Heather Wills initially dismissed the numbness in her big toes as a consequence of being on her feet too much. However, what began as a minor sensation progressed over four years, leading to a diagnosis of multiple sclerosis (MS), an incurable disease that is increasingly affecting women over 40.
Wills, then 49, sought medical attention after a week of experiencing the numbness. Her general practitioner noted an anomaly in her ability to feel light touch, prompting a referral to a neurologist. Seven months later, the numbness had extended to her shins. The neurologist initially suspected a vitamin B12 deficiency, but blood tests ruled this out. Nerve conduction tests also yielded normal results.
As the altered sensation crept up her legs, Wills grew increasingly concerned, especially given her aunt's history of MS. Despite initial reassurances from the neurologist that she was too old for MS, the progression of symptoms prompted further investigation. Her husband noted a significant drop in her energy levels, describing it as her "hitting the wall" in the evenings.
Four years into her symptoms, the numbness reached her thighs and hips. Wills contacted the neurologist again, who, recognizing her background as a physiotherapist, agreed to an urgent MRI scan. The scan revealed grey areas on her spinal cord, and a subsequent lumbar puncture confirmed the MS diagnosis. Wills expressed relief that it was not cancer, a possibility that had been raised earlier.
Wills is among a rising number of people diagnosed with MS in the UK, where cases have more than doubled in 20 years, with an estimated 190,000 individuals now living with the condition. Research suggests factors such as a common virus, Epstein-Barr virus (EBV), a Scottish heritage, and being overweight may contribute to this increase. Historically considered a disease of young adulthood, MS is now increasingly being diagnosed later in life. A 2022 report indicated that the proportion of patients whose symptoms began after age 50 rose from about 1% before 1991 to nearly 10% after 2010.
MS occurs when the immune system attacks myelin, the protective sheath around nerves in the brain and spinal cord, disrupting communication between the brain and the body. Symptoms can include blurred vision, numbness, fatigue, muscle weakness, and balance issues. The most common form, relapsing-remitting MS, involves periods of flare-ups followed by remission.
Diagnosis of MS can be challenging due to the absence of a single definitive test. While MRI scans can show damage to the brain or spinal cord, and lumbar punctures can detect antibodies indicating immune system activity, a combination of factors is often used for diagnosis. MS diagnosed after age 50 can lead to more persistent disabilities, such as poor balance and mobility issues, sometimes requiring wheelchair use. Studies suggest that MS beginning later in life may also be associated with a higher risk of disability worsening between relapses, potentially due to reduced myelin repair capacity in older individuals.
Improved diagnostic tools, including wider access to MRI scans, are credited with identifying milder cases that might have been missed in previous decades. Advances in treatment have also improved outcomes, with medications like ocrelizumab and natalizumab available. Experts note that individuals now tend to