Living with multiple sclerosis (MS) can bring unique challenges, and walking difficulties are a common concern. Many wonder how MS might change their ability to walk and what they can do to stay mobile. While MS can make walking more difficult, treatments, assistive devices, and strategies can help people maintain mobility. In fact, nearly two-thirds of people with MS report they can still walk 20 years after their diagnosis, finding new ways to adapt and stay active with the help of specialized treatments and devices.

Difficulty walking, or experiencing changes to your walking pattern (also called gait) is a common symptom of MS. Walking difficulty is one of the top three symptoms reported by MyMSTeam members. MS-related walking problems may cause unsteadiness, tripping or stumbling, and other mobility challenges.

If you notice difficulty walking, or changes to your walking pattern, talk to your health care provider or neurologist. They can help determine whether these changes are related to MS and what to do next. Your doctor will also be able to recommend ways to manage your symptoms and help you stay as mobile as possible.

Common Gait Problems With MS

Like other MS symptoms, walking challenges can vary significantly from person to person. Some people may notice changes in the way they walk, changes in their walking speed, step length, or other gait abnormalities. There’s no easy way to pinpoint MS-related walking issues simply by observing someone walk.

Common MS-related walking issues might include the following:

• Having difficulty walking down stairs
• Taking slower, shorter steps
• Feeling unsteady while walking
• Tripping or stumbling
• Feeling heaviness in the legs when stepping forward
• Experiencing weakness in the legs when placing weight on them
• Having difficulty placing each foot firmly on the ground

What Does MS Gait Look Like?

Because walking difficulties with MS vary widely, there is no single easy way to identify MS gait. As opposed to other conditions like Parkinson’s disease, which have easily identifiable walking patterns, MS walking patterns are more variable.

People with MS who are experiencing changes to how they walk may display one of several common multiple sclerosis gait patterns. Two of these MS-related gait patterns are known as steppage gait and spastic gait.

Steppage Gait

Steppage gait (also known as neuropathic gait, usually seen in people with nerve damage called neuropathies) is characterized by drop foot — an MS symptom in which the front part of the foot drops down and does not lift up correctly with the rest of the leg while walking. In a person with drop foot, the toes point downward and may drag or scrape on the ground while walking.

Spastic Gait

Spastic gait is common in people who experience involuntary muscle spasms or spasticity (stiffness). In people with spastic gait, the leg on the side of the body most affected by spasticity is stiff and drags in a semicircular motion.

MS Walking Issues Impact Everyone Differently

Walking difficulties can vary widely for people with MS. They may or may not involve pain, can change throughout the day, develop suddenly or gradually, and differ from person to person.

For example, one MyMSTeam member reported that their walking difficulties are worse in the morning: “When I wake up, my leg muscles and body are stiff and achy. I walk bent over in the morning, but after a few hours, I’m walking better.”

Some members are surprised by how quickly their walking problems developed. “I can’t believe that five months ago, I wasn’t too bad — no walking aids or having trouble walking. Now, I’m a totally different person,” one member wrote.

Others find that their walking difficulties developed slowly over time. “The walking issues are one of those things that I noticed, only to realize it’s been happening for a while, and I don’t know when it started,” another member shared.

Emotional Impact

Walking difficulties may cause a person with MS to lose confidence in their mobility. Concerns about falling, or people mistaking the symptoms for drunkenness in public can sometimes lead to social isolation and other emotional challenges. One MyMSTeam member said, “When I’m tired, I may look like I am tipsy. I want to tell people, ‘I’m not drunk, I just have MS!’"

What Causes MS Walking Problems

MS affects the central nervous system (CNS), causing slowed or altered nerve conduction. These nerve problems can contribute to walking difficulties in MS by causing spasticity, characterized by muscle stiffness and involuntary spasms, which may sometimes be accompanied by muscle weakness. MS can also cause delays between signals from your brain and responses in your body, making a complex motion like walking more difficult.

Problems With Nerve Signals

In people with MS, the immune system mistakenly attacks cells in the myelin, the protective layer surrounding nerves. The immune attack results in areas of damage known as MS plaques or lesions. Nerve damage can disrupt the signals between your brain and body, making it harder for your body to respond to your brain’s commands.

Because walking is a complex process that relies on the coordination of multiple body systems, including the CNS, the communication and signal slowdown and variability that’s part of MS can cause walking issues and gait dysfunction. One MyMSTeam member described the experience: “My problem is that my leg doesn’t listen when my brain tells it what to do. There must be a short circuit somewhere.”

Spasticity

Spasticity, which commonly affects the legs or buttocks, is a frequent symptom of MS. The muscle stiffness and involuntary spasms associated with spasticity often contribute to walking difficulties. As one MyMSTeam member wrote, “I’m having trouble walking. My legs are tightening up.”

Balance Issues

Research suggests that as many as 4 in 5 people with MS experience some degree of ataxia (a lack of voluntary coordination of muscle movements). Ataxia can cause balance problems and result in an unsteady gait that may look like clumsiness or drunkenness.

Sensory Problems

MS may cause abnormal sensations, including numbness. Severe numbness in the feet may make a person unable to feel the floor or the position of their feet, which can cause problems with walking. One MyMSTeam member shared how numbness affects their ability to walk: “I have numbness that comes and goes. This occurs with me in my right leg and the right side of my mouth.”

Muscle Weakness and Fatigue

Many people with MS experience muscle weakness in their legs and feet, which makes walking more difficult. It’s also normal to experience walking problems that worsen when you’re fatigued. Fatigue can limit stamina and cause falls in people with MS. As one member shared, “I’m having trouble walking today and fell a couple of times. It gets frustrating, but after I get some well-needed rest, I will be better tomorrow.”

Managing and Treating Gait Difficulties in MS

Let your health care provider know as soon as you notice any difficulties with walking or balance. There are many ways to manage gait problems, including medication, physical therapy, exercise, and assistive devices. Together, these approaches may help you regain your balance, increase your mobility, and help you remain confident while moving.

Medications

If you have walking problems with MS, your health care provider may identify what is causing your problem and recommend specific medications to help improve your symptoms.

Dalfampridine

Dalfampridine (Ampyra) is an oral medication approved by the U.S. Food and Drug Administration (FDA) to improve walking in people with MS. This medication works to improve the conduction of nerve signals in nerve fibers when the myelin has been damaged by MS. As one MyMSTeam member shared, “My neurologist recommended I take Ampyra for walking and mobility issues related to spasticity. My gait is not as fluid those days.”

Other Medications

MyMSTeam members report taking several other medications to help improve their walking abilities. “If your nerves are acting up like mine do,” wrote one member, “I have two different medications that help: gabapentin (Neurontin) and diclofenac.”

One member found that taking gabapentin daily “helps a little” with their walking difficulties. Talk to your health care provider about your options.

Assistive Devices

Many people with walking difficulties use assistive devices to help support their walking ability and gait speed. According to the National Multiple Sclerosis Society, studies suggest that half of all people with relapsing-remitting MS require some form of walking aid within 15 years of their diagnosis.

There are many different types of assistive devices for people with MS. A class of wearable leg sleeve devices released in 2024 has shown great promise in improving mobility and walking among people with MS.

More traditional mobility aids such as canes, wheelchairs, and walkers can also help support movement and prevent falls. People whose walking problems are caused by numbness may benefit from using a cane, walker, or Canadian crutch (a crutch that includes an arm cuff and handle). These devices help compensate for numbness by carrying sensations from the ground through the device into the hand and arm.

Supportive braces and orthotics can help control the position and movement of the body and reduce pain while walking. Drop foot, in particular, may be managed using a brace known as an ankle-foot orthotic.

Exercise and Physical Therapy

Experts have advised that even a small amount of exercise can help improve walking difficulties when performed regularly (at least five days a week). A physical therapist can work with you on gait analysis to determine the appropriate exercises to increase your muscle strength, range of motion, and improve your walking problems.

MyMSTeam members also note that pushing yourself too far with exercise may do more harm than good. As one member wrote, “I started walking on a treadmill and overdid it.” This member found that they were “stuck between exercising to build strength and finding it difficult to walk afterward.” They decided to start bringing a cane to the gym in case of unsteadiness after exercising.

Fall Risk and Prevention

Fall risk is a substantial concern for people with MS walking problems. Research has found that people with MS have a higher risk of falling and getting injured from falls. Several factors increase the risk of falls in people with MS, including poor balance, slowed gait speed, and the incorrect use of assistive devices like canes and walkers.

You may be able to reduce your risk of falling by:

• Wearing safe, low-heeled shoes
• Exercising and strengthening your core and muscles
• Adding home modifications like grab bars to make daily movement safer and improve your quality of life
• Keeping areas where you walk clear of cords, loose carpets, or other objects

Talk with your doctor to figure out the right tools to help you build confidence, regain your ability to get around, and stay as mobile as possible.

You’re not alone in facing walking difficulties with MS. Your care team can help manage your MS in ways that work best for your needs and will help preserve your mobility for as long as possible.

Talk With Others Who Understand

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 216,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you experienced walking difficulties with MS? Are you looking to learn what kinds of strategies have been helpful to others? Share your stories or advice in the comments below or by posting on your Activities page.