Living with Multiple Sclerosis — How Rehabilitation Helps You Stay Ahead of the Disease
Multiple sclerosis is one of the most unpredictable neurological conditions there is. No two people experience it the same way. Symptoms can fluctuate day to day, week to week — fatigue, weakness, balance problems, spasticity, vision changes, and cognitive fog can appear, intensify, improve, and return without warning.
Living with MS means learning to navigate a condition that does not follow a straight line. And one of the most powerful tools available for doing that — one that is still underutilized by many individuals with MS — is specialized neurological rehabilitation.
How MS affects the nervous system
Multiple sclerosis is an autoimmune disease in which the immune system attacks myelin — the protective sheath that surrounds and insulates the nerve fibers of the brain and spinal cord. When myelin is damaged the electrical signals that travel along nerve fibers slow down, become distorted, or stop altogether.
The result is the wide range of symptoms MS is known for — weakness, fatigue, spasticity, impaired balance and coordination, changes in vision, difficulty walking, cognitive changes, speech and swallowing difficulties, and pain. During a relapse new areas of demyelination can create new or worsening symptoms. Between relapses — during periods of remission — some function typically returns as inflammation resolves.
The key insight for rehabilitation is this: even when the disease itself is not in relapse, the neurological system can be trained, strengthened, and supported in ways that build reserve, slow functional decline, and prepare the body to recover more fully from future relapses.
PoNS Therapy — a breakthrough for MS rehabilitation
One of the most exciting developments in MS rehabilitation in recent years is the Portable Neuromodulation Stimulator — known as PoNS therapy. Salience NeuroRehab is one of the only certified PoNS providers in Indiana, and our PoNS certified occupational therapist has delivered this protocol with meaningful results for individuals with MS.
PoNS therapy works through a small mouthpiece device that delivers gentle electrical stimulation to the tongue. The tongue is rich in cranial nerve endings that connect directly to the brainstem and cerebellum — the brain regions that govern balance, coordination, and gait. The stimulation activates these neural pathways and creates a state of heightened neuroplasticity, during which targeted rehabilitation exercises produce deeper and more lasting changes than they would otherwise.
Clinical studies supporting FDA clearance of the PoNS device demonstrated significant improvements in walking and balance in individuals with MS compared to exercise alone. For individuals who have noticed their walking and balance worsening despite other treatments, PoNS therapy offers a genuinely new avenue of recovery.
What MS rehabilitation addresses at Salience
Our occupational, physical, and speech therapists work with MS patients on a comprehensive range of goals tailored to where each individual is in their disease course and what matters most to their daily life.
Balance and fall prevention — MS significantly increases fall risk, and targeted vestibular and balance rehabilitation reduces that risk while building the confidence to move more freely.
Fatigue management — fatigue is the most commonly reported and most disabling symptom of MS. Our therapists work with individuals to identify energy conservation strategies, pacing techniques, and activity modifications that protect function throughout the day.
Spasticity and muscle tone — functional dry needling is particularly effective for MS-related spasticity, reducing tone, relieving pain, and improving range of motion in affected muscle groups.
Gait and mobility — PoNS therapy combined with targeted gait retraining can produce meaningful improvements in walking speed, stability, and confidence.
Upper extremity function — weakness and coordination impairment in the hands and arms affects independence with daily tasks. Our occupational therapists use neuroplasticity-based approaches to recover and maintain hand function.
Speech and swallowing — MS can affect the muscles of speech and swallowing over time. Early intervention with a certified speech and language pathologist preserves these functions most effectively.
Cognitive and daily living strategies — our occupational therapists help individuals with MS-related cognitive changes develop practical strategies to maintain independence with home management, work, and community participation.
The importance of staying proactive
The most important piece of advice we offer to individuals with MS is this: do not wait for a significant decline before seeking rehabilitation. The best time to build strength, balance, and neurological reserve is before function is lost — because maintaining function is always more achievable than rebuilding it after it has been significantly compromised.
Regular rehabilitation check-ins, even during periods of remission, help identify subtle changes early, address them before they become significant, and give individuals and their families the tools to stay as far ahead of the disease as possible.
You have more options than you may know
If you or someone you love has been diagnosed with multiple sclerosis and has not yet explored what specialized neurological rehabilitation can offer — particularly PoNS therapy — we would love to have that conversation.
Salience NeuroRehab offers one-on-one clinic-based and mobile outpatient therapy for individuals with MS across Dubois, Perry, Spencer, and surrounding counties in Southern Indiana. We are one of the only providers in the state certified in PoNS therapy and we are deeply committed to helping individuals with MS stay active, independent, and ahead of their diagnosis.
Call us at 812-998-6176 or request an appointment online.
— Melanie Lindauer, Salience NeuroRehab