In multiple sclerosis, the spectrum of symptoms is so variable from patient to patient that it's no wonder people are searching online for answers. Do you spend a lot of time wondering "Is this normal?" Well, you know what? That's completely normal!

There are lots of things we don't know about multiple sclerosis, but one thing for certain is that it causes damage to the myelin sheath of the nerves that extend throughout the central nervous system. This means that symptoms of the disease can occur anywhere in the body, and everyone's experience of MS is different.

That said, there are a few symptoms that are fairly common, including fatigue, numbness and tingling, blurring of vision, problems with mobility and balance, and muscle weakness and tightness. Most people will only experience a few of these symptoms and not always at the same time. What's more, the course of MS varies – some people find their symptoms get worse over time, while others find they come (relapses) and go (remissions).

Symptoms can be very worrying (and can make day-to-day life pretty tricky), but knowing what to expect can help to lessen your anxiety and allow you to get on with things. At the very least, it can be reassuring to know that whatever weird symptom you're experiencing right now is actually quite normal.

Feeling tired
You're probably pretty familiar with this particular symptom. After all, up to 78% of people living with MS report experiencing tiredness. At times even the simplest physical and mental tasks can be a struggle. There are a number of factors that contribute to low energy, but it's known that MS-related fatigue occurs even after sleeping soundly, gets worse as the day continues, and is often aggravated by heat and humidity. So if this is something you're experiencing, rest assured it's completely normal. Your doctor will be able to rule out non-MS causes and help you develop useful coping strategies. In the meantime, try to make allowances for yourself during periods of low energy, and ask for help from colleagues, friends and family. If you need to take a day off, then so be it.

Weird sensations
Everyone experiences aches and pains from time to time, but strange sensations like tingling and numbness – or "pins and needles" – are a very common symptom of MS. This is because the disease affects the way in which the nerve cells communicate with each other. It can mean tingling in your arm, body, or face, or numbness in a limb, for example – often the first signs of the disease. If you've been diagnosed with MS, rest assured that these symptoms are a normal part of living with the condition.

For some people, these symptoms come and go. If this is the case, it can be a useful barometer of when to give yourself a break. Most numbness and tingling will resolve itself, but if it's causing you a real problem, see your doctor.

Difficulty walking
MS affects the way the brain and muscles communicate, which can lead to muscle weakness or sudden contractions (spasms) and tightness that affect balance and coordination. This can make moving around tricky at times – you may find your movements are slowed, for example, or that you need the help of a cane at times, or even a wheelchair. Your doctor will be able to advise you about possible treatments and refer you for physical therapy. While experiencing mobility issues can feel like a setback, it's important to remember that serious disability is far from inevitable.

Eye problems
Vision problems are one of the most common first symptoms of MS. Inflammation of the optic nerve (optic neuritis) is a common cause, as this affects the way in which visual information is transmitted to the brain. This can lead to vision loss, colour blindness, flashing lights, and pain that worsens when you move the eye. Symptoms usually only affect one eye (complete vision loss is rare), and problems are usually temporary. Resting your eyes as much as you can will help (you might want to reduce the amount of time you spend glued to your laptop or smartphone, for example), but speak to your doctor if your eyes bother you.

Trouble thinking clearly
The symptoms of MS aren't just physical – the disease can affect your thought processes, too. Around half of people living with MS experience cognitive issues, such as trouble concentrating, remembering, and solving problems.

Reading maps and solving crosswords are tough enough at the best of times, but there may be times when the simplest mental tasks might seem overwhelming. Often these symptoms are intermittent and can flare up in response to stress, so stress management is an important part of dealing with them. If you find yourself staring blankly at your computer screen or struggling to concentrate in meetings, it may be time to scale back your commitments and schedule plenty of downtime until your mind is firing on all cylinders again.

Needing the toilet all the time (or struggling to go)
Although no one wants to talk about it, toilet problems are a common symptom of MS. Many people with MS commonly experience bladder issues and, less commonly, bowel issues, such as constipation. Symptoms often accompany mobility issues, as damage to the nerves in the lower body can affect the body's ability to regulate toilet functions. In addition, reduced mobility can lead to sluggish bowel movements and constipation.

You may feel the need to use the toilet all the time, or you may suddenly need to go, have problems emptying your bladder, feel constipated, or experience accidents. Your doctor will be able to refer you to a continence expert who will advise you on ways to manage symptoms, whether through medication, bladder retraining, regulating fluid intake, or addressing your diet and lifestyle.

Aches and pains
More than half of people living with MS experience pain as a symptom of MS. Yes, this is very unpleasant, but there are ways to minimize the impact this particular symptom has on your life. Treatment depends on the cause of the pain, but may include drugs and physiotherapy . As well as the direct causes, other things can make the pain feel worse. These include heat, cold, poor sleep, fatigue, and mobility problems, as well as stress, depression, or anxiety. Tackling these issues will help lessen your perception of the pain and minimize its impact on your life.

There's no denying that the symptoms of MS can be challenging and can seriously affect your quality of life. It's important not to suffer in silence, however. Speak to your doctor about your symptoms and he or she will be able to advise you on management strategies and treatments that might help, and put you in touch with the right people to help you cope with them. Talking to other people with MS about how they manage their symptoms can also be reassuring. There may not be a cure for MS (yet), but there are plenty of ways to treat the irksome symptoms it brings. It just takes a little perseverance – and, OK, maybe a little Googling from time to time.

 

NPR/GILE/0035 E