Multiple sclerosis - Symptoms 

Symptoms of multiple sclerosis 

The central nervous system (brain and spinal cord) controls all of your body's actions. When MS damages the myelin coating around the nerve fibres that carry messages to and from your brain, symptoms can occur in any part of your body.

There are many different symptoms of MS and they affect each person differently. Some of the most common symptoms include:

  • extreme tiredness (fatigue)
  • numbness and tingling
  • blurring of vision
  • problems with mobility and balance
  • muscle weakness and tightness

Most people with MS only have a few of these symptoms and it is unlikely someone would develop all possible symptoms.

The symptoms are unpredictable. Some people's MS symptoms develop and increase steadily over time, while for others, they come and go periodically.

These periods when symptoms get worse are known as relapses. Periods when symptoms improve or disappear are known as remissions.

Visual problems

In around one in five cases of MS, the first noticeable symptom is problems with one of your eyes. You may experience:

  • some loss of vision in the affected eye – this can range from mild to severe (total loss of vision occurs in one in 35 cases)
  • colour blindness 
  • eye pain; usually made worse when moving the eye
  • flashes of light when moving the eye

These symptoms are the result of optic neuritis, which is inflammation (swelling) of the optic nerve that transmits visual information to the brain. This normally only affects one eye.

Other visual problems that can occur in MS include:

  • double vision
  • eye pain in both eyes
  • involuntary eye movements (usually from side to side), known as nystagmus

Abnormal sensations

Abnormal sensations can also be a common initial symptom of MS. This can take the form of numbness or tingling in different parts of your body.

Muscles in your arms and legs may also feel unusually weak.

Muscle spasms and spasticity

If messages between your brain and muscles are disrupted, this can cause problems with muscle movements. It can cause muscles to contract tightly and painfully (spasm) or your muscles may also become stiff and resistant to movement, known as spasticity.

Pain

Around half of people with MS experience pain, which can take two forms:

  • Neuropathic pain – caused by damage to the nerve fibres in the brain and spinal cord. It can be a stabbing pain, extreme skin sensitivity, or a burning sensation.
  • Musculoskeletal pain – this is not caused directly by MS, but can occur if there is excess pressure on muscles or joints as a result of spasms and spasticity.

Mobility problems

MS can affect balance and co-ordination. It can make walking and moving around difficult, particularly if you also have muscle weakness and spasticity. You may experience:

  • ataxia – difficulty with co-ordination
  • tremor – shaking of the limbs, which is rare, but can be severe
  • dizziness and vertigo can happen late on and can make you feel as if your surroundings are spinning

Extreme tiredness (fatigue)

Feeling extremely tired (fatigue) is a common symptom of MS that many people describe as one of the most troublesome.

It is estimated that as many as nine out of 10 people with MS will experience episodes of fatigue.

People with MS have reported feeling an overwhelming sense of weariness where even the most simple physical or mental activity seems to be a tremendous struggle to carry out.

Fatigue may be worse in hot weather, after exercising, or during illness.

Problems with thinking, learning and planning

Around half of people with MS have problems with thinking, learning and planning (known as cognitive dysfunction). They may experience:

  • problems understanding and using language
  • a shortened attention span
  • problems learning and remembering new things (long-term memory is usually unaffected)
  • problems understanding and processing visual information, such as reading a map
  • difficulty with planning and problem solving – people often report that they know what they want to do, but can’t grasp the method of how to do it
  • problems with reasoning, such as mathematical laws or solving puzzles

Mental health issues

Around half of all people with MS experience at least one episode of depression at some point in their life.

It is unclear whether the depression arises from the damage to the brain caused by MS, or due to the stress of having to live with a long-term condition, or both.

Anxiety can also be a problem for people with MS, possibly due to the unpredictable nature of the condition.

Some people with MS can sometimes experience rapid and severe mood swings, suddenly bursting into tears, laughing or shouting angrily for no apparent reason.

Sexual problems

MS can have an effect on sexual function.

Men with MS often find it hard to obtain or maintain an erection (erectile dysfunction). They may also find it takes a lot longer to ejaculate when having sex or masturbating, and may even lose the ability to ejaculate altogether.

For women, problems include difficulty reaching orgasm as well as decreased vaginal lubrication and sensation.

Both men and women with MS may find they are less interested in sex than they were before. This could be directly related to the MS, or it could be the result of living with the condition.

Bladder problems

Bladder problems are common in MS.

They may include:

  • difficulty emptying the bladder completely
  • having to urinate more frequently
  • having a sudden, urgent need to urinate which can lead to unintentionally passing urine (urge incontinence)
  • having to get up frequently during the night to pass urine (nocturia)

Bowel problems

Many people with MS have problems with their bowel.

Constipation is the most common problem, affecting around half of people with MS. They may pass stools much less frequently than normal, and find this difficult.

Bowel incontinence is less common but is often linked to constipation. If a stool becomes stuck, it can irritate the wall of the bowel, causing it to produce more fluid and mucus that can leak out of the anus (back passage).

Speech and swallowing difficulties

Around a third of people with MS experience difficulty chewing or swallowing (dysphagia) at some point. In some cases, speech may also become slurred, or difficult to understand.

However, for most people with MS, speech and swallowing symptoms are mild and only last for a few minutes at a time. They are often at their worst during a relapse.


Page last reviewed: 03/04/2014

Next review due: 03/04/2016

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The 8 comments posted are personal views. Any information they give has not been checked and may not be accurate.

JTSM said on 14 May 2014

I have had 2 cases of Bells Palsy in the past 3 months. First time my family thought I'd had a stroke and I spent several days in hospital but after ct scan went home on steroids. Second time I also got severe bladder infection and kidney infection and needed 3 lots of anti biotics. I have been experiencing pure exhaustion where I am mentally preparing myself for everyday to get physically through as normal as possible. Cut down work load so I can still walk my dogs etc. I have been experiencing the constant need to urinate and given anti spasmic medication. Also had several loss of bowel control or explosions! Wonder if anyone has advice. I am not very good at going to doctors and feel I haven't been away from them since turn of year. Any advice!?

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indienile said on 09 May 2014

i have been diagnosed with FM the pain is awful
but lately the fatique and the swallowing is driving me to dispare!
and cant bare the pins and needles and feel i have nowhere else to turn
can anyone help?

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Papula73 said on 02 March 2014

I have hydrocephalus and had a stroke although I have regained the use of my right side! Just lately I have had a numbness and dead kind of feeling in my arms, especially the left side to which my vp shunt is placed. Also have had lots of test on my eyes and my visual field ( blind spot) has worsened. I also get pins and needles I'm my hands and feet. I tend to drop things too. What should I do?

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Woodlandia said on 17 February 2014

Rdiana, it doesn't sound so much like MS as more like ME or Post Viral. I had Glandular fever and ended up with ME.

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Rdiana said on 22 November 2013

I have recently been diagnosed with glandular fever and I feel terrible. I have fatigue and tiredness and most of my joints ache like mad. The most severe symptom I have is very painful hip joints and I cannot walk very far because of the pain. I also have tingling in my hands and feet and have the feeling sometimes of falling forward. I have been referred to a rhumatologist as they suspect RA. I have read this article and some of the symptoms are very similar to what I have. The one thing I dont have though is the blurred vision. I am at moment off work and have been for 5 weeks now. I have a feeling that the severe hip joint pain may be a secondary complication of the glandular fever I would welcome comments from anyone in a similar situation

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Mr S Newsom said on 12 July 2013

There is stuff in this article I never realised was part of MS and yet I have suffered some of them in the past. One thing that gets me is that out of all the symptoms, there is only one I don't have much problems with. I have numbness and tingling, blurring of vision, problems with mobility and balance on a daily bases but manage to coupe and do a 24 hour week at work. I am 26 and have been diagnosed with RRMS since January 19th 2011. In the past 2 years Avonex has been my method of treatment. I was scared at first but with time I have come to live with it but there is times that it gets hard to do normal things. I also have problems with heavy sweating when I'm eating warn dinners and sleeping.

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Sunnybrid said on 24 April 2013

There are test that can help to diagnose MS. Firstly, You need to see your GP and discuss your symptoms and the concerns you have. Your GP may refer you to a Neurologist if its appropriate.

MRI scan of the brain can help to diagnose MS as can a lumbar puncture. These are test the Neurologist can request for you.

Hope this is information is helpful. The sooner you see your GP the less anxious you will feel.
Good luck!

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jblakelock said on 12 April 2013

am 37 years of age , i suffer with chronic back pain which i have done for years, over the past 5 yr s the urge to pass urine more frequently has over took me, some times resulting in getting up through the night between 2 6 times for the toilet, i am always tired i struggle to us my limbs as they feel weak and tire easy . i often feel dizzy. i get pains shouting through my arms legs and hips, and sometimes feel as if i have blurred vision, i have only had one bad case of depression but i often feel down, i cant seem to gain weight. i suffer from regular water infections. do i have ms and is there any tests i can take to get a diagnosis.

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Benign MS

In a small number of cases a person has a small number of relapses followed by a complete recovery. This is known as benign MS.

A diagnosis of benign MS can only be made with confidence if you have been largely free of symptoms for more than 20 years.

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