Primary symptoms of MS stem from the damage to the protective nerve covering, the myelin. Your doctors can help you manage these symptoms using medication, occupational therapy, and physical therapy.
Here are some of the more common symptoms of MS:
Vision problems
Visual problems are one of the most common symptoms of MS. Inflammation affects the optic nerve and disrupts vision. This can cause blurred vision or loss of vision. Sometimes the cranial nerves or the brainstem can be involved, causing eye movement problems or double vision. These are three common vision symptoms of MS:
You may not notice the vision problems immediately. With optic neuritis, pain when you look up or to one side also can accompany vision loss. There are a variety of ways to cope with MS-related vision changes.
Tingling and numbness
MS affects nerves in the brain and spinal cord (the body’s message center). The sensory nerves in the spinal cord can be affected by demyelination, causing diminished sensation when you touch something, which can affect your ability to walk or do things with your hands. You can also have paresthesias (sensations like numbness, tingling, or burning).
Tingling sensations and numbness are one of the most common warning signs of MS. Common sites of numbness include the face, arms, legs, and fingers.
Pain and spasms
Chronic pain and involuntary muscle spasmsare also common with MS. Pain can be a direct result of the demyelination or by the symptoms themselves causing secondary pain.
Types of MS pain could include neuropathic pain. This acute pain is caused by nerves miscommunicating signals to the brain. Examples include:
MS can also cause chronic neuropathic pain, where the acute pain mentioned above can also be experienced on a more ongoing basis. This may include dysesthesias (painful sensations in the limbs) or pruritis, which causes itching, tingling, and similar sensations.
Muscle stiffness or spasms (spasticity) are also common. You might experience stiff muscles or joints as well as uncontrollable, painful jerking movements of the extremities. The legs are most often affected, but back pain is also common.
Type of spasticity associated with MS include flexor spasticity, where muscles become very tight so that they bend and are unable to be straightened, and extensor spasticity, where muscles have the opposite problem — they’re so tight that the arms or legs become straightened and can’t bend.
Slurred speech and trouble swallowing, particularly in later stages of the condition, can also occur due to motor issues.
Fatigue and weakness
Unexplained fatigue and weaknessaffect many people living with MS. Fatigue is often related to the number of lesions in the brain and to inflammation. Weakness can develop due to muscle atrophy (muscles shrinking from lack or use) or due to demyelination of the nerves.
Chronic fatigue occurs when nerves deteriorate in the spinal column. Usually, the fatigue appears suddenly and lasts for weeks before improving. The weakness is most noticeable in the legs at first.
People who have MS can have intermittent fatigue, recurrent fatigue, or constant chronic fatigue. There’s sometimes an increased chance of having the separate diagnosis of chronic fatigue syndrome for people who have MS.
Balance problems and dizziness
Dizziness and problems with coordination and balance can decrease the mobility of someone with MS. This can contribute to problems with your gait. People with MS often feel lightheaded, dizzy, or as if their surroundings are spinning (vertigo). This symptom often occurs when you stand up.
Bladder and bowel dysfunction
A dysfunctional bladder is another common symptom. This can include:
Urinary-related symptoms are often manageable. Less often, people with MS experience constipation, diarrhea, or loss of bowel control.
Sexual dysfunction
Sexual arousal and function can also be a problem for people with MS because it begins in the central nervous system — where MS attacks. It could stem from physical problems with fatigue, spasticity, or secondary emotional symptoms.
Cognitive problems
Many with MS will develop some kind of issue with their cognitivefunction. This can include:
- memory problems
- shortened attention span
- trouble concentration
- difficulty staying organized
Depression and other emotional health problems are also common.
Changes in emotional health
Major depression is common among people with MS. The stresses of MS can also cause irritability, mood swings, and, rarely, a condition called pseudobulbar affect. This involves bouts of uncontrollable crying and laughing.
Coping with MS symptoms, along with relationship or family issues, can make depression and other emotional disorders even more challenging. MS support groups can be helpful in coping with these changes.