Visible and Physical Symptoms
Sometimes it is easy for others to see that you are having challenges with your relapsing MS. These symptoms can be frightening, especially when you are in the early stages of diagnosis and you don’t understand what is happening to you. Although the symptoms below are not a comprehensive list they are some of the most visible symptoms to the people around you.
Blurred vision, poor contrast or color vision, and pain during eye movement are often the first symptoms of MS for many people. Vision problems in MS often result from optic neuritis (inflammation of the optic nerve), nystagmus (uncontrolled eye movements), or diplopia (double vision). Symptoms of optic neuritis include blurring or graying of vision, blindness in one eye, or a dark spot (called a scotoma) in the center of the visual field. The uncontrolled eye movements of nystagmus may be mild and only happen when looking to the side, or they may be severe and impair vision. Double vision may occur more when your eyes are fatigued or overworked, such as after extended periods of reading or computer work.
Difficulty walking is a very common mobility problem for people with MS that can lead to falls and injuries. Several aspects of the disease can contribute to problems with walking and gait. Muscle weakness can lead to toes dragging (called foot drop), raising the heel on the stronger leg to make it easier to swing the weaker leg through (called vaulting), or compensatory hip hike, trunk lean or swinging of the leg out to the side during walking.1 Other factors that can interfere with walking properly include muscle tightness or spasticity, balance problems leading to swaying gait (called ataxia), severe numbness of the feet, and fatigue.
Spastic muscles are one of the common symptoms of MS. Mild spasticity may feel like muscle tightness, whereas severe spasticity can produce painful, uncontrollable spasms of the legs and arms, most commonly the legs.2 Two common types of spasticity in MS affect the hips and knees. Spasticity of the hamstrings, located on the back of the upper leg, and hip flexor muscles, located at the top front of the upper thigh, can cause hips and knees to be bent and difficult to straighten. Spasticity of the quadriceps and adductor muscles, which are located on the front and inside of the upper leg, can cause the hips and knees to be straight and the legs very close together or crossed at the ankles.3 Spasticity in the leg muscles can contribute to problems with walking and balance.
- Frequent and/or urgent urination
- Hesitancy starting urination
- Frequent nighttime urination
- Inability to hold in urine (called incontinence)
- Inability to empty the bladder completely2
Constipation, loss of bowel control, and diarrhea are common concerns among people with MS that can limit socializing with friends, family, and community. Bowel dysfunction can cause much discomfort and embarrassment, and can worsen other MS symptoms such as spasticity or bladder dysfunction.4