Multiple Sclerosis (MS): Symptoms, Causes, Diagnosis, Treatment, and Prevention
Neurological DisordersMultiple Sclerosis

What Is Multiple Sclerosis?

What Is Multiple Sclerosis?
Everyday Health
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Updated on March 24, 2026
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Multiple sclerosis, or MS, is a disease of the central nervous system that causes symptoms throughout the body. The progressive condition causes scar tissue, called lesions, along the nerve fibers in the brain, spinal cord, and optic nerve.

Over time, damage to the myelin sheath (covering of nerve fibers) leads to lesions and disruption of the electrical impulses between the brain and the body. While some experts believe MS is an autoimmune condition, others believe that underlying causes lead to its development. More research is needed to determine its underlying cause.

MS can’t be cured, but treatment and prevention of relapses can help reduce symptom severity. Regular MRI scans can help doctors assess disease progression and determine proper medications and lifestyle changes.

Types of Multiple Sclerosis

Scientists have long described different types of MS, the most common being relapsing-remitting MS, primary-progressive MS, and secondary-progressive MS.

But in recent years, there’s a growing consensus that these are not distinct types of MS — rather, they are points along a continuum. While the underlying changes in the brain are the same, observable symptoms are different depending on disease severity.

In all types of MS, the loss of neurons (nerve cells) and axons (the nerve fiber, or part of the nerve cell that conducts electrical impulses away from the cell) leads to progressive neurological decline, experienced as worsening symptoms by the person with MS.

Nonetheless, most people with MS are still diagnosed with a particular type of the disease based on their progression of symptoms.

Relapsing-Remitting MS (RRMS)

Relapsing-remitting MS is characterized by periods of active inflammation in the central nervous system, during which symptoms worsen (and new symptoms may develop), alternating with periods when symptoms are less acute.

Times when symptoms worsen are relapses — also known as flares or exacerbations. As a relapse ends, the severity of symptoms diminishes, but a person can be left with new, permanent symptoms. The quiet period between relapses is called remission, which can last for months or years before another relapse occurs.

RRMS is the most common type of MS, affecting about 85 percent of people diagnosed with the condition. Most people with RRMS eventually develop secondary-progressive MS.

Secondary-Progressive MS (SPMS)

Secondary-progressive MS is generally considered a second phase of RRMS, in which there is symptom progression and increased disability. People with SPMS may continue to have relapses, although they may be less frequent than in RRMS.

About 50 to 65 percent of people diagnosed with RRMS will eventually transition to SPMS, but everyone’s experience with it — whether or not they have relapses and how much progression, or disease worsening, occurs — will be unique.

Relapsing MS (RMS)

The term “relapsing MS” typically encompasses clinically isolated syndrome (CIS), which is a first episode of neurological symptoms caused by inflammation or damage to the myelin in the central nervous system; relapsing-remitting MS; and “active” secondary-progressive MS, in which relapses occur along with steady symptom progression.

A number of disease-modifying therapies have been approved to treat any of these conditions. But before prescribing such a drug to a person with CIS, a doctor would evaluate whether that person is at high or low risk of developing MS, or possibly already has MS but earlier symptoms went unrecognized or undiagnosed.

Primary-Progressive MS (PPMS)

In PPMS, there is no initial relapse that signals the beginning of the disease. Instead, MS symptoms appear over time. Those who have PPMS generally do not experience acute exacerbations or have distinct remissions, but they may have temporary plateaus during which symptoms lessen somewhat. About 15 percent of people with MS are diagnosed with PPMS.

Progressive-Relapsing MS (PRMS)

The term “progressive-relapsing MS” was once used to describe cases of MS in which a person experienced steadily worsening neurological function from the beginning, with occasional relapses.

 Today, people whose MS takes that course are said to have “active PPMS.” In addition to relapses, they may also have MRI scans showing new lesions.

Benign MS

A small percentage of people with MS have a benign form of the disease, in which symptoms progress very little over the course of a person's lifetime, after the initial attack. There’s some controversy over how (or whether) to classify people with benign MS, since the progress of the disease can vary over a person’s lifetime.

Malignant MS

A small number of people with MS have malignant MS, which is marked by the rapid formation of lesions in the brain and spine, causing severe symptoms, disability, and possibly death.

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How Can Someone Identify New or Worsening MS Symptoms?

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Signs and Symptoms of Multiple Sclerosis

The nerve damage that occurs in MS can lead to a broad range of symptoms, depending on which part of the central nervous system is affected. MS can affect several areas of the brain, as well as the optic nerve — the nerve that transmits signals from the eye to the brain — and the spinal cord.

No two people with MS have the same pattern of symptoms. And symptoms can change or fluctuate in severity over time.

Common Symptoms

Some common early symptoms of MS include visual problems, difficulties with balance and walking, numbness and tingling, and heat intolerance.

Other common symptoms include:

Uncommon Symptoms

Less-common symptoms of multiple sclerosis include:

These symptoms can happen during a relapse, or flare, which occurs because of inflammation of previously existing lesions, new areas of inflammation in the central nervous system, or both.

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How Much Do You Know About MS Symptoms?

Multiple sclerosis (MS) affects each person differently, and the list of symptoms it can cause is long. Take this assessment to see how much you know about the symptoms of MS.

Causes and Risk Factors of Multiple Sclerosis

The cause of MS is unknown — no one knows what sets off the disease process that leads to MS lesions in the first place. But it is thought that some combination of genetic susceptibility and environmental causes is necessary to trigger the disease.

  • Epstein-Barr Virus Some research points to the Epstein-Barr virus as a likely environmental trigger. A recent study of more than 10 million young adults on active duty in the U.S. military found that the risk of MS increased 32-fold after infection with the Epstein-Barr virus, but was unchanged after infection with other viruses.

  • Infectious Mononucleosis Earlier research found that having infectious mononucleosis (“mono”), which is most commonly caused by the Epstein-Barr virus, doubled the risk of MS when the infection occurred during childhood and tripled it when the infection occurred during adolescence.

  • Low Vitamin D Some other research points to low vitamin D levels as a contributing cause of MS.

  • Cigarette smoking This is also known to raise the risk of developing MS.

  • Childhood obesity This also appears to raise the risk.

Approximately 20 percent of people with MS have a family member who has it. But even having an identical twin with MS increases the risk by only 20 to 25 percent.

So even though having a family history of MS raises the risk somewhat, MS is not considered a genetic or hereditary disease.

How Is Multiple Sclerosis Diagnosed?

MS is generally diagnosed based on a person’s history of symptoms, along with the results of a variety of medical tests, which may include:

  • A neurological evaluation of physical movement and coordination, vision, balance, and mental functioning
  • Blood tests to rule out other conditions
  • Magnetic resonance imaging (MRI) scans to detect brain lesions typical of MS
  • Lumbar puncture (spinal tap) to obtain cerebrospinal fluid, which may contain substances more likely to be found in people with MS
Diagnosing MS can be challenging for doctors. No single test can confirm it, and its symptoms often mimic those of other health conditions. Also, MS severity, plus the nature of symptom flare-ups, can make it difficult to diagnose properly.

Still, diagnosing MS early is critical so that treatment can begin early. Newly revised sets of guidelines, known as the McDonald diagnostic criteria, can help spell out what’s needed to accurately diagnose MS.

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Which MS symptom has the biggest impact on your daily life?

Treatment and Medication Options for Multiple Sclerosis

In many cases, MS symptoms can be treated. Sometimes, treatment involves taking medication. Other times, it involves getting a form of rehabilitation, such as physical therapy, occupational therapy, speech therapy, or cognitive therapy. People with MS who are depressed can often be helped by the same types of antidepressants, psychotherapy, and lifestyle changes that are beneficial for depressed people who don’t have MS.

Even when treatment can’t relieve an MS symptom entirely, it can often reduce its severity.

Disease-Modifying Therapy Options

Disease-modifying medication can reduce the number and severity of relapses in those who have them. It can also slow disease progression. However, these drugs don’t treat MS symptoms, nor are they effective at shortening an MS relapse that’s in progress.

A long list of disease-modifying drugs is approved for people with relapsing-remitting MS to lower the frequency and severity of acute attacks and slow disease progression.

Only one medication, ocrelizumab (Ocrevus), has been shown to reduce the likelihood of disability progression in people with primary-progressive MS.

 In September 2024, the FDA approved a subcutaneous version of ocrelizumab called Ocrevus Zunovo. The twice-a-year, under-the-skin dosing regimen gives people living with MS another treatment delivery option.

And for people with “active” secondary-progressive MS, meaning they still experience relapses, and new lesions continue to be seen on their MRIs, a growing number of drug treatments have become available since 2019.

Other Treatments for MS Symptoms

There are a variety of other treatment options to relive MS symptoms, and they can be used in addition to disease-modifying drugs:

  • Analgesics, such as NSAIDs (like ibuprofen) or acetaminophen (Tylenol), for pain
  • Antispasmodics, such as baclofen (Fleqsuvy), to ease muscle spasms
  • Muscle relaxants, such as dalfampridine (Ampyra) and tizanidine (Zanaflex), to improve walking ability
  • Physical therapy to deal with fatigue, weakness, pain, and spasticity. A physical therapist can prescribe exercises, stretches, and other ways of doing tasks to preserve energy.
  • Occupational therapy to find easier or alternative ways to achieve daily tasks, including use of assistive devices and energy conservation techniques
  • Speech-language therapy to address trouble with speaking or swallowing
  • Cognitive rehabilitation for help with memory and thinking-related tasks
  • Psychotherapy for help with depression, anxiety, grief, or distress related to living with chronic conditions
  • Lifestyle changes like meditation and exercise to improve function and quality of life
Treating an MS relapse may also involve taking a short course of high-dose steroids, such as methylprednisolone (Solu-Medrol), delivered intravenously in an outpatient clinic or infusion center. Steroids speed recovery but cannot repair any new damage to the nervous system caused by the inflammation.

Disease-modifying drugs can reduce the number of relapses an individual has — and therefore the amount of residual disability.

Disparities and Inequities in Multiple Sclerosis

It’s unknown exactly how common MS is among minority groups, such as Black Americans and Hispanics. That's partly because researchers have only just begun to investigate this question. It's also partly because the complex causes of MS mean that the incidence of the disease can vary from one study population to another.

Medical researchers have found that people of African ancestry develop MS at about half the rate as those of Northern European ancestry in the U.S. Still, Black Americans tend to develop more-aggressive forms of MS than white Americans, with a larger percentage having spinal lesions, indicating more-aggressive disease.

Although evidence is limited, studies have generally suggested that the MS treatments that work for white Americans work for Black Americans with MS, too. According to the National MS Society, Black Americans and people who belong to other ethnic minority groups should check out several MS research initiatives in the U.S. for help with treatment and diagnosis.

Anyone, of any race or ethnicity, with symptoms that suggest MS should seek medical care for diagnosis and appropriate treatment.

Lifestyle Changes and Prevention of Multiple Sclerosis

As of yet, there’s no surefire way to prevent multiple sclerosis, in large part because the cause of the disease is not yet fully understood. But some healthy habits can reduce an individual’s risk of MS.

Get Enough Vitamin D

Getting adequate vitamin D — from sunlight, food, and supplements — is one way to potentially lower your risk of MS. Research has shown that growing up in a sunny area and having a high amount of sun exposure in summertime is linked with a lower risk of developing MS in childhood.

Older research has found that people diagnosed with clinically isolated syndrome (CIS) who went on to develop MS had lower vitamin D levels than those who didn’t develop MS.

Increasing vitamin D levels does not guarantee MS prevention, but there’s no harm in doing so, as long as you stay within the safe limits of both sun exposure and vitamin D supplementation.

Quit Smoking

Not smoking is another strategy that may lower MS risk. Smokers and people exposed to secondhand smoke are known to have an increased risk of MS. Quitting smoking may therefore lower your risk and that of people around you.

Maintain a Healthy Weight

Staying at a healthy weight, in both adulthood and childhood, may lower a person’s MS risk. Studies show that childhood obesity is linked with an increased risk of pediatric MS. It’s also linked with a higher risk of developing MS as an adult.

How Long Does Multiple Sclerosis Last?

MS is incurable, meaning it lasts a lifetime. It's rarely fatal, although studies have shown that it shortens a person’s life expectancy by about six or seven years.

MS relapses tend to last for hours or days, and they can last for days or weeks. They tend to occur at least 30 days after your most recent relapse and last for at least 24 hours. Shorter periods of symptom worsening, called pseudoexacerbations, can be triggered by heat, stress, and fatigue, among other things. Once the underlying cause of a pseudoexacerbation is reduced or eliminated, the MS symptoms should subside, too.

Prognosis of MS

Although MS can sometimes be a debilitating disease, it’s rarely fatal, and the majority of people who have it don't become severely disabled. Many people with MS maintain their mobility, largely with the help of disease-modifying drugs, plus the use of assistive devices, such as canes or crutches; some also use scooters or motorized wheelchairs to cover long distances.

People with MS who have the best prognosis are usually those who:

  • Are female
  • Were younger than 40 when diagnosed
  • Have infrequent attacks
  • Make a complete recovery from relapses
  • Have long intervals between relapses
  • Have symptoms that are mostly sensory in nature
A 2020 study that examined causes of death among people with MS found that when MS was listed on a death certificate as an underlying cause of death, the most common contributing causes were:

Of course, people with MS also die from the same systemic illnesses that kill people in the general population, such as heart disease and cancer, underscoring the importance of maintaining the type of healthy lifestyle habits that can lower the risk of these diseases.

Complications of Multiple Sclerosis

Beyond the general side effects of MS, some additional complications can occur with the condition, including:

Urinary Tract Infections

Bladder concerns are very common with MS, affecting at least 80 percent of people with the condition. Some people have trouble holding their urine (incontinence), while others can’t fully empty their bladder (retention).

Not emptying the bladder fully can increase the risk of developing urinary tract infections (UTIs). These can worsen MS symptoms and cause pain when urinating. A person with a UTI also may need to urinate more often or release only small amounts of urine at a time.

Without quick treatment, a urinary tract infection can lead to a kidney infection, which is a medical emergency.

Pneumonia

Sometimes, people with MS have trouble swallowing, known as dysphagia. When the timing of a swallow is off, or the muscles involved in swallowing are weak, foods and liquids may enter the airway instead of the esophagus, where they belong.

If the person cannot cough forcefully enough to expel them, food and liquid can end up in the lungs. This can lead to aspiration pneumonia, a serious condition that can require hospitalization.

Symptoms of aspiration pneumonia may include chest pain, fever, shortness of breath, and coughing up foul-smelling phlegm. You should seek medical help if you experience these symptoms.

Physical Trauma From Falling

Many MS symptoms — including trouble with balance, muscle weakness, fatigue, dizziness, blurred vision, and numbness — raise the risk of falling. Falls can lead to serious injuries, such as broken bones or head trauma. They can also causes a fear of falling, which can make someone less active.

While not all falls can be prevented, many can, through a range of strategies to build leg strength, improve balance, fall-proof your home, and address potential causes of dizziness.

Pressure Sores

People with MS who spend most of their time sitting or lying down need to be aware of — and take steps to prevent — pressure sores. Also known as bedsores or pressure ulcers, pressure sores are areas of damaged skin caused by extended pressure to one area.

They tend to develop in areas where the bones are close to the skin, such as the heels, tailbone, shoulder blades, and elbows. A combination of moving more often, using special cushions or mattresses, and checking your skin every day can help prevent pressure sores or catch them early.

Depression

Depression is common among people who have MS, and not just because it’s stressful to have an unpredictable progressive disease. Depression in MS may be a direct result of the immune system's attack on the protective myelin sheaths that envelop nerve fibers, causing behavioral changes, including depression.

Additionally, some medicines used to treat MS, such as interferon beta, can also cause depression.

 Sometimes, depression develops as a result of the stresses and challenges associated with having MS.

The good news: No matter the underlying cause, depression in people with MS can be treated with psychotherapy, medication, or a combination of the two.

Conditions Related to Multiple Sclerosis

Some medical conditions occur at a greater frequency in people with MS, although in many cases, the link between diseases is unclear. These conditions include:

  • Headache and migraine
  • Fibromyalgia A condition that causes widespread pain and weakness
  • Epilepsy Seizures can occur with both epilepsy and MS, occurring in about 2 to 5 percent of MS patients

The Takeaway

  • Multiple sclerosis, MS, is a progressive condition that affects the nerve fibers of the brain, spinal cord, and optic nerve.
  • Deterioration of the myelin sheath (the protective covering of nerve fibers) and nerves themselves leads to scar tissue called lesions, which can cause a variety of neurological and systemic side effects.
  • The cause of MS is largely unknown; however, factors like genetics, underlying viruses and infections, smoking, and childhood obesity may play roles in its development.
  • Treatment for MS will depend on the type and severity of your symptoms. Most types of MS can be treated with disease-modifying drugs, steroids, and a combination of therapies and lifestyle changes to reduce pain and improve mobility.

FAQ

How does multiple sclerosis begin?
Experts are unsure exactly how MS begins, but most think it starts when an environmental cause, such as a virus, triggers an autoimmune attack in someone who is genetically susceptible to MS.
Vision problems and eye pain are common early symptoms of MS. Others include numbness or tingling of the fingers, face, or other parts of the body; difficulty with balance and walking; and sensitivity to heat, which may show up as dizziness, faintness, or unusual discomfort in warm temperatures or in a warm shower or bath.

MS affects each person’s body differently, depending on where it causes lesions or nerve damage, in the brain, spinal cord, and optic nerve. Most people with MS have fatigue. Many have balance difficulties, numbness, muscle spasticity, and bladder problems. Some people have thinking and memory problems because of MS.

No, MS does not go away on its own. Disease-modifying drugs can reduce relapses and slow the overall progression of the disease. Stem cell transplants have also begun to show promise in slowing or stopping progression. Rarely, a person's MS is "benign" and progresses very little after the initial symptoms. But for most people, MS worsens over time.
Most people with MS do not die of it, but some studies suggest it shortens life expectancy by six or seven years. The most common causes of death with MS are lung infections (pneumonia), sepsis (a life-threatening response to infection), and cardiovascular disease.

Resources We Trust

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Jessica Baity, MD

Medical Reviewer
Castle Connolly Top Doctor

Jessica Baity, MD, is a board-certified neurologist practicing in southern Louisiana. She cares for a variety of patients in all fields of neurology, including epilepsy, headache, dementia, movement disorders, multiple sclerosis, and stroke.

She received a bachelor's degree in international studies and history from the University of Miami and a master's in international relations from American University. She graduated from the Louisiana State University School of Medicine, where she also did her internship in internal medicine and her residency in neurology.

Prior to practicing medicine, she worked in international relations and owned a foreign language instruction and translation company. 

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Ingrid Strauch

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Ingrid Strauch joined the Everyday Health editorial team in May 2015 and oversees the coverage of multiple sclerosis, migraine, macular degeneration, diabetic retinopathy, other neurological and ophthalmological diseases, and inflammatory arthritis. She is inspired by Everyday Health’s commitment to telling not just the facts about medical conditions, but also the personal stories of people living with them. She was previously the editor of Diabetes Self-Management and Arthritis Self-Management magazines.

Strauch has a bachelor’s degree in English composition and French from Beloit College in Wisconsin. In her free time, she is a literal trailblazer for Harriman State Park and leads small group hikes in the New York area.

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