Multiple Sclerosis (MS) Symptoms: Early Signs and When to Get Help

What are the most common symptoms of MS?

Multiple sclerosis (MS) is a condition that affects the brain and spinal cord. The immune system attacks the protective coating around nerves, so messages between the brain and body slow down or get blocked. [1] [3] [5] That is why MS can cause such a wide mix of symptoms. Everyone is affected differently, and most people only have a few of them when they are diagnosed. [1] [6]

These are some of the most common symptoms: [1] [3] [4]

Two more symptoms are worth knowing about. Lhermitte’s sign is a brief electric shock feeling that runs down the spine, sometimes into the arms and legs, when you bend your head forward. About 16 in 100 people with MS have it, but it has other causes too. [2] [8] MS can also affect mood, with depression or trouble controlling emotions. [3]

What are the early signs of MS?

There is no single first symptom. The MS Trust says these are some of the more common first signs: [4]

• Tiredness that is out of proportion to what you are doing
• Stumbling, tripping or feeling unsteady
• Strange skin sensations, such as numbness, pins and needles or burning
• Sudden eyesight problems, such as blurred vision, double vision or losing vision in one eye
• Slowed thinking, such as struggling to concentrate or remember things

NICE guidance for UK doctors describes the pattern that makes MS more likely. People are often under 50. Their symptoms come on over more than 24 hours, may last several days or weeks and then get better, and are not caused by a fever or an infection. Some have had nerve symptoms before. [2]

Vision problems are a common first sign. In optic neuritis, sight in one eye usually gets worse over a few days, is at its worst about 2 weeks in, and most people recover within 4 to 6 weeks, though for some it takes longer. About 7 in 10 people with MS have optic neuritis at some point. [9]

NICE also says doctors should not usually suspect MS if the main symptoms are tiredness, depression, dizziness or vague tingling on their own, without other specific nerve symptoms or signs. [2] The NHS adds that MS symptoms are common and can have many other causes. Having them does not mean you definitely have MS. [1] Our guides to brain fog causes and common causes of dizziness cover other explanations.

Who is more likely to get MS?

MS usually starts in young adults. NINDS, part of the US National Institutes of Health, says symptoms usually begin between the ages of 20 and 40. [3] The NHS says you may be more likely to get MS if: [1]

• you are aged 20 to 50
• you are a woman
• a parent, brother or sister has MS
• you smoke (people who smoke are about twice as likely to develop MS)
• you have had the Epstein-Barr virus, which causes glandular fever

In the US, a 2019 study estimated that between about 623,000 and 727,000 adults had MS in 2010. It projected 852,000 to 914,000 by 2017, but says that figure should be treated with caution. MS was almost 3 times as common in women as in men. [10]

What is an MS relapse?

In relapsing remitting MS, the type most people are first diagnosed with, symptoms come and go. A period when they get worse is called a relapse or flare-up. A period when they ease is called remission. [1] [3] NICE defines a relapse as new symptoms, or existing symptoms getting worse, that last more than 24 hours, with no infection or other cause, after at least a month of stable symptoms. [2]

Relapses can last from a few days to several weeks or even months. Recovery usually takes a few weeks or months, but it can take up to 12 months, and some symptoms may not go away completely. [5]

The NHS describes 3 main types of MS: [1]

• Relapsing remitting: flare-ups of symptoms, then periods when they go away or get better. Over time, this often turns into secondary progressive MS
• Secondary progressive: symptoms are there all the time and slowly get worse
• Primary progressive: symptoms slowly get worse from the start, with no periods when they go away or get better. This type is less common

Not every bad patch is a relapse. Symptoms can get worse for a while because of an infection (such as a cold, flu, stomach bug or urine infection), heat, stress, hormone changes around your period or the menopause, tiredness, or losing fitness after a long time being inactive. This is called a pseudo-relapse. The symptoms usually ease once the trigger goes, for example after resting, cooling down or treating an infection. [5]

Temperature is a common trigger. Up to 8 in 10 people with MS say their symptoms get worse when their temperature changes, and even a change of 0.5°C can have an effect. Heat is the most common type, known as Uhthoff’s phenomenon. It is temporary and is not usually a sign of new damage, so symptoms should settle once your temperature is back to normal. If they have not settled after 24 hours, the MS Trust suggests contacting your GP or MS team. Contact them sooner if the symptoms are new or much worse than usual, or you have signs of an infection or a fever. [7]

How is MS diagnosed?

There is no single test for MS. If your GP thinks you could have MS, they will refer you to a neurologist (a brain and nerve specialist). [1] Before that, NICE says the GP should take a history, examine you and rule out more common causes. [2]

Tests you may have include: [1] [3] [6]

• checks of your movement, coordination, vision, balance and reflexes
• blood tests, mainly to rule out other causes
• an MRI scan of the brain and spinal cord to look for areas of damage
• a lumbar puncture, where a small sample of spinal fluid is taken from your lower back with a needle
• evoked potential tests, where small sensors on your skin measure how quickly messages from your eyes or ears reach your brain

Neurologists use a set of rules called the McDonald criteria, which combine your history, examination, MRI and lab results. NICE now refers to the 2024 revised version. [2] In most cases, doctors can diagnose MS from someone’s symptoms and typical signs on an MRI scan. [3]

It can take time. Many conditions cause similar symptoms, and you may not have MS. [6] If the criteria are not met but MS is still possible, NICE says a review should be planned (for example once a year) and you should know who to contact if you get new or worse symptoms. [2]

If you feel you are not being listened to, the MS Trust says it is reasonable to ask for a second opinion from another GP or specialist. [6] Our guide to handling medical gaslighting has more on speaking up in appointments.

What should you tell your doctor?

A GP appointment is short, so a little preparation helps. The MS Trust suggests keeping a symptom diary and bringing a one-page summary. Note down: [6]

• each symptom and when it started
• whether it changes during the day, or comes and goes
• how bad it is, for example on a scale of 1 to 5
• what it stops you doing
• anything that makes it better or worse
• older symptoms that, looking back, might be linked
• other health conditions, all your medicines (including ones you buy yourself) and any family history of MS

If you already have MS and think you may be having a relapse, your MS team will want to know when your symptoms started and how they changed, which part of your body is affected and what they stop you doing. They will also ask whether you have been unwell, stressed or very tired, and about any changes to your medicines or recent vaccinations. [5] Write down the date your symptoms began. NICE says relapses that affect daily life should be assessed, and treatment offered, as early as possible and within 14 days. [2] Do not wait that long to get in touch: the MS Trust suggests contacting your MS team if symptoms have not improved, or are getting worse, after 24 to 48 hours. [5]

Juno’s free symptom tracker worksheet and appointment one-pager help you put all of this on one page. The energy and fatigue tracker helps if tiredness is your main symptom.

Juno can also help. You log symptoms by text or voice, and Juno turns them into a short summary for your doctor. Juno does not diagnose MS. See the MS symptom tracker page.

When should you get urgent help?

Do not assume a new symptom is MS. Symptoms that start suddenly can be a sign of a stroke, which needs help straight away. [1] [11] Having MS does not rule out other conditions. [5]

This article is for general information only and does not replace advice from your own clinician. Juno is a health assistant, not a medical provider.

Last updated 26 October 2026