MS is a complex disease with many symptoms that differ from patient to patient, vary in severity, and can change over time. When they do occur, it’s important to know how to manage or treat them so you can feel better and do more, whether it’s work productively, enjoy leisure time with family or friends, or keep up with your favorite activities. Some of the more common symptoms of MS include:
Extreme tiredness and lack of energy that interferes with daily activities at home and work is often a prominent MS symptom, even in those without other symptoms that affect their daily lives.
Management tips: A healthy diet and regular exercise can improve energy levels, but for some people, exercise worsens fatigue. Talk to your provider before you start any exercise program and avoid activities that drain you. Good sleep habits can also help. Click here for tips on getting great sleep. Ration your energy: Save tasks for times when you feel most energetic. Certain medications may also be helpful.
Lack of feeling or a “pins-and-needles” sensation that affects the face, body, arms, or legs is often the first symptom that MS patients experience.
Management tips: Intermittent mild numbness and tingling may not require treatment, but recognizing and avoiding or addressing triggers, such as exposure to extreme temperatures, lack of rest, and stress, can help prevent or ease symptoms. For example, stay cool, get good sleep, and meditate or practice other stress-reducing activities.
Stiffness and involuntary muscle spasms can occur in the arms and legs, but most often affect the legs. Spasticity in MS is usually chronic, but it may or may not cause pain.
Management tips: Rehabilitative physical therapy including stretching and balance training can help. It is important if you have spasticity to stretch at least twice a day, holding stretches for 30 to 60 seconds. Medications are also available. Talk to your provider about what’s right for you. For tips on stretches that can help, check out this guide book and this video from the National MS Society.
Loss of strength often occurs in MS and may be the result of unused or underused muscles due to other symptoms of MS and of damage to nerves that stimulate muscles.
Management tips: Rehabilitative strategies such as occupational therapy or physical therapy can help, especially for upper body weakness that interferes with daily activities and self-care. Aquatic therapy (pool workouts) is a great way to get moving as they will also keep you cool. Mobility aids and other assistive devices can be useful for helping to maintain independence and activity.
Blurred vision, double vision, poor contrast or color vision, and pain with eye movement are often an early MS symptom. Any vision problem requires medical evaluation.
Management tips: Seek medical care for vision problems. Treatment depends on the specific issue but may include special eyeglasses with prism lenses for double vision or high-dose glucocorticoids for optic neuritis, for example.
Feeling dizzy — off-balance or lightheaded — is common in MS. Vertigo, a sense of spinning or that one’s surroundings are spinning, occurs less often. Usually, these symptoms are due to brain lesions, but they can also be caused by problems in the inner ear
Management tips: Medications for motion sickness can help. Severe cases may require treatment with corticosteroids.
Many MS patients have bladder dysfunction, and many experience constipation or loss of bowel control.
Management tips: The first step in treatment of bladder problems includes conservative measures such as nighttime fluid restriction, avoiding bladder irritants like alcohol, caffeine, and tobacco, treatment of constipation, and scheduled voiding. For female patients, Kegel exercises can be very helpful. If this does not help, please talk to your healthcare provider about medications that can help with bladder dysfunction. Similar to bladder dysfunction, many bowel problems may also respond to dietary changes, fluid management, and physical activity. Read more here about exercises for bladder problems.
This is a common problem in the general population, so when you add MS issues like nerve damage, fatigue, spasticity, and depression, it’s no wonder it affects many people with MS.
Management tips: The best approach for addressing sexual issues related to MS depends on the specific problems a patient is experiencing. For men, this may include medications or inflatable devices or implants to aid with erections. The No. 1 cause of sexual dysfunction in women with MS is usually anxiety, depression, or fatigue. For these problems, counseling or medical treatment may help. Vaginal dryness can often be managed with topical creams. Managing sexual dysfunction in MS often requires a multidisciplinary approach that includes, for example, a neurologist, a urologist, and a psychologist.
These occur chronically in many MS patients, sometimes as a result of nerve damage, but sometimes due to other causes. A little over half of all MS patients experience significant pain.
Management tips: Treatment depends on the cause and severity. Medical and non-medical treatments can help, but symptoms caused by nerve damage aren’t likely to respond to treatments for other types of pain and itching, so an evaluation is important, especially for intense symptoms that interfere with daily activities.
These can be related to several other symptoms, including weakness, spasticity, fatigue, and loss of balance.
Management tips: Physical therapy and assistive therapy and devices can help. Certain medications can also help reduce spasticity. Check with your provider about your options.
Exposure to heat or humidity — due to weather, a hot bath or shower, a fever, or exercise — causes a temporary worsening of symptoms for some MS patients. This occurs because even a slight elevation in body temperature can worsen the effects of MS on nerve function. Cold can be problematic, too; some MS patients experience increased spasticity in cold weather.
Management tips: Avoid extreme temperatures (stay in an air-conditioned environment when it’s hot or humid outside or stay in a warm environment when the weather is cold, for example). For heat sensitivity, consider using cooling products such as cooling vests or neck wraps, wear lightweight and breathable clothing, drink cold fluids, exercise in a cool pool or environment, and try using a cool bath or shower to lower your core body temperature after exercise. If you need help getting a cooling vest, the MS Foundation or the National MS Society have programs that may be able to help. Ask your health advisor for more information.
Living with MS can be stressful, and that in itself can lead to a variety of emotional changes such as anxiety, irritability, and mental health concerns such as depression. But the neurologic changes and effects on the immune system that occur with MS can also contribute.
Management tips: Recognize that emotional health is part of overall health and should be addressed. Tell your provider about feelings of anxiety, intense sadness, or despair. An accurate diagnosis is necessary for effective treatment, which may include counseling and medications. Take time to address your mental and emotional health needs by practicing mindfulness, meditation, and other self-care techniques. Ask your Health Advisor for tips.
MS can affect information processing, the ability to remember new information, problem-solving abilities, word-finding, and attention or focus. New research suggests that cognitive difficulties are more common than previously thought in MS.
Management tips: Cognitive rehabilitation, including activities that restore cognitive function and those that help compensate for loss of function, is often helpful, and disease-modifying MS drugs may help stabilize cognitive changes. Other symptomatic treatments, such as stimulant medications, may help with things like attention deficits, slow processing speed, and memory problems.
MS is also associated with a number of less common symptoms, including hearing loss, seizures, tremors, swallowing problems, and speech problems. You can read more about those here, and if you have any questions or would like more information on any of the symptoms associated with MS, be sure to let your Health Advisor know. We’re here to help!