Last Updated on May 4, 2025 by Analgesia team
What is Multiple Sclerosis?
Multiple sclerosis (MS) is a chronic disease that affects the myelin and nerve fibers of the brain and spinal cord. It’s an autoimmune disorder that occurs when the body attacks its myelin, the fatty substance that protects nerve fibers. This disrupts communication between the brain and the rest of the body.
Multiple Sclerosis Symptoms
Multiple sclerosis (MS) can cause a wide range of symptoms, including vision problems, muscle weakness, fatigue, and bladder and bowel issues.
Vision problems
It’s very common for multiple sclerosis to cause eye problems, and many people with MS have difficulties with their vision at one time or another.
The most common problems with vision in Multiple Sclerosis are:
- optic neuritis
- double vision (diplopia)
- Involuntary eye movements (nystagmus)
Difficulty Moving Arms or Legs
Balance, walking difficulties, and dizziness are common symptoms of Multiple Sclerosis (MS), often caused by damage to the nervous system that affects coordination and muscle control, leading to feelings of unsteadiness and potential falls when walking; these symptoms can vary in severity from person to person and may be present intermittently depending on the progression of the disease.
Key points about balance and walking issues in MS:
Mechanism:
Lesions (damaged areas) in the brain, particularly in the cerebellum, which is responsible for balance, can disrupt the signals sent to muscles, causing difficulties in coordinating movement and maintaining stability.
Spasms and stiffness
In multiple sclerosis (MS), “spasms” refer to sudden, involuntary muscle contractions, often described as muscle stiffness or jerking movements, which are a common symptom. They are known as “spasticity” and can affect the legs, arms, and other parts of the body due to damage to nerve pathways within the central nervous system caused by the disease. These spasms can range from mild tightness to painful, uncontrollable jerks, depending on the severity of the MS progression.
Key points about spasms in MS:
- Medical term: Spasticity
- What it feels like: Muscle stiffness, tightness, sudden involuntary muscle contractions, jerking movements
- Where it can occur: Most commonly in the legs, but can affect any muscle group
- Cause: Damage to the myelin sheath surrounding nerves in the central nervous system, disrupting nerve signals
- Severity: Can range from mild discomfort to severe, debilitating spasms impacting mobility
Bladder and Bowel Issues in Multiple Sclerosis Symptoms
Bladder and bowel dysfunction are common symptoms experienced by many people with multiple sclerosis (MS), often due to nerve damage in the spinal cord, which disrupts communication between the brain and these organs. This eventually leads to issues like urinary incontinence, frequent urination, constipation, and sometimes even fecal incontinence. These problems can vary in severity depending on the individual and their MS progression.
Pain in MS Symptoms
Pain is common in multiple sclerosis (MS) and can include burning, tingling, numbness, and muscle spasms. Pain can be caused by nerve damage, muscle damage, or other factors.
Types of pain
- Nerve pain: Also called neuropathic pain, this can feel like pins and needles, burning, or tingling.
- Musculoskeletal pain: Also called nociceptive pain, this can feel like back or hip pain.
- Lhermitte’s sign: An electric shock-like feeling that runs down the back and into the arms when you bend your head.
- Trigeminal neuralgia: Stabbing pain on the side of the face.
- MS hug: A tight feeling around the chest.
Other pain-related symptoms
- Optic neuritis, which is sharp eye pain
- Stiffness or spasms in muscles
- Numbness or tingling in the hands or feet
Managing pain
- Drug treatments, such as ibuprofen or aspirin
- Physical therapy
- Massage and heat
- Meditation, tai chi, or yoga
- Nutrition therapy
- Sleep hygiene
- Aquatic therapy
Pain can be exhausting, affect mood, and make it difficult to do everyday activities.
Other factors that can contribute to pain in people with MS include fatigue, heat sensitivity, depression, infections, and medication side effects
Types of MS
- Relapsing-remitting MS: The most common type, with periods of symptoms followed by recovery
- Secondary progressive MS: Symptoms gradually worsen over time without clear attacks
- Primary progressive MS: Symptoms steadily worsen from the onset without remissions
Treatment for MS
Multiple sclerosis (MS) treatments include disease-modifying drugs, corticosteroids, muscle relaxants, and therapies.
Disease-modifying drugs
- Reduce the number and severity of relapses
- Work by calming inflammation that attacks the central nervous system
- Examples include:
- Beta interferon 1a (Avonex®)
- Beta interferon 1b (Betaferon® and Extavia®)
- Glatiramer acetate (Copaxone®)
Corticosteroids
- Reduce inflammation and relieve symptoms of acute MS flare-ups
- Steroids are only given for a short period to avoid side effects
Muscle relaxants
- Relieves muscle spasms, cramps, or stiffness
- Examples include:
- Baclofen (Lioresal, Gablofen)
- Tizanidine (Zanaflex)
- Cyclobenzaprine (Amrix, Fexmid)
Therapies
- Physical or occupational therapy can help with stretching, strengthening, and using devices to perform daily tasks
- Mobility aids can help with leg weakness and walking
Other treatments
- Medicines to treat pain, vision problems, and other symptoms
- Medicines to reduce fatigue
- Medicines to increase walking speed
- Medicines for depression, sexual dysfunction, insomnia, and bladder or bowel control troubles
Other treatments include plasmapheresis and changes to lifestyle.
Risk factors
MS usually begins in young adults, but it can develop at any age. It’s about two to three times more common in women than men.
Causes
Scientists don’t know exactly what causes MS, but they believe it’s triggered by a combination of factors.
Here are the main suspected causes and risk factors:
1. Autoimmune Response
MS is considered an autoimmune disorder. In MS, the immune system mistakenly attacks the protective sheath (myelin) that covers nerve fibres, causing inflammation and damage. This disrupts communication between the brain and the rest of the body.
2. Genetics
- MS is not directly inherited, but having a family history of MS increases the risk.
- Certain genes, especially those related to the immune system (like the HLA-DRB1 gene), are associated with a higher risk of developing MS.
3. Infections
Some viruses may trigger MS in genetically susceptible individuals:
- Epstein-Barr virus (EBV) — the virus that causes mononucleosis — is strongly linked to increased MS risk.
- Other viruses that have been investigated include human herpesvirus 6 (HHV-6) and cytomegalovirus.
4. Vitamin D Deficiency
- Low levels of vitamin D, which helps regulate the immune system, are associated with an increased risk of MS.
- This may explain why MS is more common in regions farther from the equator, where sunlight exposure (and thus vitamin D production) is lower.
5. Smoking
- Smokers are more likely to develop MS and tend to have a more severe disease course.
- Smoking may contribute to inflammation and autoimmunity.
6. Gender and Hormones
- MS is 2 to 3 times more common in women than in men, suggesting that hormonal factors may play a role.
7. Geography and Ethnicity
- People of Northern European descent are more likely to develop MS.
- The disease is more common in temperate climates—Europe, North America, and parts of Australasia.