Multiple sclerosis is more common than you might think. Worldwide, about 1 in 2500 people will be diagnosed with it in the course of their lifetime – in the Western world, that number is even higher. Still, there’s good news, too: many cases of MS are mild or progress very slowly; and with modern medicine and treatment methods improving all the time, its effects are more manageable today than they’ve ever been.

In our guide, we’ll take a look at what multiple sclerosis actually is, what types there are, how it affects the body, some common risk factors for developing it, and how it may be managed and treated once diagnosed.

Via our free online community, we would also like to invite you to become a part of a friendly, welcoming network of fellow health enthusiasts, scientists, and patients to learn even more about MS and what it’s like to live with it.

What is multiple sclerosis?

Multiple sclerosis is an autoimmune disease that affects the central nervous system, more specifically the brain and nerves along your spine. In people with MS, their immune system starts to attack the fatty tissue that surrounds their nerves, called the myelin sheath, which, in turn, lays those nerves bare and makes them susceptible to damage. This can lead to various issues, depending on which and how severely those nerves are affected. Possible symptoms include vision problems, problems walking, muscle weakness, numbness, trouble speaking, and more.

Types and stages of multiple sclerosis

There are three general types of MS: relapsing-remitting MS, secondary progressive MS, and primary progressive MS. Let’s take a look at each of them in turn.

Relapsing-remitting MS (RRMS)

More than 85% of people diagnosed with multiple sclerosis will originally be diagnosed with relapsing-remitting MS or RRMS. As the name suggests, this form of multiple sclerosis is defined by alternating periods of relapses, when the condition flares up and causes neurological symptoms, and remissions, when no new symptoms occur and any existing symptoms disappear partially or completely. Relapse periods usually last for several days to weeks, while remissions can last from days to even years.

During remission periods, the body may heal some or even all of the damage done to the myelin sheaths and underlying nerves during relapses, often reversing any resulting symptoms partially or completely. Wherever repairs occur, however, scar tissue will be left behind, which gives the condition its name: multiple sclerosis can be roughly translated as ‘having multiple scars’.

RRMS can later develop into secondary progressive MS (see paragraph below), or, if symptoms stay mild for at least 15 years, be diagnosed as benign MS, which will retain a mild course with only mild symptoms and continuing periods of remission and healing.

Primary progressive MS

While about 85% of people are first diagnosed with relapsing-remitting MS, the remaining 15% are diagnosed with Primary progressive multiple sclerosis or PPMS. This form of MS is characterized by a gradual worsening of symptoms, sometimes interrupted by periods during which the condition and all existing symptoms stabilize (don’t worsen), while no new symptoms occur. In contrast to cases of RRMS, however, there are no periods of remission when existing nerve damage could be healed. Therefore, symptoms in people with PPMS typically become permanent and worsen/accumulate over time.

Secondary progressive MS

Unlike relapsing-remitting and primary progressive multiple sclerosis, secondary progressive multiple sclerosis or SPMS is a stage of MS rather than its own type. After many years of living with relapsing-remitting MS, most – but not all – patients progress to SPMS. Just like in PPMS, SPMS is characterized by active periods, during which new nerve damage and symptoms occur, as well as stable periods, during which the condition doesn’t worsen, but there are no remission periods anymore, during which symptoms could partially or completely disappear.

A likely precursor: Clinically isolated syndrome (CIS)

Sometimes, single episodes of myelin sheath damage, resulting in neurological symptoms – called clinically isolated syndrome or CIS –, can occur in people even if they do not (yet) have MS. People who have CIS have a high risk of developing MS, though, and might, under certain conditions, undergo specific treatment to delay its onset.

Dealing with any medical condition on your own is difficult – luckily, you don’t have to. By joining our free, international carecirle.org community, you’ll be able to share your experience, ask fellow patients for advice, comment on their posts and threads, and gain insights into how to find hope and control.

Multiple sclerosis symptoms

The symptoms of MS can vary greatly, depending on which part of the central nervous system is affected and how severe the myelin/nerve damage is. In the following, let’s take a look at typical early signs of MS as well as the most common general symptoms of the condition.

Early signs of MS

• blurry or double vision
• tingling, numbness, or inexplicable pain in parts of your body
• balance issues while walking (stumbling more than usual, etc.)
• fatigue or extreme exhaustion
• forgetfulness, confusion, or concentration issues

Common symptoms of MS

• partial or complete loss of vision, typically in one eye at a time
• partial or complete loss of hearing
• the feeling of being electrocuted while moving your neck, especially while bending it forward (Lhermitte sign)
• dizziness
• being sensitive to high or low temperatures
• mood swings, anxiety, and/or depression
• persistent muscle twitches or tremors (shaking in your hands, feet, or other areas of your body)
• stiffness, muscle spasms, cramps, weakness, or paralysis in your arms, legs, or back/hip area
• balance or coordination issues (hand-eye coordination, feeling ‘clumsy’ while using your hands, stumbling, etc.)
• speech issues, such as slurry speech
• trouble swallowing
• trouble falling asleep or sleeping through the night
• bowel or bladder issues, including constipation and incontinency
• epilepsy
• sexual function issues (erection or ejaculation problems, sudden low libido, sensation issues, etc.)

What causes multiple sclerosis?

So far, the actual cause of multiple sclerosis is unknown. There are, however, several known risk factors. They include:

• family history of MS: While MS isn’t hereditary per se, several genetic factors that have been linked to it are.
• sex: women are up to three times as likely to develop MS than men.
• age: while MS can occur at any age, its onset usually occurs between 20 and 40 years.
• weight: being overweight or obese has proven to be a significant risk factor in developing MS, especially in younger people.
• low vitamin D/sun exposure: low levels of vitamin D, produced, for example, by regular exposure to the sun, are associated with a higher risk of developing MS.
• smoking
• race & location: white people are most likely to develop MS. African, Asian, and Native American people have the lowest risk. Equally, the farther away from the equator you live, the higher your risk.
• other autoimmune diseases: having some other autoimmune conditions, such as pernicious anaemia, inflammatory bowel disease, psoriasis, type 1 diabetes, or thyroid disease, can slightly increase the risk of also developing MD.
• certain existing infections: being infected with certain viruses and bacteria, such as the Epstein-Barr virus (Mono), measles, human herpes virus-6, chlamydia pneumonia, or canine distemper, can also increase your risk for developing MS.

How to diagnose multiple sclerosis?

Despite it being a rather common condition, there is no distinct way to test for MS – rather, once you’ve had at least two separate attacks, your doctor will run several tests to determine if you indeed have MS. The most common tests are:

• neurological exam: your neurologist will put you through a series of common neurological tests, such as asking you to perform certain movements or checking for sensation in different areas of your body.
• MRI scan: An MRI or magnetic resonance imaging scan can show lesions in your brain and spine that point to inflammation and damage caused by multiple sclerosis.
• spinal tap/lumbar puncture: here, a small sample of cerebrospinal fluid will be taken from you and analysed in a lab to see if there are certain anomalies in your antibodies that point to MS.
• evoked potential tests: evoked potential tests aim at stimulating your neural functions and then analyse the electrical signals your nervous system produces to check for issues.
• blood test: certain markers found in your blood may also point to you having MS.

Other than that, it is important to rule out other potential reasons for your symptoms, which can happen in the course of these or by running additional tests.

What to do if you have multiple sclerosis?

Even though there are multiple of ways to medically manage the symptoms of MS, as well as delay its onset and progression, there is currently no cure for multiple sclerosis. Therefore, once you’ve been diagnosed with the condition, you are facing a lifelong challenge in it, which can, however, become less challenging if you try and foster certain habits.

Some things to do that are helpful in managing and controlling your MS attacks and symptoms:

• stick to a healthy, balanced diet
• get regular exercise
• lose weight if you’re overweight or obese
• stop smoking
• reduce your stress
• be social
• make room for plenty of self-care
• schedule regular check-ups with your doctor

To share the burden of having to deal with MS, you can also rely on fellow patients who know exactly what it feels like to live with the condition – and our free, global community at Carecircle.org is the perfect place to do just that. Engage with on other people’s posts about MS, tell us about your own experiences, and find helpful advice, inspiring stories, and a feeling of control by interacting with other Carecircle.org members.

Treatment for MS

Apart from the possible lifestyle changes mentioned in the previous section, which can significantly improve the quality of life of people with MS, there is also a variety of possible medical treatment options that can alleviate its symptoms, reduce the number of attacks patients experience, as well as slow its overall progression.

One of the most common treatments for MS is the short-term application of steroids. These aim at fighting the nerve inflammation and symptoms caused by currently ongoing MS attacks. They do, however, not prevent further flare-ups.

Another way to treat MS attacks while they are happening is plasma exchange or plasmapheresis. Here, your plasma – a part of your blood that may contain certain proteins responsible for the attacks – is separated from the rest of your blood and replaced with new plasma. The condition is painless and used primarily in people who do not respond well to steroid therapy or cannot undergo it due to other health concerns. Just like steroids, plasma exchange does not prevent future MS attacks.

In an attempt to reduce the number of MS attacks you experience and their severity, as well as to slow down multiple sclerosis progression, you may also undergo disease-modifying therapies or DMTs. This form of MS therapy is especially useful in the early stages of MS, before any permanent damage occurs, but can also be applied later to prevent further nerve damage.

Apart from these direct MS treatments, your doctor may prescribe a number of treatments to alleviate specific symptoms resulting from the neurological damage in your brain and spine, such as medication to help with potential bowel issues, antidepressants, etc.

Multiple sclerosis FAQs

Looking for quick answers to your most burning MS questions? Here they are:

Is MS hereditary?

No, but certain genetic factors that may increase your risk of developing MS are. Therefore, a family history of MS indeed does make it more likely for you to develop MS.

What does MS mean?

MS stands for multiple sclerosis, which can be translated as ‘having multiple scars’. The condition is an autoimmune disease which makes your body attack the fatty tissue surrounding the nerves of your brain and spine, laying those nerves bare and making them susceptible to damage. Between attacks, your body may be able to partially or completely heal the affected areas, resulting, however, in scar tissue – hence its name.

What are usually the first signs of MS?

Some of the early signs of MS include blurry or double vision; tingling, numbness, or inexplicable pain in parts of your body; balance issues while walking (stumbling more than usual, etc.); fatigue or extreme exhaustion; and forgetfulness, confusion, or concentration issues.

How common is multiple sclerosis?

Worldwide, about 1 in 2500 people develop MS in the course of their lifetime, most commonly between the age of 20 and 40. White people and people living far from the equator, especially Northern Europeans, have a higher probability of developing MS than Africans, Asians, and Native Americans, as well as people living closer to the equator.

If you would like to become a valued part of a friendly, understanding community for health, where you can post, comment, or react to other people facing the same health challenges as yourself and where your voice truly matters, feel free to join us at Carecircle.org. Signing up is simple, and it’s 100% free.

Multiple sclerosis resources

• National MS Society
• MS Society
• MS Trust
• MS Society Canada
• MS Australia
• Multiple Sclerosis News Today
• NHS UK – Multiple Sclerosis

Living with multiple sclerosis can be challenging, but thanks to modern treatment methods and an ever-increasing understanding of what contributes to MS attacks, the general prospect isn’t as scary as it may seem at first glance. We hope our guide could provide you with all the info you were looking for, and wish you all the best – whether you’re still unsure if you have MS, or are already dealing with your or a loved one’s MS diagnosis.

Finally, we would like to leave you with some additional hope and support by means of our welcoming Carecircle.org community. Our free, global network pro health and healing invites you to engage with fellow patients, experienced scientists, and other health enthusiasts, to find support, hope, and control. Join us now!

Guide Sources

• National Multiple Sclerosis Society
• MS Society
• Multiple Sclerosis Trust
• MS Society of Canada
• MS.org.au
• National Health Service UK
• Multiple Sclerosis News Today
• John Hopkins Medicine