Multiple sclerosis (MS) is a progressive disease of the central nervous system (CNS) that affects your brain and the spinal cord. According to the National MS Society, about 1 million people over the age of 18 live with this condition in the United States.
MS is an autoimmune disease in which the immune system attacks the CNS. This triggers inflammation and damages myelin, an insulating material that surrounds nerve fibers. The exact mechanism of how someone gets the disease is unknown. However, we do know that there is likely a combination of triggers including genetic and environmental factors.
Damage to these fibers can trigger multiple neurological symptoms. This includes fatigue, numbness, weakness, cognitive problems, and issues with walking.
The severity of your symptoms varies from person-to-person, and depends on the type of MS you have. Many people are initially diagnosed with relapsing-remitting multiple sclerosis (RRMS). But over time, symptoms can progress to another type of MS, known as secondary progressive multiple sclerosis (SPMS).
Here’s what you need to know about both types of MS.
RRMS refers to a type of MS in which you experience periods of new MS symptoms or relapses followed by periods of remission. Remission is when symptoms improve or disappear.
During relapses, you may have new typical MS symptoms like numbness, tingling, and blurred vision. These symptoms can lasts for days, weeks, or months, and then slowly improve over weeks to months.
Some people experience complete disappearance of their symptoms during remission. On the other hand, if your symptoms continue, they may not be as severe.
About 85 percent of people with MS receive an RRMS diagnosis at first.
Many people experience progression of their symptoms after living with RRMS for some time. This means that the disease becomes more active, and periods of remission become less and less frequent.
This stage of MS is known as secondary progressive multiple sclerosis or SPMS. This condition is best described as MS without relapses.
MS affects everyone differently, and not everyone with RRMS will transition to SPMS. But SPMS only develops after an initial diagnosis of RRMS.
You’ll have typical MS symptoms during the transition from RRMS to SPMS, but you may experience a slow worsening of symptoms. You may even develop new symptoms.
Before, maybe you had numbness or mild weakness, and these didn’t interfere much with your daily life. Once you transition to SPMS, though, you may notice cognitive changes, such as difficulty finding words. You may also have increased difficulty with walking or more noticeable numbness and tingling.
The cause of this transition is unknown, but it may have to do with the disappearance of nerve fibers as the result of progressive nerve damage. Or it may be connected to the progressive loss of grey matter, which can be more subtle.
Some people transition soon after an MS diagnosis, whereas others live with RRMS for decades before transitioning to SPMS.
Since MS symptoms are unpredictable, it can be difficult to distinguish an RRMS relapse from the onset of SPMS.
Speak with your doctor if you feel that you’re experiencing new or worsening symptoms. Your doctor can use an imaging test like an MRI to examine inflammation in your brain.
Based on the level of inflammation in your brain as well as your relapse history, your doctor can determine whether your symptoms are a new relapse or SPMS.
Even though some people with RRMS eventually transition to SPMS, it’s possible to delay disease progression.
Treating MS is key to improving your symptoms and quality of life, and ultimately, slowing down the disease. Your doctor can prescribe disease-modifying therapies to help decrease inflammation, which can also improve the severity and frequency of your attacks.
These include injectable, oral, and infusion medications such as:
- dimethyl fumarate (Tecfidera)
- fingolimod (Gilenya)
- natalizumab (Tysabri)
- siponimod (Mayzent)
- glatiramer acetate (Copaxone)
- ocrelizumab (Ocrevus)
- teriflunomide (Aubagio)
These treatments and others can help with the relapsing forms of MS. Talk to your doctor to find out which one is best for you.
You may also receive intravenous corticosteroids to reduce acute inflammation in your CNS. This helps speed up recovery from an MS relapse.
MS is a progressive condition that can lead to disability. You may eventually require some type of rehabilitation to help with daily living.
Programs vary based on your needs. If you’re having difficulty with speech or swallowing, you may receive assistance from a speech or language pathologist. Or you may need appointments with an occupational therapist if you’re having difficulty with personal care, housework, or employment.
Lifestyle changes can help improve your symptoms, too. Regular exercise may reduce spasticity and joint stiffness. It can improve both your flexibility and your overall health. Plus, exercise increases the brain’s production of endorphins, which are hormones that help regulate your emotions and mood.
To avoid injury, start slow with gentle activities like water aerobics or walking. It’s also important to stretch both before and after activity to reduce muscle spasms, which are common in MS. Learn how to pace yourself and set limits.
Additionally, you’ll want to avoid foods that can increase inflammation. These include highly processed foods such as hamburgers and hot dogs and foods high in salt. Examples of foods that can reduce inflammation are whole foods such as green leafy vegetables, fish high in omega-3s, and fruits such as blackberries and raspberries.
If you smoke, talk to your doctor about ways to quit.
Some people feel better after confiding in a close friend or family member, or after joining a support group for MS.
MS is a serious condition, but early treatment can help you achieve remission and slow the progression of the disease. Worsening of symptoms can also interfere with the quality of your life. Talk with your doctor if you develop any new symptoms or signs of advancing MS.