Key takeaways
MS occurs when the immune system attacks the protective covering of nerve fibers.
Treatments such as DMTs can help manage symptoms and slow disease progression.
Most people with MS have a normal life expectancy, though symptoms and severity can vary.
Multiple sclerosis (MS) is a chronic condition involving your central nervous system (CNS). With MS, your immune system attacks myelin, which is the protective layer around nerve fibers.
MS causes inflammation and temporary lesions. It can also lead to lasting lesions caused by scar tissue, which interferes with messages in the affected areas of the brain and spinal cord.
There’s no cure for MS, but it’s possible to manage symptoms. Learn more about the causes of MS, how it’s treated, and more.
People with MS experience a wide range of symptoms. Due to the nature of the disease, symptoms can vary widely from person to person.
They can also change in severity over time and even from day to day.
Some of the most common symptoms associated with MS include:
Fatigue
Around
of people with MS report having fatigue, according to the National Multiple Sclerosis Society (NMSS). Fatigue due to MS can make it harder to do everyday tasks.
Difficulty walking
Difficulty walking can occur with MS due to:
numbness in your legs or feet
difficulty balancing
muscle spasticity
Difficulty walking can also lead to injuries if you fall.
Vision problems
are often some of the first symptoms for many people with MS. They may affect one or both eyes. These issues may come and go, get worse over time, or resolve entirely.
Common vision problems associated with MS include:
, which can cause pain or blurry vision in one eye
, or double vision
, or involuntary movement of the eyes
loss of vision in one visual field or both eyes
blindness
Speech issues
MS lesions in the brain can affect speech. These speech issues, also known as
, can range from mild to severe.
Symptoms of dysarthria can include:
slurred speech
“scanning” speech, where there are long pauses between words or syllables
changes in the volume of speech
Other symptoms
Other common symptoms of MS can include:
acute or chronic pain
cognitive issues involving concentration, memory, and word-finding
difficulty chewing and swallowing
sleep issues
problems with bladder control
Learn more about the symptoms of MS.
MS can begin with mild to severe symptoms, and it can progress slowly or rapidly. Three of the most common early symptoms of MS are:
Numbness and tingling that affects the arms, legs, or one side of your face: These sensations are similar to the pins-and-needles feeling you get when your foot falls asleep. However, they occur without a trigger.
Uneven balance and weak legs: You may find yourself tripping easily while walking or doing some other type of physical activity.
Double vision, blurry vision in one eye, or partial vision loss: These symptoms can be early indicators of MS. You may also have eye pain.
These early symptoms may go away only to return later. You may go weeks, months, or even years between
.
These symptoms can have many different causes. Even if you have these symptoms, it doesn’t necessarily mean that you have MS.
Learn about the early signs of MS.
A healthcare professional, often a neurologist, performs a neurological exam to diagnose MS. They typically also talk with you about your clinical history and order tests to confirm the diagnosis.
MRI scan
Using a contrast dye with the
allows your doctor to detect active and inactive lesions throughout your brain and spinal cord.
Optical coherence tomography (OCT)
In this test, a picture of the nerve layers in the back of your eye is taken to check for thinning around the optic nerve.
Spinal tap (lumbar puncture)
Your doctor may order a
to find abnormalities in your spinal fluid. This test can help rule out infectious diseases. It can also be used to look for oligoclonal bands (OCBs), which can be used to diagnose MS.
Blood tests
Doctors order
to help eliminate the possibility of other conditions that have similar symptoms.
Visual evoked potentials (VEP) test
This test stimulates the nerve pathways to analyze electrical activity in your brain.
and sensory-evoked potential tests may also be used to diagnose MS.
An MS diagnosis requires evidence of
occurring at different times in more than one area of your brain, spinal cord, or optic nerves.
What is demyelination?Damage to the protective myelin layer around your nerves is called demyelination. It prevents your nervous system from efficiently sending signals in the areas that are affected.
A diagnosis also requires ruling out other conditions that have similar symptoms, such as:
Learn more about the tests used to diagnose MS.
Your MS may change and evolve. You can only have one type of MS at a time, but knowing when you transition to a progressive form of MS may be difficult to pinpoint.
Types of MS include:
Clinically isolated syndrome (CIS)
is a pre-MS condition involving one episode of symptoms lasting at least 24 hours. These symptoms are due to demyelination in your CNS.
Although this episode is characteristic of MS, it’s not enough to prompt a diagnosis. CIS can fully resolve, and a person can have a single episode without any future episodes.
If you have more than one lesion or positive oligoclonal bands (OCBs) in your spinal fluid at the time of a spinal tap, then you might be more likely to eventually be diagnosed with RRMS. If you have evidence of a previous lesion, you might be diagnosed with RRMS during the evaluation for CIS.
If these lesions are absent or your spinal fluid does not show OCBs, you are less likely to receive an MS diagnosis.
Relapsing-remitting MS (RRMS)
involves clear relapses of disease activity followed by remissions. During remission periods, symptoms are mild or absent, and there’s mild to moderate disease progression.
RRMS is the most common form of MS at diagnosis and accounts for
of all initial MS diagnoses, according to the NMSS.
Primary progressive MS (PPMS)
If you have
, neurological function becomes progressively worse from the onset of your symptoms.
However, short periods of stability can occur. The terms “active” and “not active” are sometimes used to describe disease activity with new or enhancing brain lesions.
Secondary progressive MS (SPMS)
Secondary progressive MS (SPMS)
occurs when RRMS transitions into the progressive form. In addition to disability or gradual worsening of function, you may still have noticeable relapses.
Find out more about the different types of MS.
If you have MS, the protective layer of myelin around some of the nerve fibers of your brain, optic nerve, and spinal cord become damaged.
See illustrations that show these physiological changes.
Experts think that this damage may result from an autoimmune process in which the immune system targets myelin. While more research is needed, an environmental trigger, such as a virus or toxin, may set off this process.
As your immune system damages the myelin, demyelination occurs. This can go into remission as new layers of myelin form, but chronic inflammation can lead to scar tissue, which can result in lasting neurological impairment.
MS is not hereditary, but having
with MS raises your risk slightly. Scientists have identified some genes that seem to increase susceptibility to developing MS, according to a review of studies
.
Experts do not know why some people develop MS. However, several risk factors may increase the risk.
These include:
having a close relative with MS
obesity
certain infections
smoking
certain autoimmune disorders, such as
and
Find out more about the possible causes of MS.
No cure is currently available for MS, but treatment options can limit relapses or slow progression. Other medications and therapies can help manage specific symptoms.
Disease-modifying therapies (DMTs)
help slow the progression of MS and reduce your relapse rate.
Self-injectable disease-modifying medications for RRMS include
and beta interferons, such as:
Betaseron
Extavia
Plegridy
Rebif
In 2020, the Food and Drug Administration (FDA) approved Kesimpta for treatment. Kesimpta is an injectable monoclonal antibody treatment that can be self-administered.
Oral medications for RRMS include:
dimethyl fumarate (Tecfidera)
teriflunomide (Aubagio)
cladribine (Mavenclad)
diroximel fumarate (Vumerity)
siponimod (Mayzent)
ozanimod (Zeposia)
monomethyl fumerate (Bafiertam)
ponesimod (Ponvory)
Intravenous (IV) infusion treatments
for RRMS include:
alemtuzumab (Lemtrada)
natalizumab (
)
mitoxantrone (Novantrone)
Ocrelizumab (Ocrevus)
In 2017, the Food and Drug Administration (FDA) approved the first DMT for people with PPMS. This infusion drug,
, can also be used to treat RRMS.
Another drug, ozanimod (Zeposia), has recently been approved for treating CIS, RRMS, and SPMS.
Not all
are available or appropriate for every person. Talk with your doctor about which drugs are most appropriate for you and the risks and benefits of each.
Other medications
A doctor can prescribe
, such as
(Medrol) or Acthar Gel (ACTH), to treat relapses.
Other treatments may also be targeted at easing specific symptoms to help improve your quality of life, such as helping to treat pain or bladder urgency.
Because MS is different for everyone, treatment depends on your specific symptoms.
Get more information on treatments for MS.
with MS have a normal life expectancy. While MS is not a terminal illness, some complications associated with it can be life threatening.
Progressive types of MS generally advance faster than RRMS. People with RRMS can be in remission for many years. A lack of disability after 5 years is usually a good indicator for the future.
Most people with MS don’t become severely disabled and continue to lead full lives.
Take a closer look at the prognosis for people with MS.
Your quality of life with MS will depend on your symptoms and how well you respond to treatment. But even though MS can change course without warning, it’s rarely fatal.
Most people with MS find ways to manage their symptoms and function well.
Medications
Having MS means you’ll need a
doctor experienced in treating MS
.
If you take one of the DMTs, you’ll need to adhere to the recommended schedule. Your doctor may prescribe other medications to treat specific symptoms.
Diet and exercise
, such as exercise, supports your overall health, physically and mentally.
If physical movement is difficult,
or exercising in a swimming pool can help. Some yoga classes are designed just for people with MS.
A
that’s high in
and fiber can also help you manage your overall health.
Your diet should mainly consist of:
a variety of
and
lean sources of
, such as
and
and
low fat dairy products
adequate amounts of
and other fluids
The more nutritious your diet, the better it supports your overall health. You’ll not only feel better in the short term, but you’ll also be laying the foundation for a healthier future.
It’s important that you try to
:
foods and beverages high in sugar
If you have other medical conditions, ask your doctor if you should follow a special diet or take any dietary supplements.
It’s helpful to learn how to
properly. Foods that are high in calories but low in nutrients will not help you feel better or maintain a weight that works for you.
Other complementary therapies
Although studies regarding the effectiveness of complementary therapies are scarce, that does not mean these methods can’t help in some way.
The following therapies
you feel less stressed and more relaxed:
MS lesions can appear anywhere in your CNS and have wide-ranging effects. Many people with MS also have:
anxiety
some degree of cognitive impairment
muscle spasticity or stiffness
muscle atrophy or thinning
If you have other medical conditions, MS can have a more substantial impact on your overall health.
If you have mobility issues, falling may increase your risk of
. Other conditions, such as
and
, can complicate matters. Mobility issues can lead to a lack of physical activity, which can cause other health problems. Fatigue and mobility issues may also have an effect on mental health.
The National Institutes of Health (NIH) reports that around
in the United States have MS.
Other things you should know:
NMSS reports that most people diagnosed with RRMS are
at the time of their diagnosis.
Overall, research indicates that MS is
than males. NMSS reports that RRMS specifically is
more common in females than males. PPMS rates in females and males are roughly equal.
Research shows that people who relocate to a new location
generally acquire the MS risk factors associated with the new location, compared with those relocating after age 15 years. Canada has one of the highest rates of MS in the world. Rates of MS tend to be lower in places closer to the equator. This may be due to
and
exposure.
Check out more MS facts and statistics here.
MS is a lifelong condition. You’ll face unique challenges that can change over time.
It’s helpful for you to discuss your concerns with your doctor. Doing so, enables you to learn all you can about MS and to discover what makes you feel your best.
Many people with MS even choose to share their challenges and coping strategies through in-person or
support groups.
You can also try Healthline’s free MS Buddy app to share advice and support in an open environment. Download it for
or
.