Working With Your Doctor to Manage MS Progression

Medically Reviewed by Michael W. Smith, MD on December 30, 2020

Multiple sclerosis (MS) is a disease that's hard to predict. You might feel fine for a while without flare-ups of symptoms, called relapses. Or you may have frequent relapses, when your symptoms get worse. In time, your MS can change to the progressive form. That's when damage to your brain and spinal cord increases gradually but steadily.

Having MS doesn't mean you'll end up disabled. Thanks to new treatments, it now takes longer for the disease to progress.

If you go to all of your scheduled visits and follow your treatment plan, you can slow your disease and keep your symptoms under good control for a long time. Your doctor and the rest of your medical team are the partners who will help you manage your MS.

How to Know When MS Progresses

Early in your disease you'll have relapses. These are periods when you get symptoms like numbness, tingling, and vision loss. The problems should go away or improve once the relapse ends.

As MS progresses, relapses might come more often. Your symptoms will stick with you or get worse instead of going away.

Symptoms of MS progression include:

  • Pain
  • Trouble walking
  • Vision problems
  • Muscle weakness
  • Numbness
  • Problems with balance

Let your doctor know about any new symptoms or old ones that have gotten worse. You may need to discuss a treatment change.

What Tests to Expect

Your doctor will do one or more tests to look for signs that your MS has progressed. These tests can also show how well you're responding to treatment.

MRI. It uses powerful magnets and radio waves to make pictures of your brain. An MRI can show new areas of swelling and damage called lesions. These are signs that your MS has progressed. Your doctor may give you a contrast dye before the scan to make the lesions show up more clearly on the image.

Neurologic exam. This test checks the health of your brain, spinal cord, and nerves. Your doctor might ask you to walk, move your arms and legs, and answer questions to review your coordination, reflexes, strength, balance, and mental status. This can show your doctor whether you've had any nerve damage.

Treatments to Slow MS

The medicines you take to treat MS are called disease-modifying drugs because they change the course of your disease. These medications slow the attack on your nervous system by the immune system -- your body's defense against germs. They can help curb the number of relapses you get and the amount of new damage and inflammation in your brain and spinal cord.

MS treatments work best when you start on them early and you keep up with them. Don't stop taking your medicine until you check with your doctor. If you have side effects, ask your doctor what to do. And if your treatment stops working, see if your doctor can switch you to a different medicine.

What to Tell Your Doctor

Because you'll live with MS for many years and will need regular care, you want to find a doctor you trust. Once you do find someone you're comfortable with, be open and honest about how you feel. Don't be afraid to discuss sensitive issues like bladder or sexual problems. Your doctor can only help you when they know what's going on.

Come prepared for each appointment. Bring a list of the symptoms you've had and any questions you'd like to ask your doctor. List the most important questions first. You may not have enough time to cover everything during your visit.

Also bring a list of all the medicines you take. Include supplements and drugs you bought without a prescription. Go over these with your doctor to make sure none of the medicines you take interacts with each other or causes side effects.

MS may not be the only disease in your life. Let your doctor know about every other health problem you have. Heart disease, diabetes, lung disease, and depression can all make your MS progress more quickly. You may need to see other specialists to treat these conditions.

Questions to Ask Your Doctor

Here are a few questions to ask during your visits:

  • Has my MS progressed?
  • Do I need to change to a new treatment?
  • What treatment do you recommend?
  • How will it help me?
  • How much should I take?
  • For how long should I take it?
  • What side effects can it cause?
  • What should I do if my MS doesn't improve while I'm on this treatment?

If you don't understand any of the answers, ask your doctor to explain it in more detail.

WebMD Medical Reference



Mayo Clinic: "Multiple sclerosis: Symptoms & causes."

MS Focus Magazine: "5 Things to Know About MRIs and MS."

MS Trust: "Relapsing Remitting MS."

Multiple Sclerosis Association of America: "Part I: Understanding Progression in MS," "Understanding Progression in MS." "Progression."

National MS Society: "Disease-Modifying Therapies for MS," "Make the Most of Your Healthcare Provider Visits," "Managing Progressive MS."

NHS: "Diagnosis – Multiple Sclerosis."

Stanford Healthcare: "Neurological Exam."

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