Symptoms vary widely, depending on which part of the central nervous system is affected. They include weakness, numbness, spasms, trouble walking, vision problems, bladder and bowel issues, and fatigue.
The first sign of MS is usually a pins-and-needles feeling that can affect one or more limbs. This may be followed by other symptoms like a sudden loss of balance or difficulty moving your arms and legs.
Numbness and Tingling
Numbness and tingling are the first symptoms that many people with MS experience. They may occur in one part of the body (for example, the legs) or throughout the entire body. They are often accompanied by a pins-and-needles sensation, and may be more noticeable than other symptoms like fatigue or weakness. Sometimes they can be so extreme that it interferes with daily tasks, such as holding a pen or walking up the stairs. Numbness and tingling are caused by irritation or damage to nerves. These nerves connect the brain and spinal cord to the rest of the body. They can be found in the arms, legs and the central nervous system.
The severity of numbness and tingling can vary from person to person and can also change over time. It is important to report these changes to your doctor.
Some people find that their numbness is accompanied by pain, itching or burning sensations, a feeling of being scalded or having a pin stuck in your finger and a tightness around the ribs or upper belly (known as an MS hug). These are called secondary symptoms and are not caused by damaged myelin, but rather by the immune response. They can be controlled with medications that help with the underlying cause, such as antidepressants or corticosteroids.
If you are experiencing secondary symptoms, it is important to see a specialist for a full evaluation. This should include a visit to your primary care doctor who should then refer you to a specialist in disorders of the brain and nervous system (neurologist).
A neurologist will ask about your symptoms and medical history. They will do a physical examination and may recommend some blood tests or imaging tests to determine the underlying causes.
If you have unexplained numbness, it is important to see your doctor right away. It could be a sign of a stroke, so it is crucial to get treatment early. You can also try massage, acupuncture or hot or cold packs to improve the blood flow and relieve the numbness. Eating a healthy diet and taking vitamin supplements can help, too.
Muscle Spasms
Muscle spasms, especially in your legs, are a common early MS symptom. These jerks or stiffening of muscles, called spasticity, can make your body feel stiff and heavy and may also be painful. They’re the most common symptom to cause problems with walking, and can be a warning sign that you might start to fall more often or need to use a wheelchair. They’re also a risk factor for having difficulty urinating or emptying your bladder (called urinary urgency).
Tremors are another early MS symptom, and they can happen in any part of the body. They can be a minor shake or a trembling so intense that you can’t do your daily activities. In most people with MS, they’re a sign of demyelination of the brain and spinal cord.
Fatigue is one of the most common early symptoms of MS, and can get worse in hot weather or after exercise. It can affect both men and women, and may make it harder to think or concentrate. It’s also a common problem for young women to have, and can lead to them being overlooked or not taken seriously by doctors.
People with MS can also have vision problems, such as blurry or doubled vision. They can also have back or joint pain. These can be caused by muscle weakness or spasticity, but can also be due to changes in the way your brain processes information, which is a symptom of MS called cognitive dysfunction.
Other symptoms that can be caused by MS include trouble balancing or feeling dizzy, a change in the way you walk (called gait), and trouble swallowing and speaking. People with MS can also have other health problems, such as depression, or problems with their sexual function.
Your doctor will ask questions about your health history and may suggest an MRI scan of the brain or spinal cord to look for signs of damage to myelin. You might also have a test that measures the speed of messages between your brain and your body, called an evoked potentials. These tests can help your doctor find out if the slowing down of signals is caused by damage to myelin, inflammation or something else.
Loss of Vision
For some people with MS, a sudden onset of numbness or pins-and-needles is the first sign of this condition. This is because MS can damage the nerve covering in parts of the body like the arms and legs. It can also cause a lack of sensation in the face, called trigeminal neuralgia. These symptoms are similar to those that occur in conditions like carpal tunnel syndrome and diabetic neuropathy, so they shouldn’t be seen as a conclusive diagnosis until other symptoms appear.
Nerve demyelination can affect the way the eyes work, causing blurred vision or blindness. It can also lead to uncontrolled eye movements or double vision. This can make it hard to maintain balance while walking, which may cause you to fall or trip more often. It can also cause trouble with your sense of direction, known as spatial neglect or ataxia.
The cause of these symptoms is inflammation, which happens when your immune system mistakes and attacks the myelin sheath. This nerve covering protects the nerve cells in your brain, optic nerves and spinal cord. When the myelin sheath is damaged, it can slow down or stop the signals that travel between your brain and the rest of your body.
Tremors (shakes) can also happen as a symptom of multiple sclerosis. They can range from mild tremors that make it hard to carry a glass of water without spilling it, to tremors that are so strong they interfere with your daily life. They can be triggered by many different things, including anxiety and stress, and can sometimes make your hands shake so badly that you can’t hold a pen or use your computer.
Several types of multiple sclerosis can develop, but the most common is relapsing-remitting multiple sclerosis, or RRMS. This type of MS causes relapses, or attacks of new or old symptoms that last for days, weeks or months and are then followed by periods of remission, when your symptoms decrease or disappear altogether. This is the most common form of the disease, and about 85% of people diagnosed with MS have this type.
Fatigue
Fatigue is a common multiple sclerosis symptom and may be one of the most distressing symptoms for people with MS. It is described as a feeling of overwhelming tiredness that does not go away with sleep or rest, and it often interferes with daily activities. Fatigue is also a major reason that people with MS need to change their work or reduce working hours.
It is unclear what causes fatigue in MS, but it is believed that the brain and spinal cord are affected by the disease and that passing messages between these areas takes more energy than usual. In addition, certain medications can make a person feel tired. Fatigue is usually a problem for people with MS at all stages of the disease and does not appear to be related to age or gender, or the type or severity of their MS.
Fatigue can cause problems with work, social and home life. It can prevent a person from exercising, making healthy food choices and participating in family or social events. It can also affect the quality of a person’s mood. People with MS who suffer from depression or other psychiatric symptoms may find that the symptoms are worsened by fatigue.
Cognitive changes are also commonly seen in MS and can be very frustrating. They can include memory difficulties, poor concentration, slow thinking, inability to plan or make decisions and difficulty understanding what is said by others. These symptoms can affect employment, relationships and daily living and should be reported to the MS healthcare team.
A person with MS who experiences speech or swallowing difficulties is likely to need a speech therapist. This may be because of damage to nerves that control these functions or because of a side effect of a prescribed medication.
Some people with MS feel their fatigue is not understood by their friends, family or co-workers, but it is important to talk about it and try to come up with ways of coping. Keeping a fatigue diary can help to identify any patterns and provide information for those around you to understand the impact of the symptom.
