What are the early symptoms of ALS?

Published: Wednesday, May 29, 2024

The Centers for Disease Control and Prevention estimates that around 5,000 Americans are diagnosed each year with amyotrophic lateral sclerosis, or ALS. Would you be able to recognize the symptoms of ALS?

ALS is what’s known as a progressive disease, meaning it worsens over time. While there’s currently no curative treatment for the condition, there are treatments to help slow the progress of the disease.

Knowing the early symptoms of ALS can help you spot them in yourself or a loved one and seek treatment. Keep reading for a better understanding of the condition and the symptoms you should know.

Understanding ALS

ALS is a neurodegenerative disease, meaning it affects the nerve cells in the brain and spinal cord. To understand the condition, it can help to break down its name:

  • Amyotrophic comes from Greek and roughly translates to “no muscle nourishment.”
  • Lateral references the part of the spinal cord where the nerve cells that control your muscles are located.
  • Sclerosis means hardening or scarring.

The disease causes nerve cells called motor neurons to gradually degenerate and die off. Motor neurons are responsible for sending messages from the brain to the spinal cord and from the spinal cord to muscles throughout the body. When these neurons die off, the brain can no longer initiate or control muscle movements.

ALS was first discovered in 1869. You may have heard the disease called “Lou Gehrig’s disease,” though that’s not its formal name. Lou Gehrig was a famous first baseman for the New York Yankees who developed ALS and was forced to retire in 1939 because of the disease.

Who’s at risk of ALS

Any person can develop ALS at any age, but certain people are at a higher risk. Risk factors include:

  • Being between ages 55 and 75
  • Being male, though risk equals out for men and women at advanced ages
  • Being white and non-Hispanic
  • Having a family history of ALS
  • Having a genetic mutation associated with ALS
  • Having been in the military
  • Having had a brain or spinal cord injury

Researchers aren’t entirely certain why military veterans seem to be at a higher risk. They’re up to two times more likely than civilians to develop ALS, which may be related to exposure to lead, pesticides, and environmental toxins.

Signs & symptoms of ALS

When you think about your muscles, you probably think of prominent ones such as your biceps or your abs. But you have muscles throughout your body—at least 600 of them—and they’re responsible for both voluntary and involuntary movements.

As ALS causes motor neurons to die off, the brain stops sending messages to the muscles and then the muscles weaken. This can lead to symptoms throughout the body, which worsen over time.

According to the National Institute of Neurological Disorders and Stroke, early symptoms of ALS may include:

  • Difficulty chewing or swallowing
  • Muscle cramps
  • Muscle twitches in the arm, leg, shoulder, or tongue
  • Muscle weakness in an arm, leg, or the neck
  • Slurred or otherwise distorted speech
  • Spasticity, which is tight or stiff muscles

Each person experiences the onset of ALS differently, and there are two primary categories of the disease. “Limb-onset ALS” begins in the arms and legs, while “bulbar-onset ALS” begins in the tongue or affects breathing.

It’s important to note that ALS causes weakness and a breakdown in ability, but it doesn’t necessarily cause pain. Paying close attention to symptoms to notice whether pain or discomfort are among them can help with an accurate diagnosis.

As the condition progresses, muscle weakness spreads to other parts of the body, leading to a full spectrum of symptoms:

  • Constipation
  • Difficulty breathing
  • Difficulty getting enough nutrients
  • Difficulty speaking or forming words
  • Drooling
  • Unintended emotional displays such as crying or laughing

Eventually, those with ALS will be unable to stand or walk, get in or out of bed, or even breathe on their own. While most people with the disease see a degeneration to this point within five years, up to 10 percent of those diagnosed will survive for a decade or longer after initially developing symptoms of ALS.

While there’s no cure, researchers are working to uncover medication therapies that can help slow the progression of the disease. There are multiple options available today that can be helpful in slowing progress or in helping to manage symptoms.

The first step toward treatment is a diagnosis, so if you experience symptoms or notice that a loved one is having any of the symptoms above, check in with a medical provider.


Learn more

Northeast Georgia Physicians Group Neurology treats a wide range of neurological conditions, including ALS. Call 770-219-6520 or visit NGPG Neurology for more information.