Multiple sclerosis (MS) is a disease that affects the nervous system, and doctors now have powerful medicines that stop the sudden flare-ups many patients experience. However, even when these flare-ups stop, patients often still feel tired, stiff, and uncomfortable. A group of Italian doctors recently shared their ideas about using the body’s natural cannabis-like system (called the endocannabinoid system) along with healthy eating and exercise to help these patients feel better. They created a new plan that combines special medicines with lifestyle changes to treat the symptoms that stick around even when the disease seems calm.
The Quick Take
- What they studied: How doctors can help multiple sclerosis patients who aren’t having flare-ups but still feel symptoms like muscle stiffness and fatigue
- Who participated: This wasn’t a traditional study with patient volunteers. Instead, it was a meeting where experienced neurologists (brain and nerve doctors) from Italy shared what they’ve learned from treating their patients
- Key finding: Doctors suggest that activating the body’s natural endocannabinoid system—using both cannabis-based medicines and healthy lifestyle choices—may help reduce stiffness, pain, and other lingering symptoms in MS patients whose disease appears stable
- What it means for you: If you have MS and feel stuck with symptoms even though you’re not having flare-ups, this suggests a new treatment approach combining medicine and lifestyle changes might help. However, this is still an early-stage idea that needs more testing before it becomes standard treatment
The Research Details
This article is not a traditional research study where scientists test a treatment on patients. Instead, it’s an expert review where experienced neurologists from Italy met in June 2025 to discuss what they’ve learned from their patients and what published research shows about treating MS symptoms. They looked at existing scientific evidence about how the body’s natural cannabis-like system (the endocannabinoid system) affects MS symptoms, particularly muscle stiffness and spasms. Based on their clinical experience and the research they reviewed, they created a new treatment plan that combines medicines targeting this system with lifestyle changes like diet and exercise.
This approach is important because modern MS medicines are very good at stopping disease flare-ups, but many patients still struggle with ongoing symptoms that affect their quality of life. By focusing on these leftover symptoms and proposing a new treatment strategy, doctors are addressing a real gap in patient care. The endocannabinoid system is a natural part of your body that scientists are increasingly recognizing as important for controlling inflammation and nerve pain.
This is an expert opinion piece based on clinical experience and review of existing research, not a new clinical trial. This means the ideas are promising but haven’t been formally tested on large groups of patients yet. The strength comes from the doctors’ real-world experience treating MS patients, but the recommendations need further scientific testing to confirm they work. Think of this as experienced doctors sharing a promising idea that needs more investigation.
What the Results Show
The doctors propose that the endocannabinoid system plays an important role in MS-related muscle stiffness and spasms. They suggest that treatments targeting this system—including cannabis-based medicines—combined with healthy lifestyle changes may help reduce these symptoms in patients whose disease flare-ups have stopped but who still experience ongoing problems. The proposed treatment plan is personalized, meaning doctors would tailor it to each patient’s specific symptoms and needs. The combination approach is important because it addresses the problem from multiple angles: medicine targets the biological system involved, while diet and exercise support overall nervous system health.
The doctors also discuss how this approach might help with other symptoms associated with stable MS, including fatigue, pain, and mood changes. They emphasize that treating these lingering symptoms is just as important as preventing flare-ups, because these symptoms significantly impact patients’ daily lives and quality of life. The lifestyle component—including specific dietary recommendations and physical activity—appears to work together with medicines to enhance the body’s natural healing systems.
Previous MS treatment focused mainly on stopping disease flare-ups with powerful immunosuppressive drugs. This new approach builds on that success but shifts attention to managing the symptoms that remain even when flare-ups are controlled. The focus on the endocannabinoid system is relatively newer in MS treatment, representing an evolution in how doctors think about managing the disease’s long-term effects.
This is an expert discussion, not a formal clinical trial, so the recommendations are based on experience and existing research rather than new patient testing. The specific treatment plan hasn’t been formally tested on large groups of patients yet. Different patients may respond differently to these treatments. The use of cannabis-based medicines varies by country and region, which may affect availability. More research is needed to determine which patients benefit most and what the optimal treatment combinations are.
The Bottom Line
For MS patients whose disease flare-ups have stopped but who still experience symptoms: Talk to your neurologist about whether this approach might help you. The combination of endocannabinoid-targeting medicines (if available in your region) with improved diet and regular physical activity appears promising based on doctors’ experience, though it’s not yet standard treatment. Start with lifestyle changes (diet and exercise) which are safe and beneficial regardless. Confidence level: Moderate—this is a promising expert recommendation that needs more formal testing.
This is most relevant for people with multiple sclerosis who have stable disease (few or no flare-ups) but still experience muscle stiffness, spasms, pain, or fatigue. It may also interest their family members and caregivers. People with other neurological conditions might eventually benefit from similar approaches, but this research specifically addresses MS. Those with active, flare-prone MS should continue their current high-efficacy treatments.
Lifestyle changes (diet and exercise) can show benefits within weeks to months. If cannabis-based medicines are used, effects may develop over several weeks. Full benefits of the combined approach might take 2-3 months to become apparent. This is a long-term management strategy, not a quick fix.
Want to Apply This Research?
- Track daily muscle stiffness (rate 1-10), fatigue level (1-10), and pain level (1-10) each morning and evening. Also log physical activity minutes and note any dietary changes. This creates a clear picture of how symptoms change with the new approach over time.
- Set specific, achievable goals: commit to 20-30 minutes of gentle physical activity 4-5 times per week (walking, swimming, or physical therapy exercises), implement one dietary change per week (like adding anti-inflammatory foods), and take any prescribed medicines consistently. Use the app to set reminders and track completion.
- Review your symptom tracking weekly to spot patterns. Share monthly summaries with your doctor to assess whether the approach is working for you. Adjust diet and exercise based on what you notice helps most. If using cannabis-based medicines, track any side effects alongside symptom improvements to help your doctor optimize your treatment.
This article discusses expert recommendations for managing multiple sclerosis symptoms and is not a substitute for professional medical advice. Multiple sclerosis is a serious medical condition that requires ongoing care from a qualified neurologist. Do not start, stop, or change any MS treatments without consulting your doctor first. Cannabis-based medicines are not legal or available in all regions and may interact with other medications. The treatment approach described here is based on expert opinion and existing research but has not yet been formally tested in large clinical trials. Individual results may vary significantly. Always work with your healthcare team to develop a treatment plan tailored to your specific condition, medical history, and needs.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.