The role of trauma in causing MS or in triggering subsequent MS exacerbations (also known as attacks, relapses or flares) has been the subject of controversy for many years. Until recently, opinion on this issue was based upon anecdotal reports or retrospective information that relied on the memories of patients.
A Major Review Shows No Link with Onset or Exacerbation of MSA
1999 report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology based on a comprehensive study of the literature on the subject, concluded that "the evidence supports no association between physical trauma and either MS onset or MS exacerbation."
A prospective study, conducted by researchers at the University of Arizona, followed 170 MS patients and 134 controls, over a period of eight years. A prospective study is one that follows a group of people with a given disorder over a specific period of time, beginning before the occurrence of the events being studied. The results of this study, published in 1991 in the Journal of Neurology, Neurosurgery and Psychiatry, concluded that except for electrical injuries, there was no evidence of a direct relationship between traumatic injury and an MS exacerbation.
A second study, performed at the Mayo Clinic, where there is an MS patient population for whom complete clinical records have been maintained for years, supported the Sibley group's findings that traumatic injury is not related to exacerbation of MS. The Mayo study also indicated there is no relationship between traumatic injury and MS onset. Although this study, published in 1993, was retrospective, it was based upon the detailed clinical records of 164 long-term patients with definite MS, actively followed at the Mayo Clinic.
Traumatic Events Often Due to Symptoms of MS
Both studies showed that there are more traumatic events among people with MS than in the healthy control group. Many traumas were caused by MS symptoms such as in-coordination, impaired balance, or abnormalities of gait or vision. These events, however, were not precipitating factors in the onset or exacerbation of the disease.