Many people living with multiple sclerosis (MS) wonder how the condition may change their ability to walk and their gait (how they walk) — and what they can do to stay mobile.

While MS can make walking more difficult, treatments, assistive devices, and strategies can help people maintain mobility. In fact, nearly two-thirds of people with MS report that they can still walk 20 years after their diagnosis, with some finding new ways to adapt and stay active with the help of specialized treatments and devices.

If you notice difficulty walking or changes to your walking pattern, talk to your healthcare provider or neurologist. They can help determine whether these changes are related to MS and what to do next.

Common Gait Problems With MS

Like other MS symptoms, walking challenges can vary significantly from person to person. Some people may notice changes in the way they walk, changes in their walking speed or step length, or other gait abnormalities.

Common MS-related walking issues might include the following:

• Having difficulty walking down stairs
• Needing to take slower, shorter steps
• Feeling unsteady while walking
• Tripping or stumbling
• Feeling heaviness in the legs when stepping forward
• Experiencing weakness in the legs when placing weight on them
• Having difficulty placing each foot firmly on the ground

What Does MS Gait Look Like?

Because walking difficulties with MS vary widely, there is no single, easy way to identify MS gait. As opposed to other conditions like Parkinson’s disease, which have easily identifiable walking patterns, MS walking patterns are more variable.

People with MS who are experiencing changes to how they walk may display one of several common multiple sclerosis gait patterns. Two of these MS-related gait patterns are known as steppage gait and spastic gait.

Steppage Gait

Steppage gait (also known as neuropathic gait, usually seen in people with nerve damage called neuropathies) is characterized by drop foot — an MS symptom in which the front part of the foot drops down and does not lift up correctly with the rest of the leg while walking. In a person with drop foot, the toes point downward and may drag or scrape on the ground while walking.

“Neuropathy in my feet, weakness in my left quad, balance issues, and foot drop,” wrote a MyMSTeam member about their walking difficulties.

“Neuropathy in my feet, weakness in my left quad, balance issues, and foot drop.”

— A MyMSTeam member

Spastic Gait

Spastic gait is common in people who experience involuntary spasticity (muscle spasms) or stiffness. In people with spastic gait, the leg on the side of the body most affected by spasticity is stiff and drags in a semicircular motion.

MS Walking Issues Impact Everyone Differently

Walking difficulties can vary widely for people with MS. They may or may not involve pain, can change throughout the day, develop suddenly or gradually, and differ from person to person.

Some MyMSTeam members are surprised by how quickly their walking problems developed. “I can’t believe that five months ago, I wasn’t too bad — no walking aids or having trouble walking. Now, I’m a totally different person,” one member wrote.

Others find that their walking difficulties developed slowly over time. “The walking issues are one of those things that I noticed, only to realize it’s been happening for a while, and I don’t know when it started,” another member shared.

What Causes MS Walking Problems

MS affects the central nervous system, causing slowed or altered nerve conduction. These nerve problems can contribute to walking difficulties in MS by causing spasticity, characterized by muscle stiffness and involuntary spasms, which may sometimes be accompanied by muscle weakness.

MS can also cause delays between signals from your brain and responses in your body, making a complex motion like walking more difficult.

Problems With Nerve Signals

In people with MS, the immune system mistakenly attacks cells in the myelin, the protective layer surrounding nerves. The immune attack results in areas of damage known as MS plaques or lesions. Nerve damage can disrupt the signals between your brain and body, making it harder for your body to respond to your brain’s commands.

Walking is a complex process that relies on the coordination of multiple body systems. The communication and signal slowdown and variability that’s part of MS can cause walking issues and gait dysfunction. One MyMSTeam member described the experience: “My problem is that my leg doesn’t listen when my brain tells it what to do. There must be a short circuit somewhere.”

Spasticity

Spasticity, which commonly affects the legs or buttocks, is a common symptom of MS. The muscle stiffness and involuntary spasms associated with spasticity often contribute to walking difficulties.

Balance Issues

Research suggests that as many as 4 in 5 people with MS experience some degree of ataxia (impaired coordination). Ataxia can cause balance problems and result in an unsteady gait that may look like clumsiness or drunkenness.

Sensory Problems

MS may cause abnormal sensations, including numbness. Severe numbness in the feet may make a person unable to feel the floor or the position of their feet, which can cause problems with walking.

Muscle Weakness and Fatigue

Many people with MS experience muscle weakness in their legs and feet, which makes walking more difficult. It’s also normal to experience walking problems that worsen when you’re fatigued. Fatigue (extreme tiredness that doesn’t improve with rest) can limit stamina and cause falls in people with MS.

Managing and Treating Gait Difficulties in MS

There are many ways to manage gait problems, including medication, physical therapy, exercise, and assistive devices. Together, these approaches may help you regain your balance, increase your mobility, and help you remain confident while moving.

Medications

If you have walking problems with MS, your healthcare provider may identify what is causing your problem and recommend specific medications to help improve your symptoms.

Dalfampridine

Dalfampridine (Ampyra) is an oral medication approved by the U.S. Food and Drug Administration (FDA) to improve walking in people with MS. This medication works to improve the conduction of nerve signals in nerve fibers when the myelin has been damaged by MS.

Note that this medication should not be taken by people with a history of seizures or moderate to severe kidney impairment. People with mild kidney disease should talk to their doctor before starting this medication.

Antispasticity Drugs

If spasticity is affecting your gait, there are certain medications available to reduce this symptom. Along with physical therapy and reducing triggers, your doctor may recommend medications to reduce muscle tone. These drugs include, but are not limited to, baclofen, tizanidine, clonazepam, and Botox injections.

Other Medications

MyMSTeam members report taking several other medications to help improve their walking abilities. Gabapentin is a medication that can reduce neuropathic pain, which sometimes limits walking ability. Keep in mind that dizziness and coordination problems are common side effects of gabapentin.

Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) that can help reduce musculoskeletal pain in people with MS. This medication may cause dizziness as a side effect, which can worsen gait.

Assistive Devices

There are many different types of assistive devices for people with MS. There are two wearable leg sleeve devices: the Cionic Neural Sleeve, cleared in 2022, and the next-gen Neural Sleeve 2, cleared in 2025. They have shown promise in improving mobility, reducing foot drop, and aiding gait among people with MS.

More traditional mobility aids, such as canes, wheelchairs, and walkers, can also help support movement and prevent falls. People whose walking problems are caused by numbness may benefit from using a cane, walker, or Canadian crutch (a crutch that includes an arm cuff and handle).

Supportive braces and orthotics can help control the position and movement of the body and reduce pain while walking. Drop foot, in particular, may be managed using a brace known as an ankle-foot orthotic.

Exercise and Physical Therapy

Health experts agree that even a small amount of exercise can help improve walking difficulties when performed regularly. People with MS should do aerobic (heart-pumping) exercise at least two to three days per week, and resistance training at least two days per week.

Speak to your doctor to tailor these general recommendations to your symptoms, like heat sensitivity and fatigue. A physical therapist can work with you on gait analysis to determine the appropriate exercises to increase your muscle strength, range of motion, and improve your walking problems.

Fall Risk and Prevention

Fall risk is a substantial concern for people with MS walking problems. Research has found that people with MS have a higher risk of falling and getting injured from falls. Several factors increase the risk of falls in people with MS, including poor balance, slowed gait speed, and the incorrect use of assistive devices like canes and walkers.

People with MS have a higher risk of falling and getting injured from falls.

You may be able to reduce your risk of falling by:

• Wearing safe, low-heeled shoes
• Exercising and strengthening your core and muscles
• Adding home modifications like grab bars
• Keeping areas where you walk clear of cords, loose carpets, or other objects

You’re not alone in facing walking difficulties with MS. Your care team can help manage your MS in ways that work best for your needs and will help preserve your mobility for as long as possible.

Join the Conversation

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

Have you experienced walking difficulties with MS? Let others know in the comments below.