There are a wide range of symptoms of multiple sclerosis (MS), which can vary greatly from person to person.
Your central nervous system (brain and spinal cord) controls all your body's actions, so when MS causes damage to the nerve fibres that carry messages from your brain, symptoms can occur in any part of your body.
However, most people with MS only have a few of these symptoms, and it is very unlikely that someone would develop all of the possible symptoms.
Possible symptoms of MS
Fatigue
If you have MS, you may find that fatigue (extreme tiredness) is your main symptom. This fatigue may worsen your other symptoms, such as problems with balance, vision and concentration.
In MS, fatigue is not just an ordinary tiredness that people might experience after a hard day’s work or strenuous exercise. Many describe it as an overwhelming sense of tiredness with no apparent reason.
Visual problems
In 25% of cases of MS, the first symptom is inflammation (swelling) of the optic nerve, known as optic neuritis. This usually only affects one eye, and causes pain behind your eyeball and some loss of vision.
You may also experience double vision, pain in both eyes, some colour blindness, and difficulty focusing (known as nystagmus).
Muscle spasms and spasticity
MS causes damage to the nerve fibres in your central nervous system, which can cause your muscles to contract tightly and painfully (spasm). It is also possible for your muscles to stay contracted and become stiff and resistant to movement, which is known as spasticity.
Pain
There are two types of pain that can occur as a result of MS; neuropathic and musculoskeletal.
- Neuropathic pain is caused by damage to the nerve fibres in your central nervous system, and appears as stabbing pains, extreme skin sensitivity or burning sensations.
- Musculoskeletal pain is not caused directly by MS, but can occur if there is excess pressure on your muscles or joints as a result of spasms and spasicity.
Mobility problems
MS can affect your balance and coordination, and can cause you difficulty walking and moving around, particularly if you also have muscular spasms and spasicity. You may also experience a tremor (ataxia) or dizziness, which can be quite severe and make it feel like your surroundings are spinning (vertigo).
Cognitive problems
Cognitive problems refer to problems with mental processes such as thinking and learning. You may have trouble remembering and learning new things, problems with attention and concentration, slowed or confused speech, and reduced mental speed.
Emotional problems and depression
If you have MS, you may find that you laugh or cry for no reason, and you are more likely to experience depression or anxiety.
Approximately 50% of people with MS experience clinical depression at some point, which lasts for more than two weeks. Depression in MS does not appear to be linked to the level of disability experienced.
Bladder problems
MS can make your bladder either overactive or underactive. If it is overactive, your bladder may contract when it is not full, causing incontinence. If it is underactive, you may find that your urine flow is interrupted and your bladder does not feel empty.
Bowel problems
MS can often cause constipation, but you may also find that it causes bowel incontinence as well.
Relapses and remissions
The symptoms of MS are unpredictable, and some people may find that their symptoms develop and worsen steadily over time, while for others they come and go periodically.
Periods when your symptoms get worse are known as relapses, and periods when your symptoms improve, or disappear altogether, are known as remissions.
A relapse in MS is defined as a period of at least 24 hours during which new symptoms appear or your previous ones worsen. Relapses can occur at any time, and may vary in their severity with each recurrence. In some cases, a recurrence or worsening of your symptoms can be caused by outside factors such as hot weather, exercise or an infection.
The four types of MS are characterised by the patterns of relapses and remissions that your symptoms follow, and are outlined below.
Benign MS
Benign MS is the mildest form of MS, characterised by a small number of relapses followed by a complete recovery each time. However, if you have benign MS, there is no guarantee that it is ever gone for good.
It is possible to have a relapse of your symptoms after many years of benign MS.
Relapsing remitting MS
Relapsing remitting MS is the most common type of MS, characterised by numerous relapses and remissions. Your relapses may last for days, weeks or months, and you may experience new symptoms each time or a recurrence of previous ones.
After each relapse you may recover completely, but many people's symptoms only improve without disappearing altogether.
Secondary progressive MS
Secondary progressive MS is characterised by a steady worsening of your symptoms, with or without relapses. Most people who have relapsing remitting MS go on to develop this form of MS.
Primary progressive MS
Primary progressive MS is the most severe form of MS. If you have this form of MS, your symptoms will get steadily worse with no distinct relapses or remissions.
If you have MS, it is likely to have implications
for driving. See the Useful links section for how to inform the DVLA about medical conditons.
