Multiple sclerosis (MS) is caused by immune cells damaging the protective layers of nerve fibers in the brain and spinal cord. Without protective coatings, nerve fibers can no longer transfer signals properly between the brain and other parts of the body, just like electrical wires with frayed insulations. Depending on where and how severe the nerve damages are, MS patients show a wide range of symptoms ranging from mild to severe. While a small percentage of MS patients with mild disease can manage their symptoms without treatment, most MS cases worsen over time and require prescription medications such as Ocrevus, Vumerity, Kesimpta, Aubagio, Mayzent, and Zeposiato to help reduce the severity of attacks of relapsing-remitting MS and delay disability.

Here are the most common early warning signs of MS:

1. Weakness or fatigue

Weakness is common due to muscles not getting enough stimulus from the brain. Exercising the directly affected muscle does not help and may exacerbate the problem. However, strengthening surrounding muscles and using supportive devices can help. MS also causes a general feeling of weakness and fatigue that persists even after a good night of sleep. These fatigues are more serious than the normal “tired” feelings and often affect daily activities.

2. Balance problems or dizziness

When MS causes damage to nerve cells that belong to the network maintaining spatial sensations, patients can experience balance problems. It is common for patients to feel lightheaded and dizzy. Many patients also feel spinning sensations even when sitting or standing still, a symptom called vertigo.

3. Bladder issues

Around 50-80% of MS patients suffer from bladder issues. Because the communications between the bladder and the brain are compromised due to nerve damages, patients may experience difficulties both retaining urine and emptying bladders. Patients may need to use bathrooms many times a night, thus not having enough sleep. Urine leakage and accidents are also common problems for MS patients. Sometimes patients can feel the urgency to urinate but find it is hard to start releasing urine once they reach the toilets.

4. Cognitive problems

More than 50% of MS patients suffer from reduced cognitive functions. Some show problems at an early stage of their disease. Patients may show one or more of these symptoms: loss of memory, reduced attention span, difficulties making plans, and forgetting common words during a conversation.

5. Vision problems

For many patients, vision problems are what they notice first. Patients may feel pain when moving one side of the eye. Later the problem can progress to the other side. Blurred vision, double vision, and reduced color vision or grey vision are also common. As the disease progresses, a patient may lose their vision of one or both eyes.

6. Tingling and numbness

Feeling numbness and tingling on the face, body, or one side of the limbs is another common early sign of MS. The numbness can come with pinning sensations. Although this symptom is usually not disabling, the numbness can be so severe that patients start to have trouble using part of their bodies. They may bite into themselves when chewing, choke when eating, or not be able to hold onto items tightly.

7. Pains and spasms

Nerve cells damaged by MS cause neuropathic pains that give sharp sensations like stabbing, prickling, or burning. When bending the neck, a painful sensation like an electric shock goes down from the neck to either legs or arms is very common for MS patients. The pain can be caused by spasms of the legs and arms, which may happen multiple times throughout the day. These pains can be both acute or chronic and will usually get worse as the disease progresses.