Many of the symptoms of multiple sclerosis (MS) can feel like other illnesses. So it’s important to talk about any new or worsening ones with your doctor or specialist MS healthcare team.
Fatigue is a common symptom. It’s an inexplicable feeling of mental and physical tiredness that gets worse at the end of the day.
1. Fatigue
Fatigue is one of the most common symptoms of MS. It can affect people physically, emotionally and mentally and is often described as overwhelming. It can also appear at a variety of times and can vary in severity. It can be a sign of many things including illness or other conditions such as anemia, chronic fatigue syndrome, thyroid disorders, heart disease and diabetes. It can also be a side effect of certain medications or a symptom of depression. It is important to recognise that fatigue is not a normal part of life and to seek help if it becomes an ongoing issue.
Fatigue in MS may be accompanied by other symptoms such as unrelenting weakness, changes to physical sensations (such as numbness or tingling), tremors and problems with balance and coordination that can cause you to fall over, bump into things or struggle to walk. It can also be accompanied by vision problems, including blurred or double vision and eye pain. Some people with MS experience neuropathic pain, which is pain that occurs due to damage or dysfunction to the nerves and can include burning, itching, prickling or crawling feelings in the skin (called dysesthesias) and spasticity, where muscles become so tight they cannot bend (such as flexor spasticity).
Problems with thinking and memory, called cognitive symptoms, are also quite common in people with MS. These can include forgetfulness, trouble concentrating or impulsive behaviour. Some people with MS experience speech and language difficulties, such as slurred speech or difficulty swallowing. Others may experience changes to their mood or emotions, such as depression, anxiety or feeling strangely happy or sad (known as pseudobulbar affect).
The best way to manage fatigue is through regular exercise, a healthy diet and sleep habits, stress management and managing the effects of other medical conditions. If the fatigue is due to medication, it can sometimes be eased by changing your doses or switching to a different medicine. It is also important to try and identify what triggers the symptoms, so you can avoid them as much as possible.
2. Numbness or tingling in the hands or feet
Numbness is a common early symptom of multiple sclerosis. It can be caused by a number of things but most often it concerns nerves. The tingling can be in the hands or feet, but it can also affect the tongue, throat, lips or chest. In some people, a combination of symptoms such as numbness, tingling and problems with balance can cause them to stumble or fall more often.
Other early symptoms include problems with thinking or memory (cognition), such as forgetfulness, impulsiveness and difficulty making decisions. They can also be affected by changes in their perception of the world around them (visuospatial problems) or problems with their balance and coordination, such as a change in walking style (gait) or feeling off-balance or unsteady. This can be caused by a change in muscle spasticity or by demyelination of the nerves that control movement.
Cognitive changes can also include slowed processing, trouble finding words or a lack of focus. Other symptoms can include tremors, such as an action tremor where a limb shakes when you try to use it. There are medications that can help with these tremors.
Some people with MS find they have problems with their bladder and bowel, such as frequent urinary infections or constipation. They can also experience sexual problems. This can be due to the nerve damage affecting the brain that controls these functions, but also because of the emotional stress and fatigue that can occur when living with a long-term condition.
There is no test for identifying MS, but doctors can rule out other illnesses if they see the person has many symptoms that last a long time. They can also monitor a person’s progress, because most people with MS have a relapsing form of the disease.
It is important to flag any new symptom and discuss it with your doctor. They will decide if any tests need to be done and whether to monitor a person for changes in their symptoms over time.
3. Vision problems
People with MS sometimes develop problems with their eyesight. This is often the first symptom of the disease and can be caused by inflammation in the optic nerve (optic neuritis). It can also happen because of damage to the protective covering around the nerve fibres in the eye (demyelination).
The symptoms vary from person to person, but may include blurred vision, double vision, blind spots or changes to how colours look. The symptoms may come and go, or get worse when you have a flare-up of MS.
If you experience these symptoms, see your GP. It is important that they know what you are experiencing, as this could help them make an early diagnosis of MS. Your GP can refer you to a doctor who specialises in the brain and nervous system (neurologist). This tool on Healthline FindCare will help you locate one near you.
Nerve damage can cause problems with the movement of your mouth and throat, making it hard to speak clearly or swallow. It can also cause problems with the sense of smell and hearing. You might also have a feeling of fullness in the ears or feel like your ears are ringing (tinnitus).
Symptoms of MS can range in severity and may be very different from one day to the next. This can make it difficult to diagnose and treat. For example, some of the motor problems that can occur with MS – such as spasms of the muscles that can cause you to kick out or jerk your limb – are very similar to other conditions and can be confused with them.
If you are diagnosed with MS, your doctor will probably suggest medications that can help to reduce the frequency of relapses. Your doctor might also refer you to a physiotherapist or other health professional to help with the physical effects of MS, such as mobility and balance issues, pain and fatigue. They may recommend a variety of exercises to improve your strength and flexibility, as well as strategies for dealing with a lack of energy.
4. Dizziness
Dizziness is a feeling that you might faint or that the world is spinning around you. It can be caused by a number of things, and often gets better on its own or can be treated. It’s important to flag it with your MS nurse or GP so that they can help you find what’s causing it and how you might be able to manage it.
Mood problems like anxiety and depression can trigger dizziness. It may also be a sign that there is something wrong with your brain, such as nerve damage, and could lead to other symptoms. You might also experience changes in your vision, speech or swallowing that can be caused by the nerves being affected. These can cause a feeling of weakness, difficulty in speaking, or coughing while eating.
Other causes of dizziness include low blood pressure, dehydration and some medicines. Check your blood pressure before you get dizzy, and compare it when you are sitting or lying down. If it is much lower when you are lying down, this might be the cause of your dizziness. Drink water and try to rest if you are overheated or feel dizzy, and avoid sudden movements if possible.
If you do not get better after a few minutes, see your doctor or healthcare professional for further assessment. If your dizziness is accompanied by a severe headache, fever or nausea, you need to seek emergency medical attention.
You can use techniques to reduce dizziness, including lying down and using support pillows for your head. You can also take extra care when getting up and down from chairs or sofas, and if you are travelling by bus or train, sit as close to the front as possible.
