While symptoms vary greatly from person to person, and can get better or worse over time, more common symptoms include fatigue, walking (gait) difficulties, numbness or tingling, spasticity, weakness, vision problems, dizziness, bladder and bowel problems, sexual problems, pain, cognitive and emotional changes, and depression, per the NMSS. However, there are also some less common symptoms of MS. “What’s surprising about MS symptoms is that they can affect so many different functions that people rely on every day in their lives,” says Rosalind Kalb, PhD, vice president of the Professional Resource Center at the NMSS. “Some are physical, some emotional, and some intellectual. We tend to focus on the ones we can all see, but many people may be living with a variety of symptoms that just aren’t apparent.” Here are some of the less common, more surprising symptoms that you might not be aware of.
1. Vertigo
Many people with MS experience dizziness, in which you feel light-headed or off-balance, notes the NMSS. A less-common MS symptom is vertigo. When you have vertigo, you feel as though your surroundings are spinning around you, Dr. Kalb says, or that you are spinning. Vertigo in MS is a result of lesions in areas of the brain that coordinate balance. Motion sickness drugs can usually provide temporary relief, but typically do not resolve chronic vertigo from old or prior lesions. Corticosteroids can also be used to treat new or worsening vertigo that is due to a new disease flare-up or lesion. RELATED: Your Everyday Guide to Living Well With Multiple Sclerosis
2. Speech Disorders
About 25 to 40 percent of people who have MS report having speech problems as a result of lesions or damage in different parts of the brain, according to the NMSS. These symptoms, also known as dysarthria, tend to occur when you’re further along in the course of your disease, and when you’re very fatigued. Per the NMSS, speech disorders experienced by people who have MS include:
Scanning speech or scanning dysarthria, where the normal “melody” or speech pattern is alteredSlurring, which is typically due to weakness or a lack of coordination in the muscles of the tongue, lips, cheeks, and mouthDysphonia or loss of speech volume, which can be due to a weak diaphragmStuttering
If you’re having speech problems due to MS, a speech or language pathologist can help, as can assistive devices such as smartphone apps. Difficulty swallowing can be a serious problem, and it’s important to seek diagnosis and treatment as soon as possible. A speech or language pathologist can teach you strategies and exercises for safer eating and swallowing, and help you make any necessary dietary changes. RELATED: 10 Lifestyle Tips to Help You Manage MS Symptoms
4. Itching
Some people who have MS experience dysesthesias, or painful sensations in the legs, feet, arms, and hands. They typically feel like burning, prickling, stabbing, ice cold, or electrical sensations, according to the NMSS. Pruritis (itching) is a form of dysesthesias. When you have MS, the nerves in the central nervous system that convey sensory information can be damaged. This damage can cause you to feel itchy even though you don’t see any irritation. Because the cause is neurological and not physical like a bug bite or rash, topical skin creams won’t help. Treatment for this type pain or itching may include anti-seizure medications, anti-depressants, as well as acupuncture, mindfulness, meditation, and cognitive behavioral therapy (CBT). RELATED: What You Should Know About MS Complications
5. Hearing Problems
About 6 percent of people who have MS report having impaired hearing, per the NMSS. Rarely, hearing loss can occur as the first symptom of the disease. Hearing loss in MS can be linked to damaged nerve pathways in the brain and the brainstem. However, it’s important to note that hearing loss in MS is very uncommon, and most acute episodes get better over time. Be sure to talk to your healthcare provider to determine what is causing your impaired hearing.
6. Tremors
Tremors, or uncontrollable or involuntary shaking, can occur in various body parts as a result of MS-related damage to the nerve pathways that coordinate movements, notes the NMSS. The most common type of tremor (and most disabling) that occurs in MS is known as an intention tremor. It’s usually most pronounced during physical movement, and gets worse as you try to grasp or reach for something, or move your hand or foot to a specific spot. Tremor can make it challenging to perform daily activities like eating, drinking, and getting dressed, and can cause some people to feel embarrassed and to avoid social situations. Your healthcare provider may try different medications to treat tremor, but finding an effective treatment can be difficult. A few small studies have suggested that cannabis may be helpful, but further research is needed. Occupational and physical therapists can also help you find ways to manage tremor, including the use of assistive devices. RELATED: Depression, Anxiety, and MS: What’s the Connection?
7. Headache and Migraine
While headache isn’t considered a hallmark symptom of MS, a meta-analysis published in December 2020 in Brain and Behavior reviewed 16 studies covering 3,560 patients and found the pooled prevalence of headache was 56 percent. The review also found that the overall prevalence of migraine and tension headache among people with MS was 27 percent and 10 percent, respectively. Previous studies have found that up to half of people with MS who experience headache have either cortical or brainstem lesions, the review notes. RELATED: How to Get Rid of a Headache or Migraine Attack Fast
8. Breathing Problems
Breathing problems can occur as a result of MS-related damage to the nerves that control the chest muscles, according to the NMSS. This issue can get worse over time, and be especially exhausting for those who already experience MS fatigue. Breathing exercises can be helpful, but it’s important to see a healthcare provider who specializes in breathing issues to ensure proper diagnosis and treatment.
9. Loss of or Change of Taste and Smell
Research has shown that many people who have MS experience changes in how food tastes and smells. One study, published in April 2016 in Journal of Neurology, found that a significant number of people with MS have a decreased ability to sense all four basic areas of taste: sweet, sour, salty, and bitter, and that these taste deficits that are linked to MS-related lesions throughout the brain. It’s not common, but other people with MS have reported hyperosmia, or an abnormally heightened sense of smell or abnormal sensitivity to odors. RELATED: 8 Things to Try When MS Affects Your Ability to Taste and Smell Before you assume that MS is the cause of impaired or decreased taste, get your symptoms checked out by your doctor, as new loss of taste and smell can also be a symptom of COVID-19, among other conditions.