MS-UK believes that based on experience, people cope best when they look at what is happening, rather than what might be. MS can cause a long list of symptoms. This list is not exhaustive and it is extremely unlikely that any one person would experience all or even most of these symptoms. Most will only experience a small number of these. The combination, severity and frequency will be different for everyone.
Symptoms can come and go; some are much more responsive to treatment whereas others are more difficult to manage.
Outside influences can exacerbate symptoms. For example, hot weathercan make fatigue worse. Infections can cause all sorts of othercomplications, although once the infection is treated, the symptoms shouldsubside.
New symptoms may not always be down to your MS. It is important toremember that not every ache and pain is connected and if a newsymptom persists and becomes an on-going problem, you should seekmedical advice.
Below are some of the more common symptoms experienced, with a briefexplanation. If you are experiencing any of these symptoms and they arecausing you problems, it is advisable to contact your GP or MS Nurse orask to be referred to the appropriate specialist. Most symptoms can betreated; you do not have to just ‘put up’ with them!
Please note that whilst some are common to most people, some are relatively rare. Visual disturbances
There are several problems that can affect the vision of people with MS. The most common symptom is optic neuritis – inflammation of the optic nerve, which is also one of the more common first symptoms that can lead to a diagnosis of MS. Other problems can include; double vision (diplopia) a symptom which can occur as part of a relapse of MS, but will often recover partially or fully with the use of steroids and nystagmus (rhythmical oscillations of the eye ball) which sometimes goes unnoticed by the person, but is obvious to others.
NICE Guidelines for management of MS states that
be treated accordingly with either drugs or by seeing
“any person who has nystagmus that causes reduced someone like a Physiotherapist or a Pain Clinic. Pain visual acuity or other visual symptoms should be
can be described in various ways such as stabbing,
offered a time-limited trial of treatment with oral
burning, tingling or pins and needles. But all pain is
gabapentin. This should be initiated and monitored by
subjective and no two people will experience pain in
the same way and can only be described best by the person experiencing it.
For more detailed information, please see our choices leaflet ‘Visual Disturbances’.
For more detailed information, please see our choices
Bladder and Bowel problems Cognition
Bladder problems are one of the most common symptoms in MS. Bladder problems tend to fall into
Approximately half of people diagnosed with MS will
four areas; urgency – the need to ‘go’ with little or no
have cognitive problems. These will range from fairly
warning; frequency – having to ‘go’ more than 8 times
mild on a day to day basis to an increased worsening
per day; hesitancy – finding emptying the bladder
during a relapse. Initially, people may not realise that
difficult; retention – you can empty the bladder, but
cognitive problems are associated with their MS. The
have a feeling of incompletion. Many people have a
most common problems are memory, information
processing, problem solving, word finding and concentration. To manage these problems, people may
Approximately half of people with MS will have bowel
have to look at different ways to help themselves such
problems and constipation and emptying are the most as creating aide memoirs or using technology and common. The other problem area is incontinence and
avoiding jobs which need concentration when fatigued
lack of control over the bowel opening. It is possible to
Symptoms can become more pronounced when MS
A referral to a Continence Advisor will help to find
is active and may lessen or disappear again when the
ways in which to deal with problems in all these areas.
MS is quiet. In some people, symptoms fluctuate when the person is tired, upset or anxious.
For more detailed information, please see our choices
If you are experiencing some of these symptoms, or
others that may not be mentioned, you can contact
MS-UK for more information, advice and support. For more detailed information, please see our choices
The impairment of sensory perception includes the
loss of feeling in limbs and other areas; tingling, crawling sensation, numbness or tightness and varying degrees of pain. The medical term for
Muscle and Motor Disturbances
uncomfortable, abnormal sensations, such as these is dysaesthesia or paraesthesia. These feelings are
This can be the loss of control of one or more limbs.
classed as neuropathic pain symptoms.
For example: Myoclonus (sudden and uncontrollable shock-like movements or “jerks” of a muscle or a
group of muscles), swallowing difficulties, tremor and the inability to perform fine movements – e.g. doing up buttons, tying shoe laces etc. Legs or arms
There are two main types of pain that can occur –
may suddenly go into spasm which is often painful.
neuropathic and musculoskeletal and about half of
people diagnosed with MS will experience pain at
some time. Once the cause is identified the pain can
MS-UK Unsworth House, Hythe Quay, Colchester, Essex, CO2 8JF
Tel: 01206 226500 Email: info@ms-uk.org www.ms-uk.org Loss of Co-ordination
degree. This can be caused by damage affecting the coordination of the various muscles involved.
This can include dizziness and vertigo, ataxia,
The result can be difficulty chewing or episodes of
staggering, clumsiness (spilling and dropping things).
coughing or choking when eating and drinking.
If the swallowing problems are more advanced and eating is putting the individual at risk, nutrition can
be provided through a procedure called percutaneous endoscopic gastrostomy (PEG).
Extreme tiredness, otherwise known as fatigue, is a common symptom of MS. This is an invisible symptom For more detailed information, please see our choices
that is not obvious to other people and can be quite
leaflet ‘Speech & Swallowing’.
difficult to cope with and manage. There are a number of ways in which people learn to live with their fatigue and drug treatments are also available.
Spasticity
For more detailed information, please see our choices
Spasticity is where the signals from the brain are
interrupted and the muscle remains in its shortened, contracted state. This causes the affected muscle to feel stiff or tight and to be resistant to movement.
Foot Drop
The degree of spasticity will vary from person to person and can greatly impact on many activities.
Foot drop is a symptom experienced by some people
Nevertheless, spasticity can be successfully managed.
with MS and it is caused by a weakness in the ankle that causes the foot to drag along the ground or hang
Left untreated, spasticity can lead to complications
down when walking. People who experience foot drop
such as frozen or immobilised joints and pressure
are more vulnerable to tripping and falling. When
sores. However, treatment can be very effective and
walking, they use more energy and people may alter
includes physiotherapy and drugs such as Baclofen
their gait to compensate, by lifting their leg higher.
(Lioresal) and Tizanidine (Zanaflex).
Foot drop can be treated using functional electrical stimulation. FES uses small electrical charges to force the foot into a more natural position for walking and
an ankle splint (orthosis) can also be used to hold the foot in a rigid position.
Tremor is involuntary, uncontrolled movements. The type of tremor that is most frequently experienced in MS is intention tremor - a tremor that worsens as
Speech & Swallowing
the individual reaches for an object. It is thought that tremor is due to lesions in the cerebellum, the area of
Speech and swallowing disorders can arise as a
the brain responsible for balance, co-ordination and
symptom of MS for some people. Speech disorders
‘fluidity’ of movement. Tremor can also result from
include dysarthria (a slurring of speech due to
demyelination of the thalamus and the basal ganglia
weakness or lack of coordination in the muscles used
in the brain. Stress and fatigue are known to worsen
in speech) and dysphagia (swallowing difficulties).
Although they may develop at any stage, for most
About one third of people with multiple sclerosis
people, speech disorders only become apparent in
may have tremor to some degree. For some people
the later stages of the condition and this may mean
it can be a relatively mild problem with coordination
the help of a speech and language therapist. More
called ataxia, but for others it can be one of the most
complex problems may also benefit from the use of
Studies have found that around a third of people with MS experience swallowing difficulties to some
MS-UK Unsworth House, Hythe Quay, Colchester, Essex, CO2 8JF
Tel: 01206 226500 Email: info@ms-uk.org www.ms-uk.org
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