Many people with MS have some difficulties with walking, which could arise from a number of different causes. Stumbling or tripping may have been one of the first symptoms you noticed. However, although walking problems are common in MS, they may have another cause, so it is important to get advice from a health professional.
Walking problems vary considerably from one person with MS to another. Common difficulties are:
- Unsteadiness on walking or turning
- Slower, shorter steps
- Less confidence
- Needing support from walls, furniture or other people
- Tripping and stumbling
- A heavy feeling in the legs when stepping forward
- Weakness of the leg when weight is on it
- Difficulty placing the foot on the ground
A symptom called foot drop can be experienced by some people with MS. This is when the front part of the foot does not lift up correctly when the leg does, and so it may drag or catch on the floor.
In MS, many of these problems are initially caused by slowed or altered nerve conduction, which can make your muscles feel weak or suffer spasticity or stiffness. Instructions from the brain to the legs and sensory feedback from the body can be impaired. This makes coordinating the muscle movements harder and require more concentration. Some people with MS have more trouble with walking when they try to do other things at the same time.
Other MS symptoms can have a large impact on walking too. If your vision is blurred or double, or you have altered depth perception, you might find it difficult to place your feet accurately or judge steps and kerbs. Problems with balance, dizziness and tremor can affect walking and so can pain. You may feel less confident, or hold yourself awkwardly when you walk in order to reduce pain elsewhere in the body. These postural habits can produce knock-on problems themselves. Walking like this requires more effort which can contribute to fatigue, and holding the body awkwardly can stress other joints and cause long-term damage.
People with MS who have walking difficulties advise getting help early, so as to prevent this damage making life more difficult in the long run.
What can I do to improve my walking?
The best way forward depends on what is causing the walking difficulties. A health professional such as a GP, MS nurse or physiotherapist can advise, but here are some tips and techniques that may help. See also the links and references below.
- Orthotics or splints can support weaker parts of your legs
- Some drugs may reduce fatigue, spasticity and pain
- Physiotherapy may help to improve your posture and gait
- Walking aids like canes or walkers can give confidence when out and about
- Use mental visualisation techniques to practice walking in your head and train your brain
- Computer games or virtual reality may help train the brain and improve balance
- Music and rhythmic cues can help with walking speed and gait regularity
- Gentle exercise such as yoga can improve core strength, leg strength and reduce fatigue
- Try to remove trip hazards like trailing wires and rucked up carpets in your environment
Steve writes about using walking aids:
Like most MSers, I really don't need anything else to make me feel unsteady on my feet. For this reason, I'm not a massive fan of snow and ice! I highly recommend Yaktrax for snowy conditions. They are basically snow chains for your feet, and strap on over your footwear.
- Multiple Sclerosis Journal 2017 23(2) 286-296 Summary The effect of rhythmic cued motor imagery on walking, fatigue and quality of life in people with multiple sclerosis
- Arch. Phys.Med Rehabilitation 2015 96 (7) 1339-1348 Summary Exercise as a therapy for improving walking ability in adults with multiple sclerosis: A metanalysis
- Journal of Neuroengineering and Rehabilitation 2016 13 (3) 13 Full article The effect of balance training on postural control in people with multiple sclerosis using the CAREN virtual reality system: a pilot randomized controlled trial.