The list of possible MS symptoms is long, but you are unlikely to experience all of them. Here is a general overview of the different types of symptoms found in MS, and a look at which symptoms are most common, especially early on.
MS is a very personal condition because the symptoms you experience relate to the positions of the lesions or nerve damage that you have. MS symptoms can appear in any order, and range widely between almost unnoticeable to very disabling.
Our what's causing my MS symptoms tool gives a long list of possible MS symptoms, where you can find in-depth information about each one. This can look overwhelming, but you are unlikely to experience all of them yourself.
Some of the most common first symptoms of MS are:
- fatigue (a kind of exhaustion which is out of all proportion to the task undertaken)
- stumbling more than before (indicating problems with balance or co-ordination in the legs)
- unusual feelings in the skin (such as pins and needles, pain or numbness)
- slowed thinking (resulting in forgetting things, poor concentration, or getting lost)
- problems with eyesight (blurred or altered vision, or pain moving the eyes)
There are other symptoms of MS but you are less likely to experience them early on.
What are the symptoms of MS?
The symptoms experienced by people with MS can be grouped according to how they affect you. Some people develop lesions (nerve damage) without noticing symptoms, because the damage happens to be in a part of the brain or spinal cord which can re-route nerve signals around the damage.
Sometimes, symptoms can be caused by nerve damage within the part of the brain that deals with that part of the body. Alternatively, the nerve damage could have occurred in a nerve carrying information from the brain to the body. Damage at either of these places might result in a similar symptom. For example, a lesion in the spinal cord leading to the leg muscles or a lesion in the cerebellum part of the brain (which organises co-ordination and balance) could both result in you finding yourself stumbling or falling over.
All of these symptoms are treatable, and are definitely worth discussing with your MS Nurse or healthcare team for further advice.
Problems with balance and co-ordination are common in MS, because the brain regions that organise these skills are often affected by nerve damage. You might experience this as dizziness, tremor or shaking, or have trouble holding yourself or part of your body in certain positions. The medical term for co-ordination problems is ataxia.
Problems with regulating your bladder and bowel are also quite common in MS. You might find it harder to control when you need to visit the toilet during the day, or find you wake up in the night needing to urinate. Bladder and bowel symptoms can be partly due to nerve damage, but issues such as constipation or urinary tract infections can also be secondary symptoms brought on by having reduced mobility.
Problems with thinking and memory are called cognitive problems. They might include forgetfulness, finding it hard to focus or concentrate, or a general sense of being too tired to think, known as cognitive fatigue. Also included in this category might be impulsiveness, trouble making decisions, or visuospatial problems where you find you are bumping into things or having trouble finding your way around.
Occasionally, people with MS develop hearing problems when there is nothing wrong with their ears. The problem is with the part of the brain that interprets the sound we hear.
It is common for people with MS to notice that their symptoms get worse with extremes of heat or cold. Some people notice an effect at both extremes, some just in one. It is thought that extreme temperatures affect the speed that nerve impulses get transmitted through the body, making any existing symptoms worse, and sometimes bringing on new symptoms like fatigue or weakness.
People with MS often find that their mood or emotions are affected, and they notice symptoms of anxiety or depression. This may be partly due to stress about having a long term condition like MS, but it might also be caused directly by damage in the brain. Less commonly, some people with MS find that they are expressing emotion in an unusual way, perhaps by laughing or crying at inappropriate times. This is called pseudobulbar affect, and is a rarer symptom of MS.
There are several fairly common MS symptoms that might involve pain of some kind. Most are temporary, but some can be more persistent. Some pain or altered skin sensations in MS are caused by nerve damage, but some might be due to poor posture or muscle spasms which put pressure on the body in some way. Nerve pain might take the form of trigeminal neuralgia, which is pain in the face that you might think is a sore tooth or earache. It might also be experienced as an uncomfortable squeezing sensation known as the MS hug, or shooting pains in the neck and back called Lhermitte's sign.
Both men and women can sometimes find that MS can affect their participation in and enjoyment of sex. Nerve damage associated with the genital area can affect skin sensations and erectile tissue. Muscle spasms or pain can also interfere with sex.
Problems with sleep are fairly common in MS. You might have trouble dropping off or staying asleep, or feel that your sleep is not refreshing. Some sleep issues might be directly caused by nerve damage, but other MS symptoms, like spasms, pain or nocturia (needing to urinate in the night) can also interfere with your sleep. Poor sleep can impact on other symptoms, particularly fatigue and problems with thinking and memory.
Nerve damage in the parts of the brain responsible for language or co-ordinating the muscles of the mouth and throat can both lead to problems with speaking. You might stumble over words, or have trouble remembering the right word at the right time. Weakness and lack of co-ordination in the mouth, tongue and throat muscles can make swallowing difficult or less effective, leading to a risk of choking.
Problems with your eyesight are quite common in multiple sclerosis. Optic neuritis is a common early symptom, and can also occur during a relapse. It might involve feeling pain when moving the eyes, or having blurred vision, or double vision. Some people with MS might experience eye tremors, known as nystagmus, or problems interpreting the visual information from their eyes.
Many MS symptoms can eventually affect your walking and mobility. General weakness and fatigue can make walking harder, but muscle spasticity or foot drop can also lead to stumbling or unsteadiness. If your balance and co-ordination are affected by MS, you might notice it particularly when you walk.