It is generally very difficult to predict the course of MS. The disorder varies greatly in each individual but most people with MS can expect a normal life expectancy.

People who have few attacks in the first several years after diagnosis, long intervals between attacks, complete recovery from attacks, and attacks that are sensory in nature (i.e., numbness or tingling only) tend to do better. People who have frequent attacks with incomplete recoveries, or more lesions on MRI early on, tend to have a worse clinical course.

While celebrities with awful MS get most of the press, for many people, MS does not cause horrible consequences. Most people continue to work, and most people with the disease continue to walk without assistance.

A recent excellent study indicated that "patients and physicians need to be aware of the natural history of MS so that they can make informed decisions regarding whether to start immunomodulator therapy and the issue relating to enrollment in drug trials. At diagnosis, patients with MS (those most likely to be started on immunomodulatory therapies and recruited into drug trials) need to be aware that they have a > 50% chance of being fully ambulatory (EDSS score < 6) at 25 years, and for those remaining relapsing - remitting fewer than 20% developed the need for a cane to walk, regardless of whether they received treatment with the currently approved agents." Article abstract