Multiple Sclerosis

Multiple sclerosis (MS) is a chronic, often disabling disease of the central nervous system that affects more than 2.8 million people worldwide, according to the Multiple Sclerosis International Federation. [1]

In the United States, nearly 1 million individuals are living with multiple sclerosis symptoms. [2] Meanwhile, in Canada, the number of patients exceeds 90,000, making it one of the countries with the highest incidence rates in the world. An average of 12 Canadians are diagnosed every day among those who seek help for symptoms of multiple sclerosis, highlighting the importance of early recognition and evaluation. [3]

This guide covers the causes, early signs, types, and gender-specific symptoms of MS. You’ll also learn when to seek help and how MS symptoms can evolve over time.

What Is MS (Multiple Sclerosis)?

Multiple sclerosis is an autoimmune condition where the body mistakenly attacks the protective covering of nerves, known as myelin. This damage causes communication issues between the brain and the rest of the body. Over time, MS can cause permanent nerve deterioration or damage.

MS can be unpredictable. Some people experience mild symptoms, while others face major challenges in mobility and coordination. [3]

What is most commonly mistaken for MS?

Several conditions can mimic multiple sclerosis symptoms. These include Lyme disease, lupus, fibromyalgia, vitamin B12 deficiency, and migraines. Misdiagnosis is common because early signs of MS, like fatigue and tingling, are nonspecific. [4]

How Long Do People with MS Live?

Multiple sclerosis is a lifelong condition, but thanks to advances in treatment, most people with MS now have a near-normal life expectancy. Life expectancy varies greatly depending on the severity of symptoms and comorbidities. On average, MS life expectancy is only 6-7 years shorter than average. [5]

Early diagnosis, effective management of multiple sclerosis symptoms, and healthy lifestyle choices all contribute to improved long-term outcomes.

Average age of MS diagnosis

The average age of MS diagnosis is between 20 and 40 years. [6] However, MS can appear earlier or later, with women being two to three times more likely to develop it than men. 

Types of MS

There are four main types of multiple sclerosis, each defined by the pattern and progression of neurological symptoms:

1. Clinically Isolated Syndrome (CIS): A single, first-time episode of neurologic symptoms lasting at least 24 hours. CIS may or may not develop into full-blown MS.
2. Relapsing-Remitting MS (RRMS): Characterized by clearly defined attacks (relapses) of worsening function followed by periods of partial or complete recovery. About 85% of patients are initially diagnosed with RRMS.
3. Secondary Progressive MS (SPMS): Begins as RRMS but transitions into a steadily worsening condition without remission periods.
4. Primary Progressive MS (PPMS): Involves a gradual accumulation of disability from the onset, with no early relapses or remissions. [7]

Understanding your type of MS helps neurologists determine the best course of treatment and predict disease progression.

Signs and Symptoms of MS

Multiple Sclerosis: Early Signs

The early signs of multiple sclerosis are often subtle and episodic. Many patients report experiencing symptoms for months or even years before receiving a diagnosis. These symptoms often appear suddenly and may disappear just as quickly, making them easy to ignore or misattribute.

Typical early signs of multiple sclerosis include:

• Tingling or numbness in the limbs or face
• Sudden vision changes, such as double vision or pain when moving the eyes (optic neuritis)
• Muscle weakness, especially in the legs
• Fatigue that doesn’t improve with rest
• Difficulty with balance, coordination, or walking [8]

These first signs of MS are often mistaken for stress, pinched nerves, or other neurological conditions. If these symptoms persist or recur, it’s important to consult a neurologist.

Common Multiple Sclerosis Symptoms

As MS progresses, symptoms become more varied, persistent, and disabling. These symptoms of MS result from nerve damage and can affect multiple systems in the body. 

Typical multiple sclerosis symptoms include:

• Bladder and bowel dysfunction: urgency, incontinence, or constipation
• Muscle stiffness or spasms, especially in the legs
• Speech and swallowing difficulties, indicating brainstem involvement
• Cognitive challenges, such as forgetfulness and poor concentration
• Heat sensitivity: where symptoms worsen with temperature changes (Uhthoff’s phenomenon) [8] [9]

These MS symptoms may flare up and then go into remission or persist over time.

Gender Differences in Symptoms

While MS affects both genders, symptoms can manifest differently due to hormonal, neurological, and lifestyle factors.

Specific Symptoms of MS in Women

Multiple sclerosis symptoms in women are more common due to hormonal and autoimmune factors. Women may experience:

• Symptom flare-ups during menstruation, pregnancy, or menopause
• Fatigue and mood swings
• Urinary tract infections and bladder control issues
• Hormonal sensitivity that intensifies other MS symptoms [10]

Specific MS Symptoms in Men

Although less common, MS symptoms in men can be more aggressive. Men may face:

• Faster progression of muscle weakness or stiffness
• Erectile dysfunction
• Visual disturbances and poor coordination
• Greater risk of long-term mobility loss

Less Common or Overlooked MS Symptoms

While many MS symptoms are well-documented, others may be less recognized or mistaken for unrelated health issues. These include:

• Slurred speech or difficulty articulating (dysarthria)
• Seizures: Occur in about 2-5% of MS patients
• Hearing loss: Rare but can be a sign of brainstem involvement
• Breathing difficulties: When respiratory muscles are affected [11]
• Tremors: Involuntary shaking due to cerebellar damage [12]

In mild cases, symptoms may appear sporadically, leading individuals to live with undiagnosed MS for years.

Can You Have Mild MS and Not Know It?

Yes. Mild MS symptoms can be so subtle or infrequent that they go unnoticed or are attributed to other causes. Early signs may appear and then disappear, delaying diagnosis for months or even years.

Clinical Signs of MS Doctors Look For

While symptoms are self-reported, signs of MS are observed by neurologists during exams or imaging tests. These include:

• Abnormal reflexes or exaggerated responses
• Optic nerve inflammation seen via ophthalmoscope
• Positive Babinski sign, indicating central nervous system damage
• Lesions in the brain or spinal cord on MRI scans

These signs help differentiate MS from other neurological disorders.

When to Seek Medical Attention

Consult a specialist if you notice persistent or recurring symptoms such as vision problems, unexplained numbness, or muscle weakness. Early diagnosis and treatment can delay progression and improve long-term outcomes. MS is not terminal, but early intervention matters.

What Causes Multiple Sclerosis?

The exact multiple sclerosis cause remains unknown. However, experts believe it involves a combination of genetic predisposition, environmental exposures, and immune system dysfunction. [3]

What Causes Multiple Sclerosis in Women?

Hormones, pregnancy, and autoimmune differences may explain why multiple sclerosis symptoms in women are more common. Estrogen may affect immune responses, increasing susceptibility. [13]

Risk Factors for MS

Although the exact cause of MS remains unclear, several risk factors have been identified:

• Gender: Women are 2–3 times more likely to develop MS than men.
• Age: Most diagnoses occur between 20 and 40 years old. [6]
• Genetics: Having a first-degree relative with MS increases your risk.
• Low Vitamin D: People living farther from the equator have a higher risk.
• Smoking: Significantly increases the likelihood of developing MS. [14]

These multiple sclerosis risk factors help identify populations that may benefit from earlier screening and lifestyle changes.

Complications of MS

Without proper treatment, multiple sclerosis complications can affect multiple systems in the body. Long-term complications include:

• Mobility limitations: Many patients eventually require assistive devices.
• Speech and swallowing issues: Can lead to nutritional and respiratory problems.
• Bladder and bowel dysfunction: May cause infections or social distress.
• Depression and cognitive impairment: Common due to brain inflammation and life adjustments. [15]
• Increased fall risk: Due to balance and vision problems. 

Managing these symptoms of MS requires a comprehensive care plan involving neurology, physical therapy, mental health support, and sometimes occupational therapy.

Living with MS: When to Get Help

Living with MS involves physical, mental, and emotional challenges. If you notice MS flare up symptoms or a decline in mobility, contact your healthcare provider promptly. Early treatment helps manage symptoms and may slow disease progression.

If you suspect the first symptoms of MS or need help managing it, reach out to a specialist. Moore MyoWorx offers expert care tailored to your condition.