MS can affect your coordination. Let’s work together to find some balance.

Problems with balance and coordination can make it harder to walk, move and speak.¹

Balance and coordination problems are commonly experienced by people living with MS, but there are ways to manage them.¹

Read on to find out more about balance and coordination problems in MS, what causes them and how to manage them.

Balance is the ability to feel steady and stay upright, without wobbling or falling over. Coordination is the ability to control your movements smoothly. When you have balance and coordination problems, it can make you feel clumsy and unsteady. The medical name for this is ‘ataxia’. Ataxia can affect the way you walk and can also affect your speech and movement of your eyes, arms or legs, but is often hard to know if this is related to your MS or if you’re just having a clumsy moment.^2,3

Sometimes I have balance problems but I’m never sure if it’s my MS or just because I have just tripped or been clumsy for a moment.

Mike

Living with MS since 2014

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Ataxia is quite common in MS:^1,2

• 50–80% people living with MS have balance or coordination problems
• 50% of people living with MS fall over at least once a year

Problems with balance and coordination can suddenly get worse during relapses. You may also notice these gradually getting worse over time, which can be a sign of disease progression.^1,4

There are ways to help slow disease progression and ways to manage balance and coordination problems – read on to find out more.

Balance and coordination involve complex communications between your brain and different parts of your body.¹ MS causes nerve damage, which can disrupt these communications. This can interfere with your ability to control your movements and make you feel clumsy.^1,2

Your balance (ability to stay upright) can also be affected by other symptoms of MS, such as⁵:

• Muscle weakness
• Vertigo
• Fatigue
• Tremor

Some medications have side effects that can also affect your balance and coordination or they can also be caused by factors that are not related to your MS, like an inner ear infection.⁵

It’s important to talk to your healthcare team so they can determine what’s causing your balance issues. They can then work with you to get the right plan in place to help you manage them.⁵

Read on to find out ways to help manage your balance and coordination problems.

Exercise

Regular exercise can help with lots of different MS symptoms and studies have shown that it’s particularly helpful for balance and coordination.^5–9 Go to our exercise page to learn more about exercises for balance problems and for some simple exercises you can try yourself at home.

Activities like Pilates and yoga can help strengthen muscles and improve balance and coordination.^10,11 A small study in 2017 showed that an 8-week yoga programme had a positive effect on wellbeing and helped improve balance, walking and coordination in people living with MS.¹²

You may feel like balance exercises and Pilates are the last thing you want to do when you have balance problems. But I can’t emphasise strongly enough how good these exercises will make you feel, and they will actually help strengthen your muscles and improve your balance too.

Grace

Living with MS since 2017

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Remember to always seek advice from your healthcare team before starting any exercise programme to ensure it is right for you.

Therapies, treatments and ways to work around balance problems

As well as exercises for balance, other options that can help include:

• Physiotherapy - ask your healthcare team about working with a physiotherapist to create a personalised exercise and rehab plan⁵
• Medications – some medications can be prescribed to improve walking ability. If balance problems are brought on by relapses, treating the relapses with steroids may be beneficial⁵
• Technology – games consoles and virtual reality used with a ‘balance board’ have been shown to help with balance problems^13–16
• Walking aids – if balance and coordination problems are making it difficult for you to get about, you could consider using a walking aid like a stick, chair or scooter for a while.¹⁷ This can give you a bit of freedom if you’re otherwise feeling stuck

During my first relapse, I lost control of my left-hand side and I had to do a lot of rehabilitation on this side because it was my weak, non-dominant side. My next relapse caused problems with my right-hand side. I’m nearly back to full fitness and it’s slowly getting better every day. It might seem like a slow process and lots of hard work, but it’s worth it in the end.

Conor

Living with MS since 2003

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1. Cameron MH, Nilsagard Y. Handb Clin Neurol. 2018;159:237–50.
2. de Silva RN, et al. Pract Neurol. 2019;19:196–207.
3. Ashizawa T, Guangbin X. Continuum (Minneap Minn). 2016;22:1208–26.
4. Wilkins A. Front Neurol. 2017;28;8:312.
5. MS Society. Balance & MS Booklet. https://www.mssociety.org.uk/care-and-support/resources-and-publications/publications-search/balance-and-ms-booklet [accessed July 2020]
6. Hebert JR, et al. Phys Ther. 2011;91:1166–83.
7. Hebert JR, et al. Neurology. 2018;27;90:e797–807.
8. Carling A, et al. Physiother Res Int. 2018;23:e1728.
9. Carling A, et al. Mult Scler. 2017;23:1394–404.
10. National MS Society. Yoga and MS. https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Exercise/Yoga [accessed July 2020].
11. MedFitNetwork. Why do yoga if you have multiple sclerosis? https://medfitnetwork.org/public/all-mfn/yoga-multiple-sclerosis/ [accessed July 2020].
12. Cohen ET, et al. Int J MS Care. 2017;19:30–39.
13. Brichetto G, et al. Mult Scler J. 2013;19:1219–21.
14. Prosperini L, et al. Neurorehabil Neural Repair. 2013;27:516–25.
15. Ozkul C, et al. Eur J Integr Med. 2020;35:101092.
16. Maggio MG, et al. J Clin Neurosci. 2019;65:106–11.
17. MS Society. Wheelchairs and scooters. https://www.mssociety.org.uk/care-and-support/everyday-living/getting-around/wheelchairs-and-scooters [accessed July 2020].