Key takeaways

  • Corticosteroids may lead to complications like high blood pressure, infections, and mood issues, especially with long-term use. They’re typically prescribed to quickly resolve MS attacks or to manage severe symptoms.
  • MS may disrupt signals, causing bladder and bowel issues like constipation and incontinence. You can address these with high fiber diets, medications, nerve stimulation, and physical therapy.
  • MS may lead to cognitive impairments like memory loss and slower processing. You can manage these through a healthy lifestyle, brain exercises, mental health therapy, and stress management.

Multiple sclerosis (MS) is a chronic (long-term) condition with symptoms that vary from person to person. With proper management of symptoms, people living with MS can often remain active for many years.

Not everyone with MS will have complications, but some complications affect many people who live with this condition.

This article reviews 7 common complications of MS and what you can do to manage them.

Corticosteroids are the first line of defense for treating relapses in MS but not the first line for preventing relapses. This is because of the risk of side effects or complications from corticosteroids and the development of more effective MS treatments.

Now, doctors typically prescribe corticosteroids only to make an attack go away quickly or if a person is experiencing the following symptoms:

  • visual disturbances
  • severe weakness
  • extreme balance issues
  • difficulty breathing
  • severe muscle spasms and cramps

Potential complications from short-term use of corticosteroids

Possible complications from short-term oral corticosteroid use include:

  • high blood pressure
  • fluid retention
  • pressure in your eyes
  • weight gain
  • mood and memory problems

Potential complications from long-term use of corticosteroids

Few people should take corticosteroids long term. But if you do, you may be at greater risk of complications such as:

  • infections
  • high blood sugar
  • thin bones and fractures
  • cataracts
  • bruises
  • reduced adrenal gland function

MS causes interruptions in signals between your brain, urinary tract, and bowel system. This means that, sometimes, your body doesn’t receive the message that it’s time to release waste.

In some cases, nerve damage may also affect signals to your brain and muscle function in the parts of your body that release waste.

These bladder and bowel problems may include:

Your bladder may be overactive or may not empty completely. To help with bowel and bladder issues, some people follow a high fiber diet or take medications such as fiber agents or stool softeners.

Others receive nerve stimulation and physical therapy to help them regain some bowel and bladder function.

People living with MS experience higher rates of depression and bipolar disorder. The reasons for these rates are complex.

Depression may be connected to changes in brain tissue that MS can cause. It may also be the result of the emotional challenges of living with the condition. Some people with MS may feel a sense of isolation and face career, economic, and social challenges.

Bipolar disorder may also be a side effect of MS progression or certain medications such as corticosteroids.

Treatments for MS-related mental health issues include medications such as tricyclic antidepressants and selective serotonin reuptake inhibitors.

Some forms of psychotherapy, such as cognitive behavioral therapy, can also help manage symptoms.

Support for people living with MS

Organizations such as the National MS Society have member resources to help people connect with others who are living with MS and provide strategies for dealing with the challenges of the condition, including mental health issues.

Vision changes occur as MS progresses. You may experience some of these symptoms for a short time, or they may become permanent. Possible vision complications include:

Treatments may focus on helping you manage vision changes. This could involve wearing an eye patch if you have double vision or taking medication to control nystagmus.

Another potential treatment is special glasses to help with double vision.

Many people believe MS only affects mobility, but about half of people living with the condition develop cognitive issues such as memory loss and slower intellectual processing.

These issues could also result in reduced problem-solving, verbal, abstract reasoning, and visual-spatial abilities. These changes in cognition are likely due to brain atrophy or lesions caused by MS.

But cognitive changes don’t have to significantly affect your day-to-day life with MS. Medications and rehabilitation can help you retain cognitive function. Support from family and friends is also an important resource.

Managing cognitive health in MS

Here are some recommendations for improving cognitive health in MS:

People with MS may have a feeling of numbness or other physical sensations. Dysesthesia is a painful form of these sensations. This condition can cause:

  • aching
  • burning
  • a feeling of tightness

The MS hug is a feeling of tightness in your chest that makes it hard to breathe. This condition can be a form of dysesthesia or the result of a spasm.

Often, this symptom passes on its own without treatment. If the symptom persists, there are medications to treat sensory complications, including:

VTE occurs when a blood clot travels through the bloodstream to a vessel, causing a blockage.

A 2024 study found that people with MS had a greater risk of VTE than those without MS. In the study, 0.86% of people with MS developed VTE, while 0.04% of people without MS did.

This is partly because people living with MS typically have risk factors for VTE, such as:

  • disability
  • spasticity (muscle stiffness)
  • lack of mobility
  • steroid use

To reduce the risk of VTE, you can focus on overall care, including eating a healthy diet and improving your mobility as much as possible.

MS is largely an individual journey, but you can get support to meet your physical, medical, and emotional needs.

Learning about the possible complications and how to prevent or manage them is one way to be proactive about your health.

Communicate with those who care about you when you’re experiencing MS complications. Your family, friends, and doctors can help you meet the challenges of life with MS.