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Just like the initial symptoms of multiple sclerosis, the secondary and tertiary symptoms must be managed in order to avoid additional damage to an already compromised body. This article will overview everything you need to know.

Living with multiple sclerosis doesn’t just include dealing with the disease, its treatments, and the initial symptoms that come with the damage done by it. In fact, there are secondary and tertiary symptoms most people don’t even consider that are completely separate from those directly caused by the attack on the central nervous system (CNS).

In some cases, additional damage is done trying to cope with the original symptoms that appear with the disease, and others happen based on long term effects attempting to maintain a certain quality of life while under the thumb of the disease. Either way, these secondary symptoms are important to note so that patients can also try to make adjustments and have less complications due to these symptoms.

How initial symptoms lead to further issues

Because multiple sclerosis attacks the CNS, which is essentially the nerves in the brain, spinal cord, and eyes, one of the first, most common symptoms is difficulty with mobility. Unfortunately, it is also one of the most pronounced and can lead to additional trouble, noted as secondary symptoms of MS.

Mobility doesn’t just consist of the ability to walk around the house but all motor control, including functions like:

  • Changing positions
  • Maintaining a position
  • Lifting or carrying objects
  • Transferring oneself from point A to point B
  • Use of hands and arms
  • Moving using equipment
  • Moving to a new location
  • Driving or using transportation

Some or all of these mobility issues may see deterioration or even temporary trouble during a relapse, and with those come a second round of “side effects” which are considered secondary and tertiary symptoms of multiple sclerosis.

Secondary symptoms related to mobility in MS

When it’s harder to get around because nerves aren’t signaling properly, adjustments have to be made, and patients tend to create additional wear and tear on the musculoskeletal system in doing so. Often, because of weakness and stiffness in the legs caused by MS, the hips and knees become worn, causing pain and even leading to arthritis in the joints. This might seem like an intuitive secondary effect, but others are more surprising.

  • Dental health – Weakness that makes standing or holding a toothbrush difficult, as well as loss of fine motor skills that make brushing well possible, can lead to the detriment of teeth and cause problems not previously considered but that are definitely related to mobility.
  • Pressure sores – With limited mobility, a patient could find themselves in a single position for a long period of time, whether this is seated, lying down, leaning a certain direction, or other pose. Being in any position for too long where weight is resting on a particular part of the body can cause that part of the body to develop pressure sores, usually in the form of skin lesions and open wounds. Beyond the wounds themselves being painful, they also allow an opening for bacteria that could lead to infection, and infection tends to exacerbate MS symptoms.
  • Broken bones, bruises, and cuts – Again, with limited mobility, a number of issues can occur. One major concern is falling due to dizziness, weakness, or stiffness. In falling, or even limited coordination, patients can bump into things or fall on things that leave bruises and cuts, both of which are painful and could further reduce functionality. Cuts are also wounds into which infections can enter. In worse falls, bones may break, which decreases mobility significantly, and then the process becomes a vicious cycle that could lead to additional injury.

Additional symptoms not related to mobility

While mobility plays a huge role in creating secondary and tertiary symptoms of multiple sclerosis, it’s not the only culprit. Other factors are involved in some of the most complex of secondary symptoms.

  • Urinary issues – Difficulty urinating, holding urine, or sudden need to urinate are all symptoms of MS. However, the disease itself doesn’t cause the urinary tract infections (UTIs) that are often related to the disease. UTIs are caused by the symptoms of urinary problems. A UTI happens when there is incontinence or inability to empty the bladder, both of which can be caused by MS.
  • Symptoms caused by treatment – Most of the side effects caused by multiple sclerosis treatments are fairly mild, and this means they are often considered to be secondary and tertiary symptoms of MS – symptoms that are associated with the disease due to treatment that are more manageable than the symptoms they treat. For example, some of the treatments cause flu-like symptoms, injection site irritation, or even milder forms of headache and fatigue than experienced during an MS relapse.

Managing secondary and tertiary MS symptoms

As with any symptoms of multiple sclerosis, the best way to handle these secondary symptoms of the disease is a management regimen that the patient firmly adheres to. The process of management will differ from one patient to another because each case of MS is as unique as the individual, but as a general rule:

  1. Maintain a healthy diet at all times. Keeping the body flush with nutrients and maintaining a healthy weight are crucial to combating the worst of the symptoms, especially when it comes to mobility and avoiding illness and infection.
  2. Stay hydrated. It can be easy to forget to drink enough fluids, but this will help keep joints lubricated and muscles from producing excess lactic acid and growing stiff.
  3. Exercise. Whether in the middle of a relapse or throughout remission, any mobility available should be used to exercise regularly. This helps keep muscles from atrophy, keeps bones stronger, and allows the body to be ready and less susceptible to the weakness that occurs during relapses.
  4. Take medications before bed, if possible. Many of the medications that treat MS can also lead to fatigue and should be taken before sleeping in order to less negatively affect quality of life during the day.
  5. Warm the injectables. When the injectable medication is closer to the temperature of the body, there is less irritation at the injection site.
  6. Go to physical and occupational therapy. Trained professionals can help with exercises and coping mechanisms that assist with maintaining mobility, even during relapses, that cause less stress on other parts of the musculoskeletal system.
  7. Use walking aids. Rather than trying to compensate for lost motion with hips, knees, and other joints, a walker or cane can greatly assist with motion that is both less damaging and less painful.


Just like the initial symptoms of multiple sclerosis, the secondary and tertiary symptoms must be managed in order to avoid additional damage to an already compromised body. In doing so, a patient will find the entire disease to be more manageable and less life altering.

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