What Happens Next?

If untreated, people with multiple sclerosis typically progress to disability over time. In around 80% of cases, a relapsing course is usually followed by chronic progression within 20 years.1 Large studies have shown that progression is slower than previously thought, although people may need a cane in as few as seven years – or not at all after 25 years. Men typically progress more quickly than women.

Evidence shows that regular medication can alter the course of MS a little, whereas lifestyle changes involving diet, sunlight, exercise, and meditation are more likely to have a major impact.

Giving a prognosis at the onset of MS is impossible, but one of the few constant findings is that the sooner someone requires a cane, the sooner they need the use of a wheelchair.

Among the many myths about MS, it used to be said that MS did not shorten life span and that no one dies of it. However, in fact people with MS do die earlier if they do nothing about their diagnosis. Life expectancy can be reduced by as much as 10 years, according to a Danish study that analyzed records of people with MS since 1948.2

Interestingly, people whose first symptoms are visual often have a fairly benign course, developing only mild disability in the 10 years after a diagnosis of optic neuritis. 3

For more information on course and prognosis, as well as sources, please see the MS Encyclopedia.


1. Kremenchutzky M, Rice GP, Baskerville J, et al. The natural history of multiple sclerosis: a geographically based study 9: Observations on the progressive phase of the disease. Brain 2006

2. Tremlett H, Paty D, Devonshire V. The natural history of primary progressive MS in British Columbia, Canada. Neurology 2005; 65:1919-192

3. Tremlett H, Paty D, Devonshire V. Disability progression in multiple sclerosis is slower than previously reported. Neurology 2006; 66:172-177