A pins-and-needles sensation can be the first sign of nerve damage from MS. It’s usually on one side of the body and gets better over time.
Unusual pains like pricking or stabbing ones or a tightness around the chest and belly known as an MS hug can also occur. So can a lack of balance or problems swallowing (called dysphagia).
Fatigue
Fatigue is a common MS symptom and it can occur in different ways. It may be physical (tiredness in the arms or legs), cognitive (slowed processing speed, or mental exhaustion) or a combination of both. Fatigue can be temporary, such as during a relapse or after taking certain medications, or it can be a permanent symptom of MS.
Getting enough sleep is one way to help reduce fatigue. Stress management programs, exercise, membership in an MS support group and psychotherapy may also help. People with MS may experience sexual problems, including anorgasmia (delayed or absent orgasms) and dyspareunia (pain during intercourse).
Many of the symptoms of MS are a result of damage to nerves. The nerves are protected by a sheath called myelin, and MS attacks this sheath to cause damage. This damage can lead to muscle stiffness or spasms, which is a symptom known as’spasticity’. Problems with balance and feeling dizzy can also be caused by damage to nerves. It is important to see your doctor if you have any new symptoms, as they may be early signs of MS or indicative of a relapse. A medical professional will ask about your family history and your lifestyle, then give you a physical exam and check for other health problems that might be causing the fatigue.
Muscle Spasms
A sudden, painful spasm in a muscle can be a symptom of MS. You may also have pain that radiates, where it begins at the source of the tension and travels to other parts of your body, like your legs or arms. If you have spasms that interfere with your daily activities, it’s important to talk to your neurologist.
A physical exam and medical history can help your doctor understand what causes your muscle spasms. They’ll ask when they started, how often they occur and which muscles are involved. They’ll also check for other illnesses that can cause similar symptoms, like diabetes, kidney disease, hypothyroidism and spinal cord injury.
You’ll probably get blood tests to rule out these conditions and other diseases that can cause muscle twitching, such as muscular dystrophies or amyotrophic lateral sclerosis (ALS). Your doctor may also do an imaging test called an MRI to see whether your ms symptoms are caused by myelin damage, a condition known as demyelination. During an MRI, your healthcare provider uses a contrast dye to show how well the myelin sheath that surrounds nerve fibers is intact. The MRI scan also helps identify areas of scar tissue that block messages from passing easily between nerve cells.
Numbness or Tingling
If you experience numbness or tingling in your arms, legs, face, or other body parts, it is important to talk to your doctor as soon as possible. These symptoms are a common sign of MS and are related to damage to nerve coverings in the brain and spinal cord. This is called demyelination and it can cause problems with how signals travel to and from the affected area.
The numbness and tingling often affects one side of the body more than the other and may include a pins-and-needles feeling or a loss of sensation in an arm or leg. This can interfere with walking or climbing stairs and can make it hard to feel heat, cold or vibrations. Numbness or tingling in the hands can make it difficult to write, hold or grasp objects.
You may also notice a change in your balance or a feeling of unsteadiness (ataxia). This is also caused by nerve demyelination and can lead to problems with how you walk or perceive where you are in space, like tripping or falling. Other signs that you have MS include pain that feels burning, prickling, stabbing or icy hot and a tightening sensation around the ribs and belly called pruritis.
Loss of Coordination or Balance
Sometimes MS can cause changes that affect how you move, walk, talk or balance. This is usually the result of nerve demyelination affecting nerves that direct your muscles. For example, weakness can mean that you don’t swing your leg up over your knee when walking and this can lead to tripping or catching your foot on things (sometimes called compensatory gait). Balance problems may be the result of spasticity, or stiffness of the muscles. Or it could be caused by the loss of nerve myelination in special areas of your brain that control your sense of balance and body positioning. This often presents as a tremor, which can be treated with medication and/or physical therapy.
These symptoms can be worse in hot weather or after exercise. They can also be made worse by stress, depression or fatigue. It’s important to tell your doctor if these changes occur as it may indicate a change in the progression of your ms or a relapse. The sooner a problem is detected, the quicker it can be managed. For example, if you notice that your speech or swallowing is becoming slurred or that you are having difficulty breathing, speak to your neurologist right away.
Speech or Language Disorders
People with MS often have problems with speech and language. This can be due to damage in the part of the brain that controls these skills or due to other MS symptoms, like numbness or weakness. This symptom can make it harder to express yourself and may cause others to misunderstand what you mean. It can also be a sign of depression or stress. It’s important to talk to your doctor about these issues.
Stiffness or spasticity, which feels like your muscles are tight and hard to move, is another common symptom. It can happen suddenly and usually affects the arms, legs and torso. It can get worse in the cold or with fatigue. Sometimes it gets better with heat or when you relax.
Other problems that can occur are changes in thinking, tremors and bladder or bowel problems. Thinking problems can include trouble remembering things, slowed processing or being unable to focus. They can be a sign of mild dementia or depression and can sometimes improve over time.
Bladder or bowel problems can be caused by nerve damage in the areas that control them or from other MS symptoms, such as numbness or muscle spasms. These can make it harder to walk and can lead to urinary tract infections.
Vision Problems
Many people find that vision problems are among the first symptoms of MS. They can happen in different ways, but some include blurred vision, double vision, or a feeling like there’s a dark curtain over one side of your vision (diplopia).
This problem is due to nerve damage that weakens muscles that allow eye movement. When you move your eyes, you may see two images of the same object on either side of your vision or one image on top of another. This problem is also known as nystagmus.
Another common vision problem is optic neuritis, which causes inflammation of the optic nerve in one eye and can lead to blurred or dim vision. It can cause blind spots or a wavy, faded area of vision called a scotoma and may affect color vision. It usually occurs in just one eye but may affect both at some point.
Changing vision can also be a sign of diabetes or high blood pressure. You should talk to your doctor if you have vision changes, especially if they are new and accompanied by pain in the eye or a red, painful eye. You should also get help right away if you experience a sudden and severe headache.
Bowel or Bladder Problems
Many people with MS experience bladder and bowel problems. They may need to pass urine more often or have to urinate during the night, they may lose control of their bladder and leak urine (urinary incontinence) or they may be unable to empty their bladder completely and have to leave the toilet partially full causing diarrhoea or constipation.
Sometimes a person with MS can have pain in their bowel, a feeling that they are passing blood or the need to strain when trying to have a bowel movement. These problems can occur because of damage to the nerves that control muscle function, including the muscles that open and close the bladder.
Bladder problems can also be caused by spasms in the muscles of the bladder or because of the loss of sensation in the bladder and the sphincter muscle that controls its contractions.
Bowel problems can be managed with a combination of a thorough evaluation by a healthcare professional, motivation on the part of the person with MS to change their behaviour and medication to manage symptoms. This can include intermittent self-catheterisation, a programme of fluid intake, increased fibre in the diet, peristaltic stimulants and medication to help with constipation.
