Multiple sclerosis (MS) is a lifelong condition that affects the brain and nerves.
It's when the immune system attacks the protective sheath - myelin - that covers nerve fibres and disrupts the communication between your brain and the rest of your body.
Affected nerve fibres can become vulnerable to damage, and over time may be lost entirely. When this happens, messages can no longer get through and symptoms become permanent.
This gradual, steady accumulation of disability is called MS progression. The NHS says MS can cause a wide range of potential symptoms, including problems with vision, arm or leg movement, sensation or balance.
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How does the multiple sclerosis start?
While people in the UK are most likely to be diagnosed with MS in their 30s, 40s and 50s, the red flags for the disease often start years earlier. It isn't uncommon for people to notice their first symptoms for a very long time before getting the disorder confirmed.
MS is one of the most widespread causes of disability in younger adults. Thankfully in many cases the symptoms can be treated, although the average life expectancy is slightly reduced.
No one knows for sure why people get MS, and the MS Society says there's no typical pattern of MS symptoms, with different people experiencing a myriad of potential red flags across a range of ages.
While there are certain things to watch for, it's important to remember that if you do notice any of the following symptoms, you shouldn't assume they are a sign of MS. Not everyone who experiences them will get an MS diagnosis - many symptoms of MS can also point towards other conditions.
Vision Problems
One of the more obvious first signs of MS is a problem with vision, known as optic neuritis. This is where swelling (inflammation) damages the optic nerve - a bundle of nerve fibres that transmits visual information from your eye to your brain. Common signs of optic neuritis include pain with eye movement and temporary loss of vision in one eye.
Optic neuritis is considered a more 'concrete symptom', as others - such as numbness and tingling - are often vague and can be attributed to a number of other causes.
Fatigue
Every one of us gets tired, particularly following a hard day's work. But MS fatigue is very different. People describe it as an overwhelming sense of tiredness with no obvious cause.
The MS Society says warning signs to watch for include:
- Feeling extremely tired after very little activity
- Waking up feeling as tired as you did when you went to sleep.
- Your limbs feeling heavy, and it becoming harder to grasp things or to write
- Other symptoms, such as difficulty with balance, vision or concentration, which might temporarily get worse.
Numbness and tingling
The NHS says abnormal sensations can be a common initial symptom of MS. And this can often take the form of numbness or tingling in different parts of your body, such as the arms, legs or trunk, which typically spreads out over a few days.
The MS Society says a common type of discomfort in MS is unpleasant, unusual sensations that appear to be in your skin, such as numbness and tingling, which is caused by damage to nerves.
Loss of balance and dizziness
Feeling dizzy is a common symptom of MS, as is feeling 'off balance' or lightheaded. Far less often experienced is vertigo, which is the sensation that a person - or their surroundings - are spinning.
Stiffness or spasms
Muscle stiffness and spasms are common MS symptoms, and are often described as 'spasticity'. These symptoms can affect between 40 per cent and 80 per cent of people with MS at some time. For most people, the stiffness and spasms come and go.
Tremor
A tremor is a neurological disorder that causes shaking movements in one or more parts of your body, most often in your hands, says the National Institutes of Health. This can be mild or more pronounced, for example enough to spill a cup of drink if it's full or affecting handwriting.
Pain
Pain in MS can take on many different guises and be caused by direct nerve damage. Alternatively it can come from the symptoms and strains they place on your body. Such pain can feel like burning, stabbing, sharp and squeezing sensations, says the MS Society. MS sufferers can experience both acute (a rapid onset and of short duration) neuropathic pain and chronic neuropathic pain.
Acute neuropathic pain is occasionally an initial symptom of MS, or could be part of an MS relapse.
Bladder problems
There are two main types of bladder problems in MS: problems with storage and issues with emptying. The MS Society says that when the nerve pathways in the spine are interrupted, even a small amount of pee in the bladder can cause it to contract. This causes a need to pee frequently – known as frequency.
Another problem is an inability to ‘hold on’, called urgency. If this is severe, urgency incontinence will be a problem.
Bowel trouble
Some people with MS will never experience such a problem, but up to 7 in 10 people with the condition will get a bowel issue at some stage - either constipation or incontinence (leakage).
Memory and thinking
Problems with memory and thinking - also called 'cognitive problems' - can affect people with MS, but most people will be affected mildly. Some people find it harder to find the right words, to concentrate or to recall things quickly.
