You can tell MS is progressing through gradual worsening of existing symptoms (like increased weakness, spasticity, cognitive fog, or balance issues) or the emergence of new, persistent symptoms (such as severe fatigue, bowel/bladder issues, or vision problems), indicating steady decline, often confirmed by MRI scans showing new lesions or brain atrophy, even without noticeable relapses. It's a slow, steady change in function, unlike relapsing-remitting MS, and requires medical monitoring.
Common Signs and Symptoms of Secondary Progressive MS
Bowel and bladder issues, such as an urgent need to urinate. Difficulty with walking and coordination. Fatigue. Numbness or tingling.
Most people who start as RRMS will develop SPMS within 10 years of their diagnosis (approx. 50%). It is characterised by a steady progression of clinical neurological damage with/without superimposed relapses, minor remissions, and plateaus.
In primary progressive MS, there is a gradual worsening and accumulation of symptoms over time. Unlike secondary progressive MS (where a progressive phase follows an initial relapsing remitting stage), in primary progressive MS progression happens from the outset, hence 'primary'.
Most symptoms develop abruptly, within hours or days. These attacks or relapses of MS typically reach their peak within a few days at most and then resolve slowly over the next several days or weeks so that a typical relapse will be symptomatic for about eight weeks from onset to recovery.
Symptoms of advanced MS
Tests used to diagnose MS may include: MRI, which can reveal areas of MS on the brain and spinal cord. These areas are called lesions. A contrast dye may be given through an IV to highlight lesions that show the disease is in an active phase.
You may also experience periods of increasing disability with or without new relapses or lesions on MRI.
The most common visual issues experienced by people with MS are optic neuritis, double vision and eye movement problems. Optic neuritis is inflammation that damages the optic nerve, a bundle of nerve fibres that transmits visual information from your eye to your brain.
MS Flare-up Symptoms
Multiple sclerosis flare-up symptoms are the same as the general symptoms of MS: Difficulty or urgency using the bathroom. Cognitive difficulties like trouble concentrating, memory problems, brain fog, and difficulty learning new things. Eye pain.
Personal Independence Payment (PIP)
You can spend it on whatever you need, such as paying for support to remain independent during relapses, or to help with extra costs such as heating, transport or help around the house. Some people with MS assume they can't get PIP because they're 'not disabled enough'.
For those with MS, avoiding too much exercise is a big concern. Too much activity can cause fatigue and worsen symptoms. It's important to listen to your body and know when you've done too much. Pacing activities and taking breaks helps manage energy.
When the condition rapidly progresses, it is known as an acute form of the condition called fulminant multiple sclerosis. This condition is sometimes referred to as Marburg-type MS . This disorder causes destruction of the coating (myelin) that surrounds and protects nerve fibers (axons).
What are the early symptoms of multiple sclerosis?
Invisible symptoms of MS – fatigue, pain, blurred vision, numbness, and brain fog – which often go unnoticed by other people, can also interfere with daily functioning and be just as debilitating.
OCT (optical coherence tomography) is a very useful tool in detecting signs of optic neuritis, a common early symptom in MS patients.
The exact trigger for Multiple Sclerosis (MS) is unknown, but it's believed to be a combination of genetic predisposition and environmental factors, including certain infections (like Epstein-Barr Virus), low Vitamin D levels (linked to less sunlight), smoking, obesity, stress, and potentially genetic susceptibility. These factors can trigger an autoimmune attack where the immune system mistakenly damages myelin in the central nervous system.
Early eye symptoms of MS often involve optic neuritis, causing blurred vision, pain with eye movement, temporary vision loss (often in one eye), reduced color vision (especially reds), blind spots, or flickering lights; other common issues are double vision (diplopia) from uncoordinated eye muscles and involuntary rapid eye movements (nystagmus). These visual disturbances can be sudden, affect one eye more than the other, and may be the first noticeable sign of MS, but they aren't exclusive to it.
There are lots of symptoms that MS can cause, but not everyone will experience all of them.
MS can be a very difficult disease to diagnose. Typically, a person with MS will have lesions visible on MRI, but not always.
Neuromyelitis optica is often misdiagnosed as multiple sclerosis, also known as MS, or is seen as a type of MS . But NMO is a different condition. Neuromyelitis optica can cause blindness, weakness in the legs or arms, and painful spasms.
A neurological examination typically assesses movement, sensation, hearing and speech, vision, coordination, and balance. It may also test mental status, mood, and behavior. The exam is usually done in a provider's office.
Your healthcare provider will review your symptoms and medical history. Tests may include blood work, MRIs of the brain and spinal cord, and spinal fluid analysis. Receiving an official MS diagnosis can take time and may require multiple visits to your provider.
For many, fatigue is considered to be the single most debilitating symptom, surpassing pain and even physical disability. Fatigue also imposes significant socioeconomic consequences, including loss of work hours and in some instances, loss of employment.