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Health 23/12/2025 22:31

Early Signs of Multiple Sclerosis

There’s currently no definitive list of the early signs of multiple sclerosis (MS) and a first sign for one person may not be the first for another. The first symptom of MS may be numbness and tingling for one individual, while for another it’s dizziness, and for yet another it’s crushing fatigue.

But there are certain changes you should be aware of, especially if they’re persistent.

While no one symptom should trigger an immediate concern that you have MS, it’s good to know the signs and symptoms so that if you have them, you can get them checked out by a doctor.

How Can Someone Identify New or Worsening MS Symptoms?

MS can cause a broad variety of symptoms. Neurologist Mill Etienne, MD, MPH, lists some of the common ones that should prompt you to see your doctor.

Common Early Symptoms of Multiple Sclerosis

The following are some common early symptoms of MS.

Vision Loss Eye pain and loss of vision in one or, rarely, both eyes can be among the first signs of MS, says Scott Ireland Otallah, MD, an associate professor of neurology at the Wake Forest University School of Medicine in Winston-Salem, North Carolina. These symptoms are typical of optic neuritis, which is caused by an inflammation of the optic nerve. Other symptoms of optic neuritis include blurred vision and diminished color vision.

In most cases of optic neuritis, vision returns on its own or with steroid treatment.

Dysesthesia (MS Hug) The “MS hug” is a strange squeezing sensation that can feel like a blood pressure cuff around the entire torso. This symptom usually means that MS has caused damage in the cervical spine (neck).

Weakness or Numbness Weakness or numbness in one part of the body can be an early sign of MS. The feeling can be in the trunk, arms, legs, hands, or one side of the face.

 

This isn’t the temporary, pins-and-needles numbness that accompanies resting on an arm or leg in the wrong way, which lasts for seconds or minutes and goes away within a few minutes as blood flow returns to the area. Numbness or tingling associated with MS tends to develop over days or weeks and takes days or weeks to resolve, says Dr. Otallah.

Balance and Walking Difficulties Balance problems and dizziness are common early signs of MS, says Otallah. Trouble walking can be among the first indications of MS.

Fatigue This isn’t ordinary tiredness. Rather, you might feel exhausted after very little activity. Or a night of sleep may leave you feeling no more refreshed than when you went to bed. This is overwhelming tiredness with no readily apparent cause.

How MS Symptoms Typically Develop

While some symptoms of MS are very common, there’s no typical pattern of symptoms that applies to everyone.

The key to determining whether a symptom might be due to MS is how it develops, says Tanuja Chitnis, MD, a 

 professor of neurology at Harvard Medical School and the director of the Mass General Brigham Pediatric MS Center at Mass General Hospital for Children, both in Boston.

MS symptoms develop slowly over the course of several hours or days, Dr. Chitnis says, and can last for several days to a few weeks.

Symptoms that come and go within minutes or persist for only a short time — but not for hours — are much less likely to be caused by MS.

MS symptoms may also worsen in hot temperatures or when a person heats up from exercise or a hot bath, for example. The tendency for MS symptoms to worsen with heat is called Uhthoff phenomenon.

MS attacks, or flares, are also likely to cause lasting neurological deficits, or abnormalities in the function of a body part or area, even after the worst of the symptoms have subsided.

MS Prodrome: Are There Symptoms That Anticipate MS Symptoms?

A prodrome is a premonitory or warning phase of a medical problem yet to come. It’s an early stage of signs or symptoms that happens before the onset of the typical symptoms.

“Prodrome for MS has been discussed and studied more in recent years; 10 or 15 years ago, we didn’t necessarily think of MS as having a prodrome,” says Otallah.

There is now more evidence to suggest that there may be some symptoms that occur in people well before their first demyelinating event or MS diagnosis, he says.

Cognitive impairment is one potential symptom of prodrome that has been identified, says Otallah, referring to a study in which researchers followed 20,000 Norwegian men who were about to enter military service, 900 of whom went on to develop MS. Investigators found that cognitive performance in those men was reduced up to two years before they had any clinical signs of MS.

 
Increased visits to the doctor are another possible indication of prodrome. A few studies have suggested that in the 5 to 10 years or so leading up to an MS diagnosis people use more health services for a variety of reasons compared with others who don’t go on to be diagnosed.

 In a recent study of 2,038 people with MS and 10,182 individuals without MS, researchers found that physician visits — for mental health or ill-defined symptoms — were elevated 14 to 15 years before the onset of MS; neurology and ophthalmology consultations increased 8 to 9 years before onset and visits for musculoskeletal, sensory, and nervous system concerns increased 4 to 8 years before onset. The findings suggest that MS may start much earlier than previously recognized.

Increased hospitalizations and medication use could also be a symptom of prodrome. 

“There does seem to be an increase in depression, anxiety, and migraine prior to MS diagnosis, but all three of those conditions are also very common in the general population, and most of those people never go on to develop MS,” says Otallah. 

These conditions, along with other suspected prodrome symptoms, aren’t being used to identify people who may be at an increased risk of MS yet, he says. “We’re not at a point where we can use these to predict if someone is going to go on to develop MS, but when we look back, we are noticing correlations.”

When to See a Doctor for Possible MS Symptoms

MS symptoms are varied and numerous. In addition to those described above, common symptoms include:

  • Pain 
  • Bowel and urinary problems 
  • Sexual dysfunction
  • Difficulty swallowing 
  • Speech problems 
  • Cognitive (thinking and memory) problems
  • Depression 

“Some of these symptoms are common to many disorders, but if you are experiencing any of these neurologic symptoms that develop over hours or days, you want to get that checked out,” says Otallah.

If you’re experiencing pain or numbness, don’t assume that it’s caused by something else, such as a pinched nerve, especially if there’s no reason for you to have a pinched nerve, says Otallah. “Even if it is a pinched nerve, you should probably get it checked out,” he adds.

Of course, any symptom that interferes with your job performance, daily functioning, or quality of life is worth discussing with your doctor, whether or not you suspect it’s related to MS.

But if it is MS, a diagnosis and speedy treatment are the best ways to get it under control, prevent relapses, and delay or prevent disease progression and future disability.

Challenges of Diagnosing MS Early

“Any part of the central nervous system [the brain, spinal cord, and optic nerve] can have a demyelinating lesion, and so you can have almost any symptom that could potentially be perceived as neurologic; that’s part of what can make diagnosis tricky,” says Otallah.

He also notes that many symptoms of MS are found in other 
medical conditions, some of which are much more common. According to the National Multiple Sclerosis Society, close to 1 million people are currently living with MS in the United States.

 The worldwide estimate of those living with MS is 2.9 million.

One encouraging development in MS care is that the time it takes to get a diagnosis is shrinking, though it can still be challenging, says Otallah.

The Takeaway

  • Early signs of multiple sclerosis (MS) can vary widely, but common symptoms include vision loss, numbness or tingling, and balance problems. While these symptoms do not definitively indicate MS, it is important to consult a healthcare professional for an accurate diagnosis.
  • MS symptoms may develop gradually over hours or days and can be exacerbated by heat, so it’s essential to be vigilant about any persistent neurologic symptoms you may experience. 
  • If you experience these neurological symptoms significantly impacting your daily life or job performance, seek medical evaluation to rule out MS or other conditions. Early detection and prompt treatment can prevent relapses and slow disease progression, offering some reassurance amid the challenges.
  • It’s also worth noticing cognitive changes or years of increasing healthcare visits for ill-defined symptoms, which may suggest a MS prodrome (a warning phase before the onset of typical symptoms). However, more research is needed to determine the reliability of these indicators for predicting MS.

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