Weakness
Movement difficulties are a frequent symptom in people with multiple sclerosis (MS), impacting balance, coordination and mobility in daily life. Around 80% of individuals with MS experience some form of gait or coordination impairment within 10–15 years of diagnosis, making it a major contributor to disability and reduced independence.
What Are Movement Difficulties?
Movement difficulties in MS encompass a range of motor impairments, including:
- Ataxia: Unstable, uncoordinated walking and limb movements.
- Tremor: Rhythmic involuntary shaking, often of hands or head
- Spasticity: Muscle stiffness or tightness causing involuntary spasms.
- Muscle Weakness: Reduced strength leading to foot drop or difficulty rising from a chair
- Balance Loss: Tendency to sway or fall when standing or walking1.
- Vertigo: Sensation of spinning or dizziness.
What Causes Movement Difficulties?
Movement difficulties arise primarily from:
Combined, these factors create a variable spectrum of movement challenges, often fluctuating day to day.
- Myelin Damage: Disruption of nerve signalling in the cerebellum and its connections impairs timing and coordination of muscle activity
- Lesions in Motor Pathways: Plaques in the brainstem or spinal cord slow or block motor signals, leading to weakness and spasticity
- Sensory Loss: Impaired feedback about limb position and pressure undermines balance and gait stability.
- Fatigue and Heat Sensitivity: Tiredness and small temperature rises exacerbate motor control issues, worsening coordination and spasticity.
Combined, these factors create a variable spectrum of movement challenges, often fluctuating day to day.
What Should I Do If I Experience Movement Difficulties?
Movement difficulties in MS encompass a range of motor impairments, including:
- Seek Assessment: Discuss new or worsening movement problems with your neurologist, MS nurse or GP to exclude other causes and update your management plan.
- Keep a Diary: Record patterns, triggers, and severity of gait or coordination issues to guide tailored therapy.
- Home Safety Evaluation: Have an occupational therapist assess your environment to minimise fall risk with appropriate aids and layout changes.
Self-Management Strategies
- Physiotherapy Exercises: Engage in balance, strength and flexibility routines designed by a physiotherapist to maintain motor control and prevent contractures
- Assistive Devices: Use walking sticks, ankle–foot orthoses or rollators to stabilise gait and conserve energy
- Cooling Techniques: Apply cool packs or wear cooling garments to limit heat-induced spasticity flares.
- Footwear Adaptations: Choose supportive shoes with non-slip soles and consider shoe inserts to correct foot drop.
- Energy Conservation: Plan activity breaks and pace tasks to prevent fatigue-related deteriorations in movement.
How Is It Treated?
- Medication for Spasticity: Baclofen, tizanidine or diazepam can relieve muscle stiffness, under specialist supervision.
- Targeted Therapy for Tremor or Ataxia: Few drugs (e.g., propranolol for intention tremor) offer relief; in select cases, deep brain stimulation is considered.
- Rehabilitation Programmes: Multidisciplinary input from physiotherapists, occupational therapists and speech therapists enhances overall mobility and safety.
- Falls Prevention Clinics: Referral to specialised services provides comprehensive assessment and tailored strategies to reduce fall risk.
General Information
Living with movement difficulties can be challenging, but support is available:
- Multiple Sclerosis Society of New Zealand-ational resources and regional peer support.
- Healthline – 0800 611 116 – Free 24/7 nursing advice on symptom management and services.
- Regional MS Societies (Auckland, Wellington, Canterbury) – Local information, exercise groups and equipment loan.
- Falls Prevention Clinics – Access via GP referral for assessment and home safety recommendations2.
- Work and Income New Zealand – 0800 559 009 – Financial assistance and disability support.