Multiple sclerosis (MS) symptoms can affect your quality of life and keep you from doing the activities that you enjoy and tasks that you need to accomplish. MS can get in the way of your ability to work, and you may need to apply for disability benefits. Even if you’re working, MS symptoms such as mobility problems and pain can affect your daily functioning and have an impact on your caregivers and family members, too.

The type of MS you have may affect your symptoms. People who have relapsing-remitting MS (RRMS) — the most common type — go through periods when they don’t experience symptoms, known as remission. They then have relapses, with new or worsening symptoms each time.

The progression of RRMS can lead to secondary progressive MS (SPMS). People with SPMS have symptoms of some kind at all times. About 15 percent of people with MS have primary progressive MS and never experience remission.

Even though MS isn’t a disability by itself, symptoms from any type of MS can make it harder to function. The following four effects of MS can have an impact on activities of daily living and cause disability.

1. Nerve Damage

MS causes the immune system to attack the central nervous system. Rogue immune cells attack both nerve cells and the protective nerve coverings (myelin) during a process called demyelination. Nerve damage makes it harder for the brain to send messages through the nerves to communicate with different parts of the body. This lack of communication can affect the muscles and cause weakness, spasticity (muscle stiffness), and pain.

Dysfunction caused by nerve damage can cause disabling mobility impairment, affecting your legs and your walking ability, including your gait and walking speed. One study reported that more than three-quarters of people with MS experience walking impairment. Nerve damage can also make it difficult to use your arms and hands, so even simple tasks like opening a door or holding a cell phone are challenging. Difficulties like these can keep you from working.

Nerve damage pain can also be disabling. From 25 percent to 90 percent of people with MS report experiencing pain. Types of nerve damage pain include:

• Lhermitte’s sign — Pain that runs down your spine when you bend your neck
• Dysesthesia — A burning or squeezing sensation in your limbs or chest
• Trigeminal neuralgia — Sharp pain in your cheek or jaw

This nerve pain can be severe and life-changing. One MyMSTeam member said, “I feel like there’s a snake around my abdomen squeezing me.”

“When my trigeminal neuralgia is most vile, I can’t feel my face if I touch it. It feels like everything from my cheekbones on down is on fire,” another member shared.

One way to help offset the effects of nerve damage and participate in daily life is to address the residual weakness with physical therapy and, if needed, mobility aids and assistive devices. Using a mobility aid, such as a cane or wheelchair, may make some people feel like the disease is “winning.” However, in reality, these aids can be liberating — they allow you to save energy, avoid the onset of fatigue, and prevent falls. Pain management can also improve function and quality of life.

2. Fatigue

MS fatigue is incredibly common — up to 95 percent of people with MS experience it. Fatigue feels like being much more tired than you’d expect for the effort you’ve made. The fatigue caused by MS can be disabling. “Today has been a struggle. I’ve been so tired — not done a single thing,” said one MyMSTeam member.

Another shared a frustrating experience: “If I do anything while I am fatigued, the symptoms get worse. But if I do just a little before the fatigue starts, I can’t accomplish enough.”

Researchers aren’t sure what exactly causes MS fatigue. The symptom could be a side effect of nerve damage or of the underlying immune system issues that cause MS. Medication side effects can also lead to fatigue. Your healthcare provider can help you find the best strategies and medications to help you reduce your fatigue and regain some energy.

3. Muscle Atrophy

Together, nerve damage and fatigue can make it difficult to keep physical activity in your daily routine. Over time, this lack of movement can cause a medical condition called muscle atrophy. This can become a vicious cycle. Muscle loss makes it even harder to move and stay active, and not getting enough exercise can make MS symptoms worse and speed up how the disease progresses.

The good news is that MS-related muscle deconditioning can often be stopped or even reversed, restoring some physical functioning. Exercise, physical therapy, and an improved diet can help rebuild muscle.

4. Psychological Issues

MS can take a toll on your mental health. Dealing with the limitations of an MS diagnosis can have psychosocial effects and lead to mental health conditions, such as depression. In fact, half of the people with MS may experience depression, which can lead to feelings of sadness, irritability, and hopelessness.

Depression can also worsen MS symptoms such as brain fog and fatigue, sometimes making it hard to tell them apart. “I am exhausted — absolutely drained, not sleepy. I would be too tired to make it through a meal. Can MS bring depression?” asked one MyMSTeam member.

A tool called the Expanded Disability Status Scale (EDSS) measures disability level, including some of the disabling effects of MS on both body and mind. A 2020 review study found that worse symptoms, as quantified by EDSS, were associated with diminished quality of life. The study also found that depression had a negative effect on quality of life.

Taking care of both your mental and physical health is important when you’re living with MS. Your neurologist or other healthcare provider can help you find ways to manage depression. Treatment options may include therapy and medication. “Depression often accompanies MS. Mental and emotional health is key, and antidepressants work,” said one MyMSTeam member.

Talk to Your Healthcare Provider

Be sure to tell your doctor about the ways MS affects your mobility and function. They can help you find the best approaches to keep you as active and engaged as possible while living with MS. Research shows that disease-modifying treatments can help slow the worsening of MS over time. Talk to your MS specialist about your treatment goals and what plan can best help you reach them.

Find Your Team

On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.

Have you experienced walking problems with multiple sclerosis? Share your stories or advice in the comments below.