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MS symptoms: What are the early signs of MS?

Medically reviewed by Anne Jacobson, MD, MPH
Board-Certified Family Physician
Updated Feb. 21, 2024  •  Published Mar. 6, 2023
Fact Checked
MS symptoms: What are the early signs of MS?

Overview: What does multiple sclerosis (MS) feel like?

Multiple sclerosis is an autoimmune disease that affects nerves in the brain and spinal cord. The immune system attacks the myelin sheath, the protective layer around nerves. This interrupts the nerve signals to and from the brain. Because nerve damage can occur anywhere in the central nervous system, people have widely varying experiences and symptoms from numbness and vision changes to muscle twitching and paralysis. 

In addition, some people will have periods of remission punctuated by relapses; others may experience a chronic, progressive decline. Some people may remain stable for a long time; others may rapidly become disabled. 

MS is a serious, chronic, and debilitating disease. Rapid diagnosis and appropriate treatments can help slow its progress, prevent relapses, and help people live with the condition. 

Key takeaways:

  • MS is a rare health condition that affects around 1 million people in the U.S. and 2.8 million around the world. Find updated MS statistics here.

  • Early signs of MS include numbness and vision problems, though other symptoms may also occur at the onset of the illness.

  • Serious symptoms of MS such as seizures or problems breathing may require immediate medical attention.

  • Although the exact cause of MS is unknown, there are links with genetics and environmental triggers. You may be at risk for developing MS symptoms if you have family members diagnosed with multiple sclerosis.

  • MS usually requires a medical diagnosis.

  • MS requires treatment. There is currently no cure for MS.

  • Treatment of MS may include disease-modifying drugs and symptomatic treatments including drugs, physical therapy, surgery, mechanical aids, and other therapies. Read more about MS treatments here.

  • Untreated MS may result in complications and more rapid disease progression.

  • Use coupons forCopaxone (glatiramer acetate), Gilenya (fingolimod), and Tysabri (natalizumab), and Ocrevus (ocrelizumab) to save up to 80%.

What are the early signs of MS?

The most common early warning signs of multiple sclerosis are numbness or vision changes. Numbness or tingling can affect any part of the body. Other early symptoms may include dizziness, muscle weakness, or a sudden squeezing of the torso, called “MS hug.” 

Once symptoms appear, disease progression can vary widely. For people with relapsing-remitting MS, the most common form, symptoms may worsen with each relapse, resulting in some level of disability within 10 or 15 years. In people who do not have remission periods, MS progresses more quickly. In a small group of people, MS progresses very rapidly.

MS symptoms

The symptoms of multiple sclerosis depend on where nerve damage occurs during flare-ups. Common symptoms of MS include:

  • Numbness or tingling

  • Blurred vision, color vision changes, double vision, or pain with eye movements 

  • Squeezing sensation around the torso (MS hug)

  • Fatigue (80%)

  • Muscle weakness

  • Stiff muscles or muscle spasms, particularly in the legs (80%)

  • Problems walking

  • Loss of balance

  • Tremor

  • Bladder problems (80%)

  • Bowel problems, including constipation and loss of bowel control

  • Pain (55% to 80%)

  • Dizziness and vertigo

  • Trouble with thinking and memory (50%)

  • Mood swings

  • Problems swallowing (40%)

  • Slurred speech or decrease in speaking volume (25% to 40%)

  • Loss of taste (25%)

  • Sudden and inappropriate laughing or crying (10%)

  • Hearing loss (6%)

As the disease progresses, other symptoms such as seizures and trouble breathing can occur.

Symptoms data sources:

MS vs. ALS symptoms

Amyotrophic lateral sclerosis, or ALS, is also a progressive disease of nerve cells, but it is limited to the nerves that move and control muscles. MS, on the other hand, can affect different types of nerve cells. So, there are some shared symptoms between the two conditions, and some that are unique to each condition.

MS ALS
Shared symptoms
  • Muscle weakness
  • Fatigue
  • Difficulty swallowing
  • Muscle tightness or cramps
  • Balance problems
  • Coordination problems
  • Slurred speech or reduced voice volume
  • Constipation
  • Urinary urgency
  • Cognitive problems
  • Mood and emotional changes
  • Uncontrollable or inappropriate laughing or crying
  • Trouble breathing
Unique symptoms
  • Numbness, tingling, and other changes in touch
  • Vision changes
  • Hearing problems
  • Dizziness and vertigo
  • Sexual problems
  • Muscle twitching
  • Muscle shrinkage
  • Trouble closing one or both eyes
  • Drooling
  • Stomach problems and bloating
  • Prolonged inability to move or paralysis (late stages)

Sources:

Types of MS

There are different types of multiple sclerosis: 

  • Relapsing-remitting: 70% to 80% of people with MS have relapsing-remitting MS. After an initial bout of MS symptoms, they experience varying periods of remission followed by symptom flare-ups. 

  • Primary progressive: Approximately 15% to 20% of people with MS experience primary progressive MS. After symptoms first appear, there is gradual worsening without remissions.

  • Secondary progressive: People with relapsing-remitting MS may eventually experience progressive worsening of symptoms with only occasional relapses.

  • Progressive relapsing: About 5% have progressive MS from the start but also experience relapses.

Some additional subtypes of MS include: 

  • Fulminant MS: Severe MS that progresses rapidly.

  • Clinically-isolated syndrome (CIS): A single bout with inflammation, nerve damage, and MS symptoms. People who experience CIS may or may not go on to develop MS.

  • Benign MS: A relapsing-remitting form of MS with long remissions and rare relapses.

Multiple sclerosis type data sources:

When to seek medical attention for symptoms

Multiple sclerosis is usually diagnosed from a symptom history, a neurological exam, and magnetic resonance imaging (MRI). Sometimes additional testing is done, such as testing the spinal fluid, or doing blood tests to rule out other conditions.

See your healthcare provider for symptoms of numbness, tingling, vision changes, weakness, or dizziness that last more than a few days. This is especially important if another member of the family has MS. 

Always get medical attention when experiencing loss of vision or vision changes. Even if the vision changes are not from MS, there may be other serious problems at work such as glaucoma.

Complications of MS

Some complications of MS may include:

  • Sleep problems

  • Sexual function problems

  • Falls and injuries

  • Urinary tract infections 

  • Depression and anxiety

  • Pressure sores due to immobility

How to treat MS symptoms

There are medications to treat the underlying autoimmune disease process that causes MS. These are called disease-modifying therapies.

Individual symptoms can be managed with medications, physical therapy, surgery, mechanical aids, counseling, and other treatments. People with MS may use different MS treatments during periods of remission and relapses.

Examples of these medications include Copaxone (glatiramer acetate), Gilenya (fingolimod), Tysabri (natalizumab), and Ocrevus (ocrelizumab).

Drugs commonly used to treat MS symptoms include:

RELATED: What is Ocrevus?

Living with MS

As with many chronic illnesses, lifestyle changes can help extend remissions and manage symptoms: eating a healthy diet, managing stress, exercising, and reducing or eliminating unhealthy habits such as smoking, overeating, or drinking. Complementary treatments such as acupuncture or yoga can help people manage some symptoms such as fatigue or pain. Good sleep hygiene, activity, and healthy relationships can go a long way in managing the emotional burden of a chronic illness.

Most importantly, get medical help as soon as possible

See a healthcare provider as soon as possible if you experience MS symptoms. Rapid diagnosis can make a difference. MS symptoms are manageable and, for many, relapses can be controlled through disease-modifying therapies. Symptomatic treatment may involve many different types of therapies and drugs that involve a team of healthcare professionals. 

FAQs about MS symptoms

Are MS symptoms different for women and men?

 More women than men are diagnosed with MS, but the symptoms are similar. Women are more likely to experience optic neuritis (swelling of the optic nerve ) during relapses. And in general, men do not recover from relapses as well or as quickly as women, so MS progresses more rapidly in men. 

What are symptoms of MS in seniors?

MS is a progressive condition, so seniors typically experience greater disability because they have lived with the condition for a longer time.

When do MS symptoms start?

Generally, the first MS symptoms appear between the ages of 20 and 40, though onset can happen at any age. Approximately 3% to 5% of people with MS are diagnosed before they reach the age of 18.

How long do MS symptoms last?

MS relapses vary in their symptoms and duration. At the start of an MS relapse, symptoms appear quickly, worsen over the next few days, and then last for a few days to a few weeks. On average, an MS relapse lasts about eight weeks from start to finish. 

What’s next? Additional resources 

Test and diagnostics

Treatments

Scientific studies and clinical trials

Medically reviewed by Anne Jacobson, MD, MPH
Board-Certified Family Physician

Anne Jacobson, MD, MPH, is a board-certified family physician, writer, editor, teacher, and consultant. She is a graduate of University of Wisconsin School of Medicine and Public Health, and trained at West Suburban Family Medicine in Oak Park, Illinois. She later completed a fellowship in community medicine at PCC Community Wellness and a master's in Public Health at the University of Illinois-Chicago. She lives with her family near Chicago.

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