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Multiple sclerosis (MS)

Multiple sclerosis (MS) affects the nerves in your brain and spinal cord (central nervous system), causing problems with muscle control, vision and balance.

About multiple sclerosis

Around 100,000 people in the UK have MS. It usually starts in early adulthood, and it affects about three times as many women as men.

MS is a condition that affects the nerves in your central nervous system. Nerves are made up of thousands of fibres that transmit tiny electrical impulses (messages) between your brain and spinal cord to the rest of your body, for example to your muscles, skin or organs (such as your heart and lungs). Your nerves are protected by a sheath made of a substance called myelin. This makes sure the messages are transmitted correctly from your brain and spinal cord to the rest of your body.

MS is thought to be an autoimmune disease. This means that your body's immune system, which usually just attacks harmful things like bacteria and viruses, attacks and damages your own healthy body tissue causing inflammation.

If you have MS, your immune system damages the myelin sheaths around the nerves in your brain and spinal cord. These become scarred and hardened. This scarring prevents the affected nerves from sending messages properly. The signals can slow down, become altered or not get through at all.

There are several different ways of describing patterns of MS and each progress differently.

  • Relapsing/remitting MS – your symptoms will come and go. This means you have periods of good health (remission) followed by sudden flare ups (relapses). Remission can last for any length of time, while relapses can last for anything between a few days and a few months. For about eight out of 10 people with MS, it begins as a relapsing and remitting condition. About two out of 10 people with relapsing/remitting MS have a benign form. This means your symptoms are milder.
  • Secondary progressive MS – you will gradually have more or worse symptoms and fewer periods of good health. About half of all people who have relapsing/remitting MS go on to develop secondary progressive MS within 10 years.
  • Primary progressive MS – from the beginning, your symptoms will gradually develop and get worse over time. Up to two in 10 people with MS have primary progressive MS.

Symptoms of multiple sclerosis

The symptoms of MS can vary widely from person to person and will depend on the area of your central nervous system that is affected. You may have very few mild symptoms, especially in the early stages. However, you may have symptoms that get worse over time. Some of the most common symptoms include:

  • extreme tiredness (fatigue)
  • muscle weakness, stiffness and spasms
  • eye problems, including pain, blurred or double vision and temporary loss of vision
  • bladder problems, particularly emptying your bladder completely or needing to urinate frequently and urgently, in some cases leading to incontinence
  • bowel problems
  • loss of balance, co-ordination and dizziness
  • pain from nerve damage or related to loss of mobility
  • numbness or tingling on your skin
  • difficulty speaking and swallowing
  • feeling emotional, anxious or depressed
  • sexual difficulties, such as problems with erections or vaginal dryness – see our frequently asked questions for more information

Most people won’t experience all of these symptoms, especially at the same time. These symptoms may be caused by problems other than MS. If you have any of these symptoms, see your GP for advice.

Causes of multiple sclerosis

The exact reasons why you may develop MS aren't fully understood at present. However, several factors are thought to be involved.

  • Having a certain combination of genes may make you more likely to get MS. However, these genes are also found in the general population so having them doesn’t mean you will develop MS. MS isn’t inherited and most people who develop MS have no previous family history of it. However, you will have a slightly higher risk of developing MS if you have a relative with the condition.
  • A lack of vitamin D could play a part in the development of MS in some people. Your body produces vitamin D when your skin is exposed to sunlight. More research needs to be done to say for certain, but where you live in the world may affect your risk. MS is more common in countries further from the equator (such as the UK, USA and Canada), where sun exposure is less.
  • Environmental factors, such as a virus or bacteria, may also trigger MS. However, no single virus has been identified to cause MS and it’s more likely to be a combination of several factors.

Diagnosis of multiple sclerosis

MS can be very difficult to diagnose. There is no single test that can confirm MS and many of the symptoms are also found in other conditions, so these may need to be excluded first.

If your GP thinks you may have MS, he or she will refer you to see a neurologist (a doctor specialising in conditions that affect the nervous system). Your neurologist will ask detailed questions about your symptoms and your general health. He or she may recommend tests, including:

  • a neurological examination to test your nerve reflexes and your ability to move different parts of your body
  • an eye examination to show any vision or eye problems
  • an MRI scan – this uses magnets and radiowaves to produce images of the inside of your body that may show up areas of scarring or inflammation in the myelin
  • evoked potential testing – this measures the time it takes for messages to travel to your brain, usually from your eyes
  • a lumbar puncture (also known as a spinal tap) – a sample of the fluid that surrounds your brain and spinal cord (cerebrospinal fluid) is taken from your lower back

Unfortunately, these tests don't always give a definite result and if your initial symptoms get better, your neurologist may wait and see if you have another relapse. It can be difficult and take time (possibly several months) to get a firm diagnosis.

Treatment of multiple sclerosis

Unfortunately, there is currently no cure for MS. If you're diagnosed with the condition, you will always have it. However, this doesn't mean that you will have symptoms all of the time. The treatment you receive will depend on the type of MS and your symptoms. The aim of treatment is to relieve the symptoms of your MS, manage its progression and improve your mobility.


Therapies and management techniques can be used to help you control your symptoms. Some examples include:

  • exercise to help with fatigue and muscle weakness
  • cognitive behavioural therapy (CBT) for depression
  • pelvic floor exercises to reduce urinary incontinence
  • speech therapy to help with communication
  • physiotherapy to help with musculoskeletal pain

Talk to your GP for more information about different self-help treatments.


If you have symptoms, such as depression, incontinence and pain, there are medicines that may help to manage your symptoms. These medicines don't prevent relapses or slow the progression of your MS, but they may help you to deal with your symptoms and allow you to continue with your day-to-day life.

If you get new symptoms or your symptoms get worse, visit your GP or talk to your specialist MS nurse.

If you have a relapse, you may be given a course of steroids for a few days to improve your symptoms. Steroids reduce your inflammatory response and can speed up your recovery from a relapse.

Disease modifying drugs (DMDs) can reduce the frequency and severity of relapses in people with relapsing/remitting MS. However, they aren't a cure for MS and they don't seem to work for the progressive forms of MS.

Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your GP or pharmacist for advice.

Complementary therapy

Although there isn't enough scientific evidence to show that these are effective, many people with MS use complementary and alternative medicine, such as reflexology, massage and t'ai chi. Speak to your doctor before trying any complementary therapy.

Living with multiple sclerosis

Good practical and emotional support is important. Your neurologist will usually refer you to specialist services that aim to help you carry on living independently and continue your daily activities. As well as your GP and neurologist, other health professionals who can help include:

  • MS specialist nurses
  • physiotherapists
  • occupational therapists
  • speech and language therapists
  • clinical psychologists
  • social workers

You may be entitled to support services at work. Under the Equality Act, your employer can make reasonable adjustments to help you continue with your job.

Infections can trigger a relapse, so you should consider having seasonal flu immunisations to reduce the risk.


Produced by Dylan Merkett, Bupa Health Information Team, June 2012.

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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