There are different stages of multiple sclerosis (MS). When you have relapsing-remitting MS (RRMS), you usually have flare-ups -- or relapses -- which are periods when symptoms are new or tend to get worse. In between those flare-ups, things usually get better.
In most cases, RRMS eventually will turn into secondary progressive MS (SPMS). In this stage, you might still have relapses between attacks. But you have fewer breaks between those flare-ups. Your symptoms usually get worse, too.
Why RRMS becomes SPMS
We're not sure why people advance from RRMS to SPMS.
Some researchers think it's because of a nerve injury that happened early in the disease that starts to show up. That injury, they believe, causes nerve fibers to disappear, which they think triggers the disease to progress.
Treatment seems to have some impact on how your MS advances, but it won't stop it.
If RRMS isn't treated, half of people who have it will get SPMS within a year after they learn they have it. About 90% of those with RRMS will get SPMS within 25 years.
Watching It Happen
It's hard to tell that RRMS becomes SPMS because the symptoms of both are largely the same.
You may have more:
- Fatigue, memory loss, and problems thinking
- Tight, stiff muscles
- Bowel and bladder problems
- Walking and coordination issues
- Double vision
Your doctor can diagnose SPMS by comparing your symptoms over time and by taking note of how much time you have between flare-ups.
Your doctor may also give you a neurological exam or an MRI. Those are tests used for all stages of MS, but they can't confirm that the disease has advanced.
Is It a Relapse?
Sometimes you might wonder if you’re just having a flare-up. If you’re still having periods where your symptoms get better then get worse, it can be hard to tell if what you’re feeling is a relapse instead of a move to SPMS.
That's why your doctor will look at your symptoms and your relapse history. And that's why it's so important to tell your doctor about all your symptoms and problems. They become part of your medical history.
Living With the Transition
There are medications that can ease some SPMS symptoms. But mentally, it can be hard to come to terms with the fact that your MS is getting worse.
It's also important to focus on doing activities that you enjoy. You may want to try meditation or other types of self-care that make you feel good, too.
And remember, you're never alone. Find a support group of friends, family, or other people with MS to talk to about how you feel.