Multiple sclerosis presents challenges to both patients and professional providers of vocational rehabilitation. That is significant because of the irregular character of its progress throughout the affected person's life and because "the exact etiology of multiple sclerosis (MS) is unknown," with causes being variously attributed to abnormal immune systems, allergic mechanisms, or even a slow-acting virus (MS, 1997). For these reasons, MS has a history of eluding diagnosis (Gordon, Lewis, & Wong, 1994). What is known is that the disease attacks and wastes the neural myelin sheath, which protects the nerve fibers of the spinal cord and brain. The progressive appearance of plaque lesions in the myelin leads to neural dysfunction, which leads to a variety of manifest symptoms, including loss of muscle control. Symptoms can be temporarily controlled or managed with drugs, and the disease may go into remission from time to time. There is, however, no cure for MS. It is a chronic condition. Physical therapy, exercise, and drug therapy are used in various combinations to manage and lessen the impact of disease symptoms. Research continues.
Treatment options for MS may be classified into two broad categories: the medical model and the therapeutic or disease-management model. By and large, the medical model presumes treatment with pharmaceuticals, a consequence of research that has yielded a limited roster of drugs that are aimed at arresting and/or reversing demyelination. However, where neural damage may be irreversible, somatic function in general and muscular function in particular may be irrecoverable or in need of drastic retraining. Accordingly, the consensus of the medical literature is that therapeutic/rehabilitative model remains relevant to any comprehensive course of treatment of the disease (Kraft, 1999). It is in the latter context that vocational rehabilitation becomes relevant.
Pharmacological and therapeutic intervention...