter.
Urethral catheter
A urethral catheter is inserted into the urethra – the tube through
which urine empties from the bladder – usually by a district
nurse. Once it is fitted, you would use this to empty your bladder
rather than urinating in the usual way.
It can help people to get used to having a catheter and managing
a bag, but many people find it is not a long-term option for several
reasons: urine may leak around the catheter, and it can stretch
and damage the neck of the bladder.
Managing bladder problems © MS Society 07/11
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A urethral catheter needs to be changed regularly, at intervals
of up to 12 weeks. In some cases carers can learn to do this.
Supra-pubic catheter
A supra-pubic catheter is inserted into the bladder through
a small incision in the abdomen. The procedure would usually
be carried out under anaesthetic by a surgeon. As with any
operation, your doctors should explain the potential risks and
benefits, and discuss with you whether they will use a general
anaesthetic for the procedure. It is important that your local
service inserts the catheter, so that they can provide support
afterwards.
A supra-pubic catheter needs to be changed regularly, usually
every 12 weeks though it can be more frequently. You or your
carer can learn to do this. Some people tend to produce a
lot of sediment in their urine, which sticks to the catheter,
and they may need more frequent catheter changes.
Many people prefer supra-pubic catheters to urethral catheters
as they are easier to change – particularly for people who
experience leg spasms – and sexual activity is easier.
Managing with a catheter and preventing
problems
Keeping a catheter clean is vital. Yet even with the most careful
attention to hygiene some people seem to be more prone than
others to recurrent infections.
For people who have an indwelling catheter, just as for people
who do not, some problems can result from not drinking enough.
Therefore it is important to keep up your intake of fluids. This
can help to prevent infections and also prevent ‘crystallisation’
of calcium that can occur round the catheter and lead to blocking.
Managing bladder problems © MS Society 07/11
Some people may experience ‘bypassing’ or leaking around the
catheter. Constipation can be a cause, so it is also important
to have regular bowel movements.
12
If you have recurrent infections or other difficulties, you should
discuss them with your continence adviser.
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Surgery
While very few people with MS have urological surgery, it may
be the best option for a small number of people.
An operation called an ileocystoplasty, to make the bladder
larger, is sometimes carried out when medical management
has not been successful. However, since the arrival of botox
infections, this operation is becoming far less common.
Another operation, known as a ‘urinary diversion’, creates
a kind of tube between the bladder and the skin of the abdomen.
The tube, formed from tissue from the small bowel, drains into
a bag or pouch attached to the skin, so self-catherisation is not
needed. This type of operation may also be called a urostomy.
MS alone does not mean someone should not undergo surgery,
as long as all the risks are well assessed and the operation is
performed by an experienced team.
Managing bladder problems © MS Society 07/11
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Further
information
UK Information Team
020 8438 0799
[email protected]
National offices
– see back cover
www.mssociety.org.uk
Page 14
Read more
Our free booklets help explain MS, look at its practical and
emotional effects, and help you find your own ways to manage
life with MS. Titles are available in large print, audio format and
a number of languages.
We can help you find and borrow other books, research articles
and DVDs about living with MS. Search online or call the UK
Information Team.
Find out more online
Get the latest on research, campaigns and MS news. Chat online
with our message boards and Facebook. Follow us on Twitter,
see the MS community at Flickr and watch us on YouTube.
Children and teenagers can find out more and link up through
our YoungMS site: www.youngms.org.uk
Join us
Receive local and national magazines and newsletters, and get
involved locally and nationally. Be as involved as you like. Just
by being a member you strengthen the voice of all people with
MS, and help us continue our vital work. Join online, or call
020 8438 0759 or your national office.
Get in touch
The freephone MS Helpline offers confidential emotional support
and information for anyone affected by MS, including family, friends
and carers. Information is available in over 150 languages through
an interpreter service. 0808 800 8000 (weekdays 9am-9pm)
or [email protected]
Contact the UK Information Team or your national office if you
have any questions about MS.
Managing bladder problems © MS Society 07/11
Near you
14
Our volunteers run over 300 local branches and support groups.
They provide information about MS and local services, and a chance
to meet others affected by MS and take part in a range of activities.
In many parts of the country, you can pick up our booklets at
MS Society Info Points. Larger information centres – including
ones in our national offices in London, Belfast, Cardiff and
Edinburgh (Newbridge) – can help you with information about
MS and services in your area.
Or come along to our local and national events and learn more
about MS from expert care professionals, researchers and
other people with the condition. Find out more online or call
your national office.
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Page 15
Further reading
Bladder problems – factsheet Published by the
MS Trust (latest version at time of print – February 2011).
Available to order or download at www.mstrust.org.uk
A UK consensus on the management of the bladder in
multiple sclerosis Published by the MS Trust. A summary
of the consensus statement published in the Journal
of Neurology, Neurosurgery and Psychiatry 2009.
Available to order or download at www.mstrust.org.uk
Managing bladder problems © MS Society 07/11
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Useful organisations
Bladder and Bowel Foundation
Information and support for anyone affected by bladder or bowel
problems. The Foundation also runs a nurse helpline and can
tell you where to find your nearest continence specialist.
SATRA Innovation Park
Rockingham Road
Kettering NN16 9JH
Helpline 0845 345 0165
Telephone 01536 533 255
www.bladderandbowelfoundation.org
PromoCon
Offers independent advice on continence products available
in the UK.
PromoCon
Redbank House
St Chad’s Street
Manchester M8 8QA
Helpline 0161 834 2001 (Monday to Friday, 10am-3pm)
www.promocon.co.uk
RADAR
Runs the national key scheme, allowing access to around
9,000 accessible toilets across the UK.
12 City Forum
250 City Road
London EC1V 8AF
Managing bladder problems © MS Society 07/11
Telephone 020 7250 3222
www.radar.org.uk
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References
1 Kalsi, V. and Fowler, C. J. (2005) Therapy insight: bladder
dysfunction associated with multiple sclerosis. Nature Clinical
Practice, 2(10), 492-501.
2 Fowler, C. J. et al. (2009) A UK consensus on the management
of the bladder in multiple sclerosis. Journal of Neurology,
Neurosurgery and Psychiatry, 80, 470-7.
3 National Institute for Health and Clinical Excellence (2003)
NICE Clinical Guideline 8. Multiple Sclerosis: Management
of multiple sclerosis in primary and secondary care.
London, NICE.
4 Dasgupta, P. et al. (1997) The ‘Queen Square bladder stimulator’:
a device for assisting emptying of the neurogenic bladder.
British Journal of Urology, 80, 234-7.
5 Jepson, R. et al. (2004) Cranberries for treating urinary tract
infections (Cochrane Review). The Cochrane Library, Issue 4,
Chichester, John Wiley & Sons Ltd.
6 Jepson, R. et al. (2007) Cranberries for preventing urinary tract
infections (Cochrane Review). The Cochrane Library, Issue 1,
Chichester, John Wiley & Sons Ltd.
7 Guay, D. R. (2009) Cranberry and urinary tract infections.
Drugs, 69(7), 775-807.
8 Hess, M. J. et al. (2008) Evaluation of cranberry tablets for the
prevention of urinary tract infections in spinal cord injured patients
with neurogenic bladder. Spinal Cord, 46(9), 622-6.
9 Kalsi, V. et al. (2007) Botulinum injections for the treatment of
bladder symptoms of multiple sclerosis. Annals of Neurology,
62(5),452-7.
10 Freeman, R. M. et al. (2006) The effect of cannabis on urge
incontinence in patients with multiple sclerosis: a multicentre,
randomised placebo-controlled trial (CAMS-LUTS). International
urogynecology journal and pelvic floor dysfunction, 17(6), 636-41.
11 Brady, C. M. et al. (2004) An open-label pilot study of cannabisbased extracts for bladder dysfunction in advanced multiple
sclerosis. Multiple sclerosis, 10, 425-33.
12 Dalton, C. M. et al. (2010) Multiple sclerosis and other noncompressive myelopathies. In C J Fowler, J N Panicker and
A Emmanuel (eds) Pelvic Organ Dysfunction in Neurological
Disease, Cambridge University Press.
Managing bladder problems © MS Society 07/11
Find these references at
www.mssociety.org.uk/
library or call the UK
Information Team on
020 8438 0799. There
may be a charge for
the full article.
17
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Authors and contributors
Based on articles written by Professor Clare Fowler,
Department of Uro-Neurology, The National Hospital
for Neurology and Neurosurgery, London.
With thanks to Professor Clare Fowler, Collette Haslam,
Yasmin Keyani, Brian Kinsella, Susan Lambert, Shirlee
McKeown, Melanie Ranford-Mills, Samantha Roberts
and Kate Wilkinson.
Disclaimer: We have made every effort to ensure that
information in this publication is correct. We do not accept
liability for any errors or omissions, and policy and practice
may change. Seek advice from the sources listed.
Suggestions for improvement in future editions are welcomed.
Please send them to [email protected].
© Multiple Sclerosis Society, 2011
First edition, August 2004
Fourth edition, November 2009
Revised and reprinted, July 2011
Managing bladder problems © MS Society 07/11
This title will be reviewed within two years of publication.
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MS Society
Multiple sclerosis (MS) is the most common disabling neurological
disorder affecting young adults and we estimate that around
100,000 people in the UK have MS. MS is the result of damage
to myelin – the protective sheath surrounding nerve fibres of the
central nervous system. This damage interferes with messages
between the brain and other parts of the body.
For some people, MS is characterised by periods of relapse
and remission while, for others, it has a progressive pattern.
For everyone, it makes life unpredictable.
The MS Society is the UK’s largest charity dedicated to supporting
everyone whose life is touched by MS. We provide a freephone
MS Helpline, grants for home adaptations, respite care and mobility
aids, education and training, support for specialist MS nurses and
a wide range of information.
Local branches cater for people of all ages and interests and are
run by people with direct experience of MS.
The MS Society also funds around 80 vital MS research projects
in the UK.
Membership is open to people with MS, their families, carers,
friends and supporters. You can help the work of the MS Society by:
•
•
•
becoming a member
making a donation
offering your time as a volunteer
Contact information
MS National Centre
372 Edgware Road
London NW2 6ND
Telephone 020 8438 0700
[email protected]
MS Society Scotland
National Office, Ratho Park
88 Glasgow Road
Ratho Station
Newbridge EH28 8PP
Telephone 0131 335 4050
[email protected]
MS Society Northern Ireland
The Resource Centre
34 Annadale Avenue
Belfast BT7 3JJ
Telephone 028 9080 2802
[email protected]
MS Society Cymru
Temple Court
Cathedral Road
Cardiff CF11 9HA
Telephone 029 2078 6676
[email protected]
National MS Helpline
Freephone 0808 800 8000
(weekdays 9am-9pm)
www.mssociety.org.uk
Multiple Sclerosis Society.
Registered charity
nos 1139257 / SC041990.
Registered as a limited
company in England and
Wales 07451571.
ES07/0711