Early Signs and Symptoms of MS: What You Need to Know to Protect Yourself

Last Updated on May 22, 2024 by Lauretta Iyamu, PharmD

Multiple sclerosis (MS) is a disease that affects the brain and spinal cord. In MS, the immune system attacks the protective covering of nerve fibers. This can cause problems with how the brain communicates with the rest of the body. Over time, this can damage the nerves, leading to serious issues [1]. This post will discuss the early signs and symptoms of MS, its diagnosis, and its management.

What is multiple sclerosis?

Multiple sclerosis is an autoimmune disease in which the immune system mistakenly attacks the myelin sheath, the protective layer around nerve fibers. 

This disrupts the signals between the brain and the rest of the body, causing various symptoms that affect physical and mental abilities. The severity of MS varies; some people may have mild symptoms, while others might have severe problems [2].

According to a study review published in the European Journal of Neurology, MS is the most common non-traumatic disabling disease to affect young adults.

The disease goes through cycles where it can improve for a while and then worsen.

Detecting MS early is very important. It helps in managing the symptoms better and slowing down the disease. If you know what signs to look for, you can get help sooner and start treatment to improve your quality of life [3].

Early Signs and Symptoms of Multiple Sclerosis

It’s important to catch the signs of MS early so you can get the right treatment and take control of the disease. If you notice any of these symptoms, you should talk to your doctor about testing for MS.

Common signs and symptoms of multiple sclerosis are [3, 4]:

1. Vision problems
2. Numbness and Tingling
3. Fatigue
4. Muscle Weakness and Spasms
5. Difficulty Walking
6. Cognitive Changes
7. Chronic Pain
8. Bladder and Bowel Issues
9. Dizziness and Vertigo
10. Mood changes

1. Vision Problems

Vision problems are often one of the first signs of MS. You might experience blurred vision, double vision, or even a complete loss of vision in one eye.

This happens because of inflammation in the optic nerve, known as optic neuritis [4].

Recognizing Vision Problems

• Blurry or hazy vision
• Seeing double
• Pain when moving your eyes
• Losing color vision

2. Numbness and Tingling

Numbness or tingling, especially in the face, arms, legs, and fingers, is another common early sign of MS. These sensations are caused by nerve damage and can be mild or severe [5].

Areas Prone to Numbness

• Face
• Arms
• Legs
• Fingers

3. Fatigue

Fatigue is a frequent symptom of MS. This is not just normal tiredness; it’s a kind of exhaustion that doesn’t go away even after resting. It can make daily activities very difficult [6].

Signs of MS-Related Fatigue

• Sudden onset
• Feeling tired every day
• Triggered by heat and humidity
• Getting worse as the day goes on

4. Muscle Weakness and Spasms

This happens because MS damages the nerve fibers that stimulate your muscles. This can make moving and doing everyday tasks hard [7].

According to the National Multiple Sclerosis Society, up to 60 percent of people with MS have muscle weakness in their arms, legs, or faces.

Signs of Muscle Issues

• Stiff or tight muscles
• Sensitivity to heat or cold
• Weakness in arms or legs
• Uncontrolled muscle movements

5. Difficulty Walking

MS can affect your balance and coordination, making it hard to walk. This might be due to muscle weakness, stiffness, or dizziness [8].

Signs of Walking Problems

• Tripping or stumbling often
• Feeling unsteady
• Dragging one leg

6. Cognitive Changes

Problems with memory and concentration, can also happen early in MS. These issues can affect your ability to think clearly and solve problems [9].

Symptoms to Watch For

• Trouble focusing
• Short-term memory loss
• Difficulty organizing or planning

7. Chronic Pain

Chronic pain is another early symptom of MS. This pain can be caused by nerve damage or muscle stiffness and spasms [10].

Types of MS-Related Pain

• Burning or tingling pain (neuropathic pain)
• Joint or muscle pain (musculoskeletal pain)

8. Bladder and Bowel Issues

MS can cause bladder and bowel problems, such as frequent urination, urgency, constipation, or incontinence [11].

Common Bladder and Bowel Symptoms

• Needing to urinate often
• Urinary incontinence
• Constipation
• Loss of bowel control

9. Dizziness and Vertigo

Dizziness and a sense of spinning (vertigo) are also early symptoms of MS. These can make it hard to keep your balance [12].

Signs of Dizziness and Vertigo

• Feeling lightheaded
• Room spinning sensation
• Loss of balance

10. Mood changes

If you find yourself feeling sad or moody for no clear reason, it could be related to MS. Mood changes are also a symptom of depression. If you are diagnosed with multiple sclerosis and experiencing depression, it’s best to speak with your doctor to get treatment for both conditions as soon as possible.

Risk Factors of Multiple Sclerosis

Women are more likely to get MS than men, with about three women getting MS for every man who does [5]. 

Several environmental factors and lifestyles may increase your exposure to MS [3]. Factors that can increase your risk of getting MS include [6]: 

• Not Enough Vitamin D or Sunlight
• Epstein-Barr virus (EBV)
• Infection
• Obesity
• Smoking
• Family History

Is MS Hereditary?

The chance of having MS occurs throughout life, starting in the womb. Your genetic makeup influences your risk of MS if you have a family history of the disease, as well as environmental factors [3]. 

When you have a first-degree relative with multiple sclerosis, your risk of developing MS is around 5%, 25% if you’re identical twins, and higher chances if present in the family history [6].

For example, you may find that when MS affects an identical twin, one twin can have mild MS that comes and goes away, while the other’s condition may be more severe with serious long-term effects [6]. 

Comorbid Disorders 

A big red flag to check for MS is comorbid symptoms and signs.

These signs help your doctor differentiate MS from other autoimmune diseases with similar signs and symptoms.

MS can coexist with other autoimmune disorders, such as [7],[8].

• Systemic lupus erythematosus
• Sjögren’s disease
• Behçet’s disease
• Susac’s disease
• Other vasculitides
• Lyme disease
• HIV
• Parkinson’s disease
• Rheumatoid Arthritis
• Alzheimer disease
• Inflammatory bowel disease

How to Diagnose Multiple Sclerosis

There is no single, defined test for multiple sclerosis. Your doctor will only diagnose you with MS after ruling out other diseases or comorbid disorders that might be causing your symptoms.

The diagnosis of multiple sclerosis remains clinical. However, once all the signs and symptoms of MS are known, you will get either of the following diagnoses:

Differential diagnosis

A differential diagnosis is when your doctor distinguishes between two or more conditions that could be causing your symptoms. 

Diagnosis of exclusion 

A diagnosis of exclusion is when your doctor diagnoses the condition as MS by elimination. This occurs because they could not confidently conclude the cause of your symptoms from your history, examination, or test.

When to See a Doctor

Seeing a doctor is important if you notice any of these symptoms and they don’t go away. Early treatment can make a big difference in managing MS [13].

Preparing for Your Appointment

• Keep a diary of your symptoms
• List any medications and supplements you take
• Note any family history of autoimmune diseases

Diagnostic Tests for MS

Doctors use several tests to diagnose MS. These tests help rule out other conditions and confirm an MS diagnosis [14].

Common Diagnostic Tests

• Blood test
• Medical history
• Physical examination
• MRI scans to look for lesions in the brain and spinal cord
• Lumbar puncture (spinal tap) to check cerebrospinal fluid
• Evoked potentials to measure electrical activity in the brain

Treatment for Early-Stage MS

Medications

Some medications can help manage MS symptoms and slow down the disease. These include disease-modifying therapies (DMTs), steroids for acute relapses, and medications to manage specific symptoms like muscle spasms or pain [15].

Types of Medications for Multiple Sclerosis

• Corticosteroids
• Muscle relaxants
• Disease-modifying therapies (DMTs)

Lifestyle Changes

Making lifestyle changes can also help manage MS. These include eating a healthy diet, exercising regularly, and managing stress [16].

Tips for a Healthy Lifestyle

• Eat a balanced diet with lots of fruits and vegetables
• Exercise regularly
• Use stress management techniques like meditation or yoga

Diet and Supplements

Nutrition in managing MS

Good nutrition is important for managing MS. Eating a balanced diet can help reduce inflammation and support your overall health [17].

Nutrition Tips for MS

• Eat plenty of fruits and vegetables
• Choose whole grains
• Include sources of omega-3 fatty acids, like fish

Supplements for MS

Certain supplements can help manage MS symptoms. Always talk to your doctor before starting any new supplements [18].

Common Supplements for MS

• Vitamin D
• Omega-3 fatty acids
• Biotin

For more information on high-quality supplements for multiple sclerosis, visit our Vitamins and Supplements section.

How to Manage MS Symptoms and Prevent Relapses

Physical Therapy

Physical therapy can help improve mobility, strength, and balance in people with MS. A physical therapist can create a custom exercise program for you [19].

Benefits of physical therapy

• Better mobility
• Less muscle stiffness
• Improved balance and coordination

Occupational Therapy

Occupational therapy helps people with MS stay independent in their daily activities. This can include adaptive techniques and equipment to make tasks easier [20].

Benefits of Occupational therapy

• Assisting with daily tasks
• Recommending adaptive equipment
• Providing strategies to save energy

Support Groups and Counseling

Support groups and counseling can provide emotional support and practical advice for managing MS. Connecting with others who understand can be very helpful [21].

How to find Support groups

• Local MS support groups
• Online forums and communities
• Professional counseling services

The Importance of Regular Check-Ups

Regular check-ups with a neurologist are important for tracking MS and adjusting treatment plans as needed [22].

What to Expect During Check-Ups

• Neurological exams
• MRI scans to monitor lesions
• Blood tests to check for medication side effects

Self-care for MS

Adapting to Lifestyle Changes

Living with MS often means changing one’s lifestyle. This might include modifying one’s home, work environment, or daily routine [23].

Practical Tips for Daily Living

• Install grab bars in the bathroom
• Use mobility aids if needed
• Plan rest periods throughout the day

Staying Active and Engaged

Staying active and engaged can help maintain physical and mental health. Find activities that you enjoy and that fit your energy levels and abilities [24].

Activities to Consider

• Swimming or water aerobics
• Gentle yoga or stretching
• Hobbies like reading, painting, or gardening

Conclusion 

Recognizing the early signs and symptoms of MS is key to getting help early and managing the disease. You can improve your quality of life by understanding these symptoms, seeking medical advice, and making lifestyle changes.

Regular check-ups, a balanced diet, appropriate supplements, and support from healthcare providers and community resources all play a vital role in managing MS.

For more information on managing health conditions and symptoms, visit our Health Conditions and Signs and Symptoms sections.

Frequently Asked Questions

Q1: What are the first signs of MS?

A: The first signs of MS often include vision problems, numbness, tingling, and fatigue. These symptoms can appear suddenly and may be mistaken for other issues. If you notice these, it’s important to see a doctor.

Q2: How does MS affect your daily life?

A: MS can cause fatigue, muscle weakness, and difficulty walking, making daily tasks harder. Early treatment and lifestyle changes can help manage these symptoms and improve your quality of life.

Q3: Can diet help manage MS symptoms?

A: A balanced diet rich in fruits, vegetables, and omega-3 fatty acids can help reduce inflammation and support overall health. Supplements like vitamin D may also be beneficial.

Q4: How important is early diagnosis of MS?

A: Early diagnosis is crucial for managing symptoms and slowing the disease’s progression. If you experience symptoms like vision problems or numbness, immediately see a doctor.

Q5: What lifestyle changes can help with MS?

A: Regular exercise, a healthy diet, stress management, and physical therapy can help manage MS symptoms. These changes can improve mobility, reduce fatigue, and enhance your overall well-being

References

1. Browne P, Chandraratna D, Angood C, Tremlett H, Baker C, Taylor BV, et al. Atlas of Multiple Sclerosis 2013: A growing global problem with widespread inequity. Neurology [Internet]. 2014 Sep 9 [cited 2023 Nov 11];83(11):1022–4. Available from: https://www.neurology.org/lookup/doi/10.1212/WNL.0000000000000768
2. Kobelt G, Thompson A, Berg J, Gannedahl M, Eriksson J, the MSCOI Study Group, et al. New insights into the burden and costs of multiple sclerosis in Europe. Mult Scler [Internet]. 2017 Jul [cited 2023 Nov 11];23(8):1123–36. Available from: http://journals.sagepub.com/doi/10.1177/1352458517694432
3. Dobson R, Giovannoni G. Multiple sclerosis: a review. Eur J Neurol [Internet]. 2019 Jan [cited 2022 Nov 11];26(1):27–40. Available from: https://onlinelibrary.wiley.com/doi/10.1111/ene.13819
4. Mollaoğlu M, Üstün E. Fatigue in multiple sclerosis patients. Journal of Clinical Nursing [Internet]. 2009 May [cited 2022 Nov 11];18(9):1231–8. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2702.2008.02733.x
5. Orton SM, Herrera BM, Yee IM, Valdar W, Ramagopalan SV, Sadovnick AD, et al. Sex ratio of multiple sclerosis in Canada: a longitudinal study. The Lancet Neurology [Internet]. 2006 Nov [cited 2022 Nov 11];5(11):932–6. Available from: https://linkinghub.elsevier.com/retrieve/pii/S147444220670581
6. Baecher-Allan C, Kaskow BJ, Weiner HL. Multiple sclerosis: mechanisms and immunotherapy. Neuron [Internet]. 2018 Feb [cited 2022 Nov 11];97(4):742–68. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0896627318300461
7. Ascherio A. Environmental factors in multiple sclerosis. Expert Review of Neurotherapeutics [Internet]. 2013 Dec [cited 2022 Nov 11];13(sup2):3–9. Available from: http://www.tandfonline.com/doi/full/10.1586/14737175.2013.865866
8. Makhani N, Tremlett H. The multiple sclerosis prodrome. Nat Rev Neurol [Internet]. 2021 Aug [cited 2022 Nov 11];17(8):515–21. Available from: http://www.nature.com/articles/s41582-021-00519-3