Common MS Symptoms and Their Causes

Multiple sclerosis (MS) is a chronic condition that affects the central nervous system, causing a variety of symptoms that can disrupt daily life. For those newly diagnosed or seeking to understand MS, knowing the common symptoms and their causes is essential for effective management. In this article, we’ll explain the underlying mechanisms of MS and dive into its most common symptoms, offering insights into what they feel like and why they occur. Whether you’re living with MS or supporting someone who is, this guide will help you navigate the condition with confidence.

Understanding the Pathophysiology of MS

MS is an autoimmune disease, meaning the immune system mistakenly attacks the body’s own tissues. In MS, the target is the myelin sheath, a fatty layer that insulates nerve fibers in the brain and spinal cord. This process, known as demyelination, damages the myelin, slowing or distorting the electrical signals that travel along nerves. Imagine myelin as the insulation on a wire—when it’s frayed, the signal weakens or fails, leading to the symptoms of MS.

This autoimmune attack also triggers inflammation, which can further damage nerves and form scar tissue (sclerosis) in multiple areas of the nervous system—hence the name “multiple sclerosis.” The symptoms vary depending on which nerves are affected, making MS highly individualised. Below, we explore the most common symptoms and their causes, with practical insights to help you understand and manage them.

Common Symptoms of MS

The following symptoms are among the most frequently experienced in MS, each linked to the damage caused by demyelination and inflammation. We’ve included detailed explanations of what each symptom feels like and why it happens, and each corresponds to a dedicated module in our MS PhysiKit for personalised management strategies.

Fatigue

What This Looks Like

Fatigue in MS is not just feeling tired after a long day—it’s an overwhelming, bone-deep exhaustion that can strike even after minimal activity. You might feel like your energy is drained, making simple tasks like getting dressed or cooking feel monumental. This fatigue often worsens in the afternoon or with heat exposure (a phenomenon called Uhthoff’s sign) and may not improve with rest.

Why It Happens

MS-related fatigue stems from the extra effort the body expends to send nerve signals through damaged pathways. Demyelination forces the nervous system to work harder, draining energy reserves. Inflammation and immune system overactivity also contribute, as does disrupted sleep from other MS symptoms like spasticity or bladder issues. The brain’s compensatory efforts to reroute signals around damaged areas further amplify this exhaustion.

Weakness

What This Looks Like

Muscle weakness in MS might feel like heaviness in your arms or legs, making it hard to lift objects, climb stairs, or even hold a pen. It can affect one side of the body, a single limb, or specific muscle groups. You may notice your grip weakening or your legs giving out unexpectedly, impacting daily activities.

Why It Happens

Weakness occurs when demyelination disrupts the motor pathways that carry signals from the brain to the muscles. Without clear signals, muscles can’t contract effectively, leading to reduced strength. Over time, disuse due to fatigue or mobility challenges can worsen weakness, as muscles lose conditioning. Inflammation in the nervous system may also temporarily exacerbate this symptom during MS flares.

Stiffness/Spasticity

What This Looks Like

Spasticity feels like muscle tightness or involuntary spasms, often in the legs or arms. You might experience a stiff, jerky movement when walking or find your muscles locking up, making it hard to bend a joint. Spasms can be painful and may occur unexpectedly, disrupting sleep or movement. For some, it’s a constant sensation of resistance in the muscles.

Why It Happens

Spasticity results from damage to the nerve pathways that regulate muscle tone. Normally, the brain sends signals to balance muscle contraction and relaxation. In MS, demyelination disrupts this balance, causing muscles to stay overly contracted. The spinal cord, often affected in MS, plays a key role in this dysregulation, leading to stiffness and spasms that worsen with fatigue or stress.

Altered Sensation

What This Looks Like

Altered sensation in MS can manifest as numbness, tingling, or a “pins and needles” feeling, often in the hands, feet, or limbs. Some describe it as a burning sensation or like wearing an invisible glove. These sensations may come and go or persist, and they can affect any part of the body, sometimes making it hard to feel textures or temperature.

Why It Happens

These sensory changes occur when demyelination affects the sensory nerve pathways that carry touch, pain, or temperature signals to the brain. Damaged nerves may misfire, creating tingling or burning sensations, or fail to transmit signals, causing numbness. The location and severity depend on which sensory pathways are impacted, with inflammation often intensifying symptoms during relapses.

Dizziness

What This Looks Like

Dizziness in MS can feel like a spinning sensation (vertigo), lightheadedness, or unsteadiness, as if the room is tilting. You might feel off-balance when standing or walking, or experience brief episodes of disorientation. It can be disorienting enough to cause nausea or make you hesitant to move.

Why It Happens

Dizziness often stems from damage to the brainstem or cerebellum, which coordinate balance and spatial awareness. Demyelination in these areas disrupts the brain’s ability to process signals from the inner ear, eyes, and sensory nerves, leading to vertigo or unsteadiness. Fatigue, heat, or sensory overload can worsen this symptom, as can disruptions in the vestibular system.

Coordination Difficulties

What This Looks Like

Coordination difficulties might make fine motor tasks—like writing, buttoning a shirt, or using utensils—feel clumsy or imprecise. You may notice tremors when reaching for objects or struggle to control movements smoothly. These challenges can affect daily tasks, from typing to eating, and vary in severity.

Why It Happens

Coordination issues arise when demyelination affects the cerebellum, the brain region responsible for synchronizing movements. Damage here disrupts the precise timing needed for smooth, controlled actions. Sensory nerve damage can also impair feedback about limb position, making movements less accurate. Fatigue or spasticity may further complicate coordination.

Balance Challenges

What This Looks Like

Balance issues in MS can make you feel unsteady, as if you’re swaying or about to fall, especially when standing or walking. You might need to hold onto walls or furniture for support or feel hesitant on uneven surfaces. These challenges increase the risk of falls, impacting confidence and mobility.

Why It Happens

Balance problems result from damage to multiple systems: the cerebellum (for movement coordination), sensory nerves (for position feedback), and vestibular pathways (for spatial orientation). Demyelination in these areas disrupts the brain’s ability to integrate signals from the body and environment, leading to instability. Weakness or spasticity can further compromise balance.

Postural Changes

What This Looks Like

Postural changes might appear as slouching, leaning to one side, or difficulty sitting or standing upright. You may feel like your core is weak, making it hard to maintain good posture. Over time, these changes can lead to discomfort or pain in the back, neck, or hips, especially during prolonged sitting or standing.

Why It Happens

Postural issues stem from weakness in the core and back muscles, often due to disrupted motor signals from demyelination. Spasticity can also pull muscles unevenly, altering alignment. The brain’s impaired ability to regulate posture, combined with fatigue, contributes to slumping or compensatory postures that strain the body over time.

Walking Challenges

What This Looks Like

Walking difficulties in MS might include limping, dragging a foot, or feeling unsteady with each step. You may tire quickly when walking or struggle to lift your feet, leading to a shuffling gait. Some experience a “foot drop,” where the toes catch on the ground, increasing the risk of tripping.

Why It Happens

Walking challenges are caused by a combination of MS symptoms: weakness (reducing muscle strength), spasticity (causing stiffness), balance issues (impairing stability), and coordination difficulties (disrupting smooth movements). Demyelination in motor and sensory pathways disrupts the complex signaling needed for walking, while fatigue can exacerbate these issues during activity.

Take Control with the MS PhysiKit

Living with MS presents unique challenges, but you have the power to manage your symptoms and improve your quality of life. Our MS PhysiKit is designed to support you every step of the way, with dedicated Toolkit modules for each symptom discussed above.

Each Toolkit includes:

• Detailed explanations of the causes behind fatigue, weakness, spasticity, and more.

• Practical tracking tools to monitor symptoms, identify triggers, and measure progress.

• Evidence-based strategies you can apply at home, from exercises to lifestyle adjustments, to enhance comfort and mobility.

Whether you’re tackling balance challenges, managing fatigue, or addressing walking difficulties, the MS PhysiKit provides science-backed solutions tailored to your needs.

🔗 Take the first step toward better symptom management by visiting MS PhysiKit today and exploring these comprehensive resources.

_Reference

_{Dobson, R., & Giovannoni, G. (2019). Multiple sclerosis–a review. European journal of neurology, 26(1), 27-40.}