Multiple Sclerosis: signs and symptoms

Lesley Dobson / 07 March 2016

Multiple sclerosis, often known as MS, is a condition that affects the human central nervous system (CNS).



MS affects about 100,000 people in the UK, with about three times as many women as men having this condition.

Symptoms often appear when people are in their 20s and 30s, but it also affects people 50 and over. In the latest figures from the Multiple Sclerosis Society, 2,260 people aged from 50 to 89 were newly diagnosed with MS (using research published in 2013 by the University of Dundee).

With MS the damage is caused when our body’s immune system, which protects us by fighting off infections, attacks the myelin layer that covers our nerve fibres. This damages the myelin and strips it off, leaving scars, better known by their medical terms as lesions or plaques.

The result is that the messages that should be racing down our nerve fibres can’t run smoothly. The messages may be damaged, or they may never reach their destination.

As well as damaging the myelin layer, our immune system can cause damage to the nerves too. This affects their ability to send messages around our bodies, and the body’s ability to work as it should. It is this nerve damage that causes the increase in disability that can occur over time in MS.

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Multiple Sclerosis progression

Ms doesn’t just stay the same, once you have this condition it usually follows one of these routes.

Relapsing-remitting MS (RRMS)

People with this type of MS have distinct attacks of symptoms which then fade away either partially or completely.

So someone would have periods where their symptoms were very clearly active. This is known as relapsing. They might have the same symptoms that they’ve had in previous attacks, or they may have new symptoms. These would last for at least 24 hours, and then the symptoms would become much weaker, or would disappear completely. This is the remitting stage.

People often recover well from relapse, with complete remission. However, this is not always the case. Some people experience lingering problems because of the residual damage caused by the relapse.

About 85 percent of people with this condition have this type of MS.

Primary Progressive MS (PPMS)

With PPMS, multiple sclerosis is progressive right from the beginning. This means that from the time your symptoms start, they will become worse as time goes on. You won’t have the relapses, where the symptoms appear suddenly, and then go into the remitting stage, so that they are barely noticeable, or go completely.

PPMS isn’t usually diagnosed until people are in their forties or fifties, which is later on in life than for RRMS. It can take some time for this type of MS to be diagnosed, as the symptoms tend to become worse gradually. The first symptoms are often minor walking problems, which become progressively worse with time.

About 10 to 15 percent of people with MS have PPMS.

In some cases, people with PPMS do have relapses, although the condition carries on progressing. This is sometimes called progressive relapsing MS.

Secondary Progressive MS (SPMS)

This stage often comes after relapsing remitting MS. In fact most of those who have relapsing remitting MS, will, in time, develop SPMS. With this stage of the condition, you tend not to have a complete recovery from a relapse.

While changes tend to happen slowly, your symptoms will become worse. Because this can take some time to become clear, it may be a while before you and your doctor know that you now have SPMS.

MS symptoms

Our Central Nervous System (CNS) is composed of the human brain and spinal cord. From here nerves send messages all over the body. As the Multiple Sclerosis Society explains, the symptoms that each person with MS has, depend on the part of the CNS that has been affected, and on the job that the damaged nerve was meant to carry out.

Because of this MS can cause a large number of different types of symptoms. You may only have symptoms on one part of your body, or you may have a range of symptoms that affect various parts of your body.

Many people with MS only have a few symptoms, and you’re unlikely to have all the symptoms that MS experts know about. And most people with MS don’t have constant symptoms – they tend to come and go.

  • Visual problems are a common first symptom in people with MS. This happens when the optic nerve becomes inflamed and swollen. The result can be partial loss of vision, and pain behind one eye. You can also have blurred and double vision.
  • Feeling extremely tired, to the point where you find it hard to concentrate. This feeling of fatigue can be so extreme that you may find it difficult to think and concentrate, and may even affect your balance.
  • Having numbness and tingling sensations are also common early symptoms.
  • Others include feeling weakness and tightness in some of your muscles, which can affect your ability to walk and keep your balance. You may also have muscle spasms, where your muscles suddenly contract tightly, which causes pain. Spasticity is when your muscles become stiff, which can make it difficult for you to move.
  • Pain can be a problem for about 50% of people with MS. This can be either neuropathic pain, which can feel like stabbing or burning, or your skin may become very sensitive. Musculoskeletal pain can happen when spasms or spasticity put extra pressure on your muscles and joints.

Bowel problems

About 50% of people with MS experience constipation. This means that they may not be able to go to the toilet (to pass stools) as often as they used to. Additionally, perhaps 30-50% of people experience bowel incontinence at some stage. This can cause discomfort and be embarrassing and distressing for people with MS.

Speech and swallowing

Between 40 to 50% of people with MS can have some degree of problems with their ability to speak. These difficulties can last only a short while, appearing on and off throughout the day. They can also be one of the symptoms of MS that happens during a period of relapse.

People with MS can have problems swallowing (dysphagia), but as with speech and other symptoms, this symptom can be temporary, happening during a relapse for instance, and then improving. In most cases problems with speech and swallowing last for just a few minutes, and these symptoms are usually only mild.

Learn more about dysphagia

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Cognitive Problems

MS can also affect your memory and thinking, and your ability to think clearly, learn and plan. These are known as cognitive problems, and can affect your ability to carry out normal every-day tasks, and those that involve more planning.

The effects of MS on cognitive ability aren’t the same for everyone – as with other symptoms of MS, they vary from person to person.

The most common problem areas with cognitive symptoms include:

  • Learning and memory, in particular remembering to carry out tasks, or to be somewhere at a particular time
  • Recall – having difficulty finding a memory
  • Concentrating, especially for long periods, and, if interrupted, remembering what you were doing before this happened
  • Taking more time and mental effort to carry out tasks than before
  • Difficulty with making plans, dividing tasks into a logical order, and solving problems
  • Finding the right word to convey what you want to say.

Easy ways to boost your memory

Mental health

About 50% of people with MS experience depression at some point in their lives. Depression can make it difficult to live a normal life by making you feel hopeless, with little or no interest in activities you normally enjoy.

It can also mean that you find it difficult to concentrate, have problems sleeping, feel that you have no value, and feel overly guilty, but with little reason for this feeling.

It can be difficult to know what is causing your depression. There may be a connection between three different factors that are thought to, when combined, cause depression:

  • Depression is caused by a neuro-chemical or hormonal imbalance
  • Depression is caused by certain styles of thinking
  • Depression is caused by a negative experience

How to spot the signs of depression in a loved one

The MS Society is the leading UK charity for people with MS. The Society has a free helpline – 0808 800 8000, and you can find information on their website www.mssociety.org.uk

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