What Increases Your Risk

Your risk for multiple sclerosis (MS) increases with:

• Geographic location, or where you lived during childhood (up to age 15). People who spend the first 15 years of their lives in colder climates that are farther away from the equator tend to be more likely to get MS than people who lived closer to the equator during those years.
• Family history of MS. About 15 out of 100 people who have MS have a relative with MS, most often a brother or sister.²
• Certain genetic characteristics associated with the immune system. These appear more frequently in people who have MS. This may mean that there are one or more genes that may increase the chance of getting MS.
• Race. People of Western European ancestry are more likely to get MS.
• Being female. MS is about 3 times as common in women as in men.

When To Call a Doctor

Some of the symptoms of multiple sclerosis (MS) are similar to those of many other illnesses. See your doctor if over a period of time you have more than one symptom, such as:

• Blurry, foggy, or hazy vision, eyeball pain, loss of vision, or double vision.
• A feeling of heaviness or weakness, involuntary leg dragging, stiffness, walking problems, and clumsiness.
• Tingling or a pins-and-needles sensation; numbness; tightness in a band around the trunk, arms, or legs; or electric shock sensations moving down the back, arms, or legs.
• Inability to hold urine or to completely empty the bladder.
• Dizziness and unsteadiness.
• Problems with memory, attention span, finding the right words for what you mean, and daily problem-solving.

If you have been diagnosed with MS, see your doctor if:

• Your attacks become more frequent or severe.
• You begin having a symptom that you have not had before or you notice a significant change in symptoms that are already present.

Watchful waiting

Milder MS-type symptoms can be caused by many other conditions or may occur now and then in healthy people. For example, lots of people have minor numbness in their fingers or a mild dizzy spell once in a while. Stiffness and muscle weakness can result from being more active than usual. Watchful waiting is appropriate for these types of everyday aches and pains, so long as they do not continue.

If your symptoms occur more often or don't go away, talk to your doctor.

For people with MS

Talk to your doctor about what to expect from the disease and from treatment. MS is an unpredictable disease, but you probably can get some idea of what is "normal" and what symptoms or problems are reasons for concern.

Some people who have MS want active, regular support from their doctors. Others want to manage their condition on their own as much as possible. Wherever you are in this range, find out which signs or symptoms mean that you need to see your doctor. And seek help when you need it.

Who to see

Health professionals who may be involved in evaluating symptoms of MS and treating the condition include:

• Family doctors or internists. Consult your doctor when symptoms first start. He or she will refer you to a neurologist if needed. If you have MS, your family doctor or internist can treat your general health problems even if you see a neurologist for MS treatment.
• Neurologists. A neurologist can decide whether your symptoms are caused by MS. He or she can also help you decide what may be the best treatment for your condition.

Many university medical centers and large hospitals have MS clinics or centers staffed by neurologists and other health professionals who specialize in diagnosing and treating MS. They may be able to provide the most thorough evaluation.

If you have been diagnosed with MS, at some point you may need to seek the help of:

• A physical therapist, to assist with exercise to maintain body strength and flexibility and deal with movement problems.
• An occupational therapist, to identify ways of accomplishing daily activities if MS has caused any physical limitations.
• A speech-language pathologist, to improve speech, chewing, and breathing if MS has affected the muscles of the face and throat.
• A physiatrist, to help with managing pain, maintaining strength, and adapting to physical disability.
• A psychologist or psychiatrist, to evaluate and treat depression, anxiety or other mood disorders, and problems with memory and concentration if these develop.
• A pain management specialist, to help with any significant chronic pain that MS may cause. A pain specialist, often as part of a pain clinic, can help find ways of reducing pain when possible and dealing with pain that doesn't go away.
• A neurosurgeon, to do surgery for severe tremors or spasticity.

To prepare for your appointment, see the topic Making the Most of Your Appointment.