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Managing Your Multiple Sclerosis

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Speech and Swallowing Issues With Multiple Sclerosis

Medically Reviewed By William C. Lloyd III, MD, FACS
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young woman with sore throat, squeezing eyes shut with painful swallowing
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Do your friends or loved ones often ask you to repeat yourself? Have you been told your voice sounds soft or slurred? If you have multiple sclerosis (MS), these may be signs that you have speech issues related to the condition.

It’s estimated that up to 40% of people with MS have speech problems at some point. Sometimes, a health care provider or loved one notices first. If someone comes to you with concerns about your speech, take heart. There are treatment options that can help.

The Speech and Swallowing Connection

Experts think that MS-related speech problems stem from lesions in the part of your brain responsible for controlling your vocal cords, diaphragm, soft palate, tongue, and lips. This can result in many different types of speech problems. Some people develop slurred speech or difficulty articulating words. Others exhibit long pauses between words or syllables, disrupting the natural flow of speech. Some experience voice changes, taking on a nasal, harsh, hoarse, or weak tone.  

Some individuals with MS-related speech problems also develop difficulty swallowing, called dysphagia. For many people, swallowing issues are fairly mild. However, if you ever cough while drinking or eating, or occasionally choke on food, it’s important to get checked out. Serious swallowing issues can lead to dehydration, poor nutrition, or aspiration pneumonia. This occurs when food or liquids accidentally enter your lungs.   

Taking Control Through Treatment

The good news is that speech and swallowing problems can often be successfully treated. The first step is to see a speech-language pathologist (SLP). An SLP is trained to evaluate, diagnose, and treat both types of problems.  

An SLP will perform a thorough examination and, depending on your symptoms, conduct tests to better understand your problem. For example, patients with swallowing difficulties may take part in a modified barium swallow. This is an imaging test that can help pinpoint the location and defect causing the problem. Depending on your unique situation, a number of treatment options might help.

Treatment of speech problems may include:


  • Exercises to improve breath support and control

  • Guidance on how to practice self-correcting your speech

  • Strategies to help with clearer speech, such as slowing down or overarticulating

If your speech problems become severe enough that they prevent you from communicating effectively, an SLP can find technology aids that can help. These may include speech amplifiers or computer-assisted communication devices.
Treatment options for swallowing issues may include:

  • Strategies for choosing the safest food consistencies

  • Techniques for safer eating and swallowing, such as taking smaller bites, positioning your body slightly differently, and swallowing a second time after each bite or sip

  • Placement of a feeding tube to ensure adequate nutrition, if swallowing problems are severe

Although speech and swallowing issues can be discouraging, it’s important that you don’t let them stop you from living a full life. Work with your SLP to stay engaged and social. Remain positive. And be an active partner in your care.

Key Takeaways

  • About 40% of people with MS experience speech-related problems.

  • Some people develop slurred speech or difficulty articulating words, while others experience voice changes. 

  • Some also have difficulty swallowing, a condition known as dysphagia.

  • A speech-language pathologist can help you work through speech and swallowing issues.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Feb 11
View All Managing Your Multiple Sclerosis Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. When Words Don’t Come Easily: Understanding and Improving MS Speech and Communication Symptoms. Multiple Sclerosis Foundation. November 2012. (http://www.msfocus.org/article-details.aspx?articleID=869);
  2. Speech and Voice Problems. National Multiple Sclerosis Society (http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/symptoms/speech-diso...;
  3. Swallowing Problems (Dysphagia). National Multiple Sclerosis Society (http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/symptoms/swallowing-...;
  4. You Can...Speak More Clearly and Swallow More Safely. National Multiple Sclerosis Society. (http://www.nationalmssociety.org/living-with-multiple-sclerosis/you-can/speak-more-clearly-and-swall...;
  5. Dysarthria in Multiple Sclerosis. National Multiple Sclerosis Society. 2011. (http://www.nationalmssociety.org/ms-clinical-care.../)