Most people with MS are first diagnosed with relapsing-remitting MS (RRMS). In this type of MS, periods of disease activity are followed by periods of partial or complete recovery. Those periods of recovery are also known as remission.
Eventually, most people with RRMS go on to develop secondary progressive MS (SPMS). In SPMS, nerve damage and disability tend to become more advanced over time.
If you have SPMS, getting treatment may help slow the progression of the condition, limit symptoms, and delay disability. This may help you stay more active and healthier as time goes on.
Here are some questions to ask your doctor about life with SPMS.
If you have SPMS, you probably won’t go through periods of complete remission when all of the symptoms go away. But you may go through periods when the disease is more or less active.
When SPMS is more active with progression, symptoms get worse and disability increases.
When SPMS is less active without progression, symptoms may plateau for a period of time.
To limit the activity and progression of SPMS, your doctor may prescribe a disease-modifying therapy (DMT). This type of medication may help slow or prevent the development of disability.
To learn about the potential benefits and risks of taking a DMT, talk to your doctor. They can help you understand and weigh your treatment options.
SPMS can cause a wide variety of symptoms, which vary from person to person. As the condition progresses, new symptoms may develop or existing symptoms may get worse.
Potential symptoms include:
- muscle weakness
- muscle spasticity
- visual problems
- balance problems
- walking problems
- bladder problems
- bowel problems
- sexual dysfunction
- cognitive changes
- emotional changes
If you develop new or more significant symptoms, let your doctor know. Ask them if there are any changes that could be made to your treatment plan to help limit or relieve the symptoms.
To help manage symptoms of SPMS, your doctor may prescribe one or more medications.
They may also recommend lifestyle changes and rehabilitation strategies to help maintain your physical and cognitive function, quality of life, and independence.
For example, you might benefit from:
- physical therapy
- occupational therapy
- speech-language therapy
- cognitive rehabilitation
- use of an assistive device, such as a cane or walker
If you’ve been having difficulty coping with the social or emotional effects of SPMS, it’s important to seek support. Your doctor can refer you to a support group or mental health specialist for counseling.
According to the National Multiple Sclerosis Society (NMSS), more than two-thirds of people with SPMS maintain the ability to walk. Some of them find it helpful to use a cane, walker, or other assistive device.
If you can no longer walk for short or long distances, your doctor will likely encourage you to use a motorized scooter or wheelchair to get around. These devices can help you maintain your mobility and independence.
Let your doctor know if you’re finding it harder to walk or complete other daily activities as time goes on. They might prescribe medications, rehabilitation therapies, or assistive devices to help manage the condition.
To learn how your condition is progressing, you should undergo a neurologic exam at least once a year, according to the NMSS. Your doctor and you can decide how frequently to do magnetic resonance imaging (MRI) scans.
It’s also important to let your doctor know if your symptoms get worse or you’re having trouble completing activities at home or work. Likewise, you should tell your doctor if you’re finding it hard to follow your recommended treatment plan. In some cases, they might recommend changes to your treatment.
Although there’s currently no cure for SPMS, treatment can help slow the development of the condition and limit its effects on your life.
To help manage the symptoms and effects of SPMS, your doctor may prescribe one or more medications. Lifestyle changes, rehabilitative therapies, or other strategies can also potentially help you to maintain your quality of life.