Multiple sclerosis - Symptoms 

Symptoms of multiple sclerosis 

The central nervous system (brain and spinal cord) controls all your body's actions. When MS causes damage to the nerve fibres that carry messages to and from your brain, symptoms can occur in any part of your body.

There are many different symptoms of MS and they affect each person differently. Some of the most common symptoms include:

  • numbness and tingling
  • blurring of vision
  • problems with mobility and balance
  • muscle weakness and tightness

Most people with MS only have a few of these symptoms and it is very unlikely that someone would develop all possible symptoms.

The symptoms of MS are unpredictable and some people's symptoms develop and worsen steadily over time, while for other people they come and go periodically. Periods when your symptoms get worse are known as relapses. Periods when your symptoms improve or disappear are known as remissions.

Visual problems

In a quarter of cases of MS, the first symptom is inflammation (swelling) of the optic nerve, which transmits visual information to the brain. This is known as optic neuritis and usually only affects one eye. It causes pain behind your eyeball, loss of vision and colour blindness.

MS can also cause double vision, pain in both eyes and difficulty focusing (known as nystagmus).

Muscle spasms and spasticity

MS can cause damage to the nerve fibres in your central nervous system. This can cause your muscles to contract tightly and painfully (spasm). Your muscles may also become stiff and resistant to movement, which is known as spasticity.


Pain is common in MS. The two types of pain that can occur as a result of MS are neuropathic and musculoskeletal pain.

  • Neuropathic pain is caused by damage to the nerve fibres in your central nervous system. It can be stabbing pains, extreme skin sensitivity or burning sensations. 
  • Musculoskeletal pain is not caused directly by MS, but can occur if there is excess pressure on your muscles or joints as a result of spasms and spasticity.

Mobility problems

MS can affect your balance and co-ordination. It can make walking and moving around difficult, particularly if you also have muscle weakness and spasticity.

  • You may experience difficulty with co-ordination, called ataxia.
  • Shaking of the limbs (tremor) is rare but can be severe.
  • Dizziness can happen late on and can make you feel as if your surroundings are spinning (vertigo).

Cognitive problems

Cognitive problems refer to problems with mental processes, such as thinking and learning. These usually occur when MS is severe. The problems may be temporary or permanent. You may have trouble remembering and learning new things, problems with attention and concentration, slowed or confused speech, and reduced mental speed.

Emotional problems

If you have MS, you may find yourself laughing or crying for no reason, and you may also be more likely to experience depression or anxiety.

Fatigue and tiredness

Extreme tiredness (fatigue) may be your main symptom of MS. You may find that fatigue causes your other symptoms s(uch as problems with balance, vision and concentration) to get worse.

Bladder problems

MS can make your bladder either overactive or underactive. If it is overactive, your bladder may contract when it is not full, causing incontinence. If it is underactive, you may find that your urine flow is interrupted and your bladder does not feel empty.

Bowel problems

MS often causes constipation but may also cause bowel incontinence.

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Types of multiple sclerosis

The symptoms of MS are unpredictable. Some people's symptoms develop and get worse over time, while other people's symptoms come and go periodically.

Periods when your symptoms get worse are known as relapses. Periods when your symptoms improve or disappear are known as remissions.

A relapse in MS is defined as a period of at least 24 hours in which new symptoms appear or previous ones worsen. Relapses can occur at any time and may vary in severity. Sometimes, a short-lived worsening of your symptoms can be caused by other factors, such as hot weather or exercise. This does not necessarily mean that you are having a relapse.

There are three types of MS. They are characterised by the pattern of relapse and remission that the symptoms follow.

  • Relapsing remitting MS (RRMS)
    Relapsing remitting MS (RRMS) is the most common type of MS. It is characterised by numerous relapses and remissions. Relapses may last for days, weeks or months. You may experience new symptoms each time, or a recurrence of previous ones. After each relapse, you may recover completely. However, many people's symptoms improve but do not disappear altogether.
  • Secondary progressive MS (SPMS)
    Secondary progressive MS (SPMS) follows on from RRMS. It is characterised by a steady worsening of symptoms, with or without relapses. Studies show that most people with RRMS go on to develop this form of MS, on average 15-20 years after the onset.
  • Primary progressive MS (PPMS)
    Primary progressive MS (PPMS) is the rarest form of MS. If you have this form of MS, symptoms will get steadily worse with no distinct relapses or remissions.

Benign MS (BMS)

If you have had no symptoms for 10 to 15 years, you may be told that you have benign MS (BMS). Benign MS is characterised by a small number of relapses followed by a complete recovery each time. There is no guarantee that MS is ever gone for good and it is even possible to have a relapse after many years of no symptoms.

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Last reviewed: 29/01/2010

Next review due: 29/01/2012


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