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Walking (Gait) Difficulties


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Free From Falls Part 1

Part one of a two-part series. Free From Falls is a comprehensive fall prevention program for people with multiple sclerosis.

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Free From Falls Part 2

Part two of a two-part series. Free From Falls is a comprehensive fall prevention program for people with multiple sclerosis.

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Difficulty in walking — also known as problems with gait —  is among the most common mobility limitation in MS. Difficulty walking is related to several factors:

  • Weakness: Muscle weakness can cause problems such as  foot drop (which causes toe drag), “vaulting” (a compensatory technique that involves raising the heel on the stronger leg to make it easier to swing the weaker leg through), compensatory hip hike, trunk lean or circumduction (swinging leg out to the side). Weakness in both legs is known as paraparesis; weakness in only one leg is called monoparesis. Weakness can often be compensated for with the use of appropriate exercises and assistive devices, including braces, canes or walkers.

  • Spasticity: Muscle tightness or spasticity can also interfere with gait. Stretching exercises and antispasticity medications such as baclofen or tizanidine are generally effective in treating this symptom.

  • Balance: Balance problems typically result in a swaying and “drunken” type of gait known as ataxia. People with severe ataxia generally benefit from the use of an assistive device.

  • Sensory deficit: Some people with MS have such severe numbness in their feet that they cannot feel the floor or know where their feet are. This is referred to as a sensory ataxia.

  • Fatigue: Many people will experience increased gait problems when fatigue increases.


Studies from several countries report that 50-70% of people with MS report falls within the past 2 to 6 months. About 30% of those individuals report falling multiple times, with injuries resulting from those falls. Enhancing a person’s ability to walk comfortably and safely, while preventing falls, is critical.  Not only can falls cause injuries, but the time required to recover from broken bones or strained muscles can worsen mobility problems and reduce independence.

People with MS typically fall in or around their homes and neighborhoods, usually while doing basic activities like bathing, preparing meals or walking in crowded areas.  Risk factors for falls are complex and include:
  • poor balance and slowed walking
  • reduced proprioception (the sensation of where your body parts are in space)
  • incorrect use of assistive devices (canes and walkers) or use of inappropriate devices
  • neurologically active medications (medications that affect the messaging within the nervous system)

Treatment and self-management strategies

Most gait problems can be helped to some extent by physical therapy (including exercises and gait training), the use of appropriate assistive devices and, in some cases, medications for spasticity, fatigue, and walking speed (e.g., Ampyra).

If you’re having difficulty walking, speak to your healthcare provider.  Fall prevention is important for your mobility, independence and safety.



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