Early signs of MS progression include:

  • difficulty walking
  • frequent falls or near falls
  • missing steps
  • stumbling
  • worsening memory

Other early signs may include difficulty with fine motor skills, such as buttoning a shirt or tying shoelaces.

Disease progression generally occurs 10 to 15 years after a diagnosis of relapsing remitting MS. This phase is referred to as secondary progressive MS.

Two things happen in MS that contribute to this progression. The first and more well-known is the loss of myelin, the protective coat around the axon, which is part of a nerve cell. The second event is neurodegeneration, meaning cell death.

We’re still not sure whether these two phases occur independent of one another or at the same time or even if the myelin loss itself eventually leads to cell death.

Regardless, the end result is a loss of brain cells. This process happens slowly over years until a certain number of cells is lost and progressive symptoms begin to develop.

If your symptoms are worsening, you should see your neurologist.

Progression can occur either from the underlying disease itself or from other causes. These causes may include:

  • depression
  • poor sleep
  • pain
  • orthopedic issues
  • long-term stress

It’s important to see a doctor to understand whether the worsening symptoms are from a reversible, and therefore treatable, cause.

Yes. Generally, once someone starts to notice worsening or progression of their MS symptoms, relapses tend to occur less often. Relapses are more common early on in the disease.

However, it’s still important to see your neurologist and continue therapy unless you’re told to stop, since the newer disease-modifying treatments have been shown to slow disease progression.

Yes. Many new MS therapies can be used for active secondary progressive MS.

Talk to your neurologist about switching therapies if there’s evidence of disease progression or new lesions on your MRI.

Other medications like dalfampridine (Ampyra) are used to treat different types of progressive symptoms, such as worsening gait.

See your doctor at the first sign of disease progression. If caught early, there are treatment options to help slow progression.

The National Multiple Sclerosis Society website is a great place to get ideas and resources that might make life easier for you and your loved ones.

You can also reach out to your local chapter to see if there are programs and resources nearby that are available to you.

Dr. Sharon Stoll is a board certified neurologist, multiple sclerosis specialist, and assistant professor in the department of neurology at Yale School of Medicine. She completed her neurology residency training at Thomas Jefferson University Hospital in Philadelphia, PA, and her neuroimmunology fellowship at Yale New Haven Hospital. She’s an investigator on several international multi-center clinical trials and currently serves on several advisory boards including BeCare MS Link, Forepont Capital Partners, One Touch Telehealth, and JOWMA. Dr. Stoll has received numerous awards including Top Neurologist 2019 and a Rodney Bell teaching award and is a National Multiple Sclerosis Society Clinical Fellowship grant recipient. Dr. Stoll also spent time as a medical editor at ABC news headquarters and is currently medical editor for several media sources, including Healthline.