Living with multiple sclerosis (MS) can be challenging, especially when it comes to managing symptoms. MS is an autoimmune disease that targets the central nervous system (CNS), which includes the brain and spinal cord. The immune system’s attacks cause lesions that damage the myelin sheath, the fatty substance that insulates nerve fibers. When myelin is damaged — a process called demyelination — nerve signals are affected, disrupting the brain’s ability to communicate effectively. Because the brain controls many bodily functions, MS can affect various parts of the body.

MS symptoms vary between individuals and across different types of the disease. People with relapsing-remitting MS may experience periods of remission (when symptoms decrease or disappear) followed by flare-ups (when symptoms worsen or reappear). In contrast, those with primary progressive MS tend to experience a gradual worsening of symptoms.

MS causes neurological symptoms that can manifest in various ways. MS symptoms may appear in different combinations, depending on which parts of the CNS are damaged. Most of the common symptoms of MS fall within broad categories, including motor symptoms, cognitive symptoms, and symptoms that affect other aspects of the body.

In this article, we’ll explore the various types of MS symptoms, which can range from mild and irritating to severe and debilitating. Fortunately, therapies are available to help manage MS symptoms effectively.

Motor Symptoms

Motor problems can severely affect mobility and quality of life. These issues occur when lesions in the CNS form in areas that control voluntary muscle movement. Difficulty with gait (walking) is common due to these motor symptoms:

• Muscle weakness
• Slowness
• Muscle spasms
• Balance problems

These issues raise the risk of falls and injury. Doctors use the word “ataxia” — meaning “loss of full control over bodily movements” — to describe coordination problems related to balance and movement.

Speech and Swallowing Difficulties

Between 25 percent and 40 percent of people with MS develop speech problems. Speech issues often develop later in the disease course and worsen with fatigue (persistent exhaustion that doesn’t improve with rest). Common speech problems in MS include:

• Dysarthria (slurring)
• Dysphonia (low speaking volume)
• Stuttering

Similarly, many people with MS may develop dysphagia (trouble swallowing). Dysphagia raises the risk of choking or inhaling food or drink, which can lead to lung infections.

Less common motor symptoms may include breathing problems — if MS affects muscles or nerves in the chest — and tremors.

Cognitive Symptoms

More than 50 percent of people with MS experience cognitive difficulties, which occur when lesions form in areas of the CNS that control cognitive functions. These changes, often referred to as “cog fog” or brain fog, can cause difficulties with:

• Remembering information and past events
• Solving problems
• Focusing
• Maintaining attention
• Processing information
• Learning new things
• Staying organized
• Navigating places, even familiar ones, without getting lost

Other Common Symptoms

In addition to causing motor and cognitive symptoms, MS can affect other parts of the body, leading to a wide range of symptoms that affect daily life.

Fatigue

Fatigue is one of the most common MS symptoms. About 80 percent of people with MS experience fatigue, which is often described as overwhelming and can interfere with daily activities, making it difficult to maintain a normal work or home life.

Vision Problems

MS often affects the optic nerves, which are responsible for sending visual information from the eyes to the brain, causing inflammation known as optic neuritis. Optic neuritis may cause vision problems, including:

• Blurred vision
• Blind spots
• Double vision
• Pain or difficulty with eye movement
• Loss of vision in one eye

Strange Physical Sensations

Paresthesia — changes in physical sensation, such as numbness, tingling, or pins and needles — are very common in people with MS. Paresthesia may occur in the face, body, or arms and legs. The sensation may be mild enough to be ignored or so severe that it becomes difficult to walk, eat, or write, depending on which body part is affected.

Dizziness

Dizziness and vertigo are common in those with MS. These sensations are sometimes described as feeling lightheaded or that the room seems to be spinning.

Mood Changes

MS can cause emotional changes such as mood swings, irritability, and sudden bouts of intense laughter or crying (known as pseudobulbar affect) that don’t reflect the person’s actual feelings. People with MS often experience depression.

Pain

Neuropathic pain, which arises from damaged nerves, can range from acute (short-term), sharp sensations to chronic (long-term), persistent pain. MS-related pain often affects the legs, back, and face.

Bladder Problems

At least 80 percent of people with MS experience bladder dysfunction, which can lead to incontinence, urinary tract infections, and kidney problems. Bowel issues, especially constipation, are common in those with MS.

Sexual Dysfunction

MS can affect sexual function, causing problems including:

• Erectile dysfunction
• Vaginal dryness
• Loss of sexual sensation
• Painfully heightened sensation

Less Common Symptoms

Seizures, severe itching, and hearing loss affect a small percentage of people with MS.

What Are the Early Signs of MS?

MS begins differently for each person, but early symptoms often include changes in vision and sensations such as numbness or tingling. Other early signs may include motor difficulties — such as weakness, balance issues, or clumsiness — and, in some cases, bowel problems like constipation. Some people may experience several symptoms at once, whereas others notice just one or two early warning signs.

Does Biological Sex or Gender Affect MS Symptoms?

Women are about three times as likely as men to develop MS, according to Penn Medicine. According to a research review in the Journal of Neuroscience Research, males are more likely to have a progressive form of the disease and accumulate disability faster than women. According to the review, men’s relapses are also more likely than women’s to affect motor function, such as walking or coordination. However, the findings showed that women going through menopause often face worsening MS symptoms, including sleep disturbances, likely due to hormonal changes.

MS symptoms often improve during pregnancy, especially in the later stages, according to the review. However, these improvements are usually temporary, as symptoms tend to worsen again after delivery when hormone levels shift back.

Talk to Your Doctor

Living with MS can be challenging, as symptoms vary widely from person to person and can change over time. While there is no cure, a range of treatments, including disease-modifying therapies, can help manage symptoms and slow disease progression.

If your current treatment isn’t providing relief or you’re experiencing new or worsening symptoms, it’s essential to talk to your neurologist or another healthcare provider. Open communication can help ensure that your treatment plan is adjusted to keep you feeling your best. Managing MS is a team effort, and staying proactive about your health is a key part of that process.

Find Your Team

On MyMSTeam, the social network for people with multiple sclerosis and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with MS.

What symptoms do you experience with MS? What tips do you have for managing them? Share your experience in the comments below, or start a conversation by posting on your Activities page.