What Are MS Symptoms?

Emily Inkpen Jul 26, 2017 5 min

The symptoms of MS include: fatigue, problems with sight, balance and dizziness, numbness and tingling, muscle spasms, cognitive difficulties, bladder and bowel problems.

What is Multiple Sclerosis?

Multiple sclerosis, or MS is a neurodegenerative disease, which means that the brain degenerates over time. It’s characterised by damaged areas (lesions) on the brain and spinal cord. MS causes, among other things, muscle spasms, problems with thinking and learning, and mobility problems.

For more information about the history, causes, and treatments of multiple sclerosis, see MS: A Deeper Dive

What are MS symptoms?

The symptoms of multiple sclerosis are varied, can affect any part of the body, and every patient is affected differently.

For some, the symptoms develop and get more pronounced over time, and for others the symptoms come and go. Two terms that are often used are:

Relapse – when symptoms that have abated for a time, come back.
Remission – When symptoms that have been bad, improve or clear.

The most common symptoms include:

Fatigue
Problems with sight
Trouble with balance and dizziness
Numbness and tingling
Muscle spasms, stiffness and weakness
Problems when thinking or planning
Sexual problems
Bladder problems
Bowel problems
Problems with speech and swallowing

Fatigue

Fatigue is an ‘invisible symptom’ of multiple sclerosis. It comes as a sudden loss of energy that prevents the patient from being able to continue an activity. It can be either or both mental and physical. It cannot be ‘worked through’, and the recovery time can be long.

It’s difficult for family, friends or colleagues to understand fatigue and how debilitating it can be. The most common assumption is that the patient simply isn’t ‘trying hard enough’. Understandably it’s the most common cause of MS patients needing to reduce their working hours or give-up working entirely.

Problems with sight

As multiple sclerosis affects nervous system, it’s not surprising that it should affect the optic nerve, which connects the eye to the brain. 20% of MS patients experience a problem with one or both of their eyes (at different times). It can be temporary loss of vision, colour blindness, flashes of light, blind spots with otherwise good vision, and often causes pain.

Trouble with balance and dizziness

Roughly speaking there are 3 parts to the balance system, and all rely on swift transmission of information about the outer environment, to the brain. When the pathways that carry these signals are interrupted, the physical effects can be destabilising. To balance we need:

Effective sight to communicate information about the environment
A stable inner ear to update the brain on the angle of the head
Clear senses, that might be interrupted by numbness or tingling, to communicate where the various parts of the body are

Incidentally, successfully marrying these three elements is a constant challenge to the Virtual Reality industry. When the eyes are communicating movements like running and jumping, and the ears are sensing a rotating and tilting head, and the body is communicating no movement whatsoever, the effect can be nausea-inducing to even the strongest stomach.This sensation is not dissimilar to the sensation experienced by some MS patients.

Numbness and tingling

Numbness and tingling can affect any part of the body, but commonly affects the face, arms and legs. This is one of the most common symptoms of MS, and often the first symptom that raises alarm. The numbness can be slight, or it can be so severe that it has an effect on carrying out everyday activities.

If feet are numb or tingling, then walking can be difficult
If hands are numb then holding objects can be unadvisable, especially items such as a cup of tea, which if dropped, might cause both injury and a terrible mess
If the face is numb, then eating without biting the inside of the mouth or tongue can be difficult

Most cases of numbness and tingling wear off on their own.

Problems with thinking and planning

Cognitive problems affect about 50% of people with MS, and those patients will experience some problems with memory, attention span, planning, decision making, and understanding. These problems are more likely to arise the longer the condition persists.

These symptoms are easy to dismiss as related to stress, overwork, tiredness, or the ageing process. The most common description given for these cognitive problems is ‘brain fog’, or ‘fuzziness’. As these symptoms usually get progressively worse, it is possible to come up with ways to cope with them on a daily basis.

Sexual problems

MS can cause complications with sexual responses and relationships.

Mechanically, orgasms require messages to be sent through the nervous system between the brain and the sexual organs, and if there’s nerve damage in the pathways involved, then this can cause simple functional barriers.

Less mechanically, living with a condition, especially one where the ongoing symptoms can be hard to understand, can create a barrier between two people. The worry and stress that can come from facing a long-term condition can also cause a breakdown in libido.

MS in itself can cause a loss of interest in sex, and post diagnosis, the grief of adjusting to the new reality can affect sexual desire. Embarrassment and feeling less attractive can also impact.

Bladder problems

The bladder works when the senses communicate with the brain that the bladder is getting full. This warning usually allows time for getting to a toilet. Once there, the muscles in the bladder need to coordinate; one relaxes while the other contracts.

There are two problems that can face people with MS:

Storage
Emptying

When nerve pathways are interrupted, even a small amount of urine in the bladder can cause it to contract, which can cause frequency; the need to visit the bathroom on a very regular basis. Then the inability to coordinate the bladder muscles can affect the ability to ‘hold on’, which causes ‘urgency’.

If the problems are to do with emptying, then the difficulty lies in interrupted flow and an inability to empty completely.

Bowel problems

These can be a source of great discomfort and embarrassment for MS patients. The two extremes are constipation and diarrhoea.

Constipation can be caused by:

Reduced fluid intake
Reduced physical activity
The side effects of certain medications

Regularity can be maintained by:

Keeping fluid levels high
Eating plenty of fibre; fresh fruit and vegetables and whole grains
Physical activity

Problems with speech and swallowing

Just like the bowel, swallowing relies on a series of muscle contractions, and the successful execution of this can be interrupted by damaged neural pathways. In MS, this specific problem is called dysphagia. Dysphagia commonly affects both speech and swallowing.

Problems with swallowing can cause coughing or choking when eating, and the feeling that something is lodged in the throat.

Challenges with speaking can cause speech patterns to be disrupted by long pauses and slurring.

Caring for someone with MS

Caring for a loved one is rewarding, but it can also be immensely stressful. Multiple sclerosis is a degenerative disease, so the care required will become more demanding as time goes by.

If your loved one’s MS becomes ‘advanced’, they will be entirely dependent on a carer for their personal care. At this time it’s likely that their clinical needs will be complex and they will need to be supervised most if not all of the time.