Multiple sclerosis is an autoimmune condition of the central nervous system in which the immune system attacks a special coating on the nerves called myelin. There are different types of this condition, one of which is relapsing-remitting multiple sclerosis.
Relapsing-remitting MS (RRMS) is the most common type of MS. About 85% of people with the disease will first receive a diagnosis of RRMS.
In this article, we look at RRMS in more detail, including its symptoms, risk factors, and treatment. We also discuss the outlook for people with this condition.
Most people who receive a diagnosis of RRMS are in their 20s and 30s at the time, although the disease can sometimes appear in children or people in their 40s and beyond.
Alternating periods of relapse and remission characterize this type of MS. Symptoms flare up during a relapse, which might last for days, weeks, or months. A relapse may have similar effects on the body each time, or it might sometimes involve new and different symptoms.
A period of remission follows a relapse. When MS enters the remission phase, a person will usually have no symptoms.
However, this may change over time as the myelin can develop further scarring with each relapse, resulting in nerve damage that does not recover during remission. This damage can lead to disabilities or other symptoms that persist outside of a relapse.
Doctors recognize RRMS by its pattern of relapse and remission.
MS symptoms are highly individual. No two people will have the same symptoms, and a person's symptoms can change over time.
Some of the most common symptoms of MS include:
- severe fatigue
- numbness and tingling in the hands and feet
- vision issues
- balance problems
- limited mobility
- difficulty concentrating
- slurred speech
- problems with bowel or bladder control
Medical researchers do not fully understand why some people get MS while others do not.
It appears that a combination of factors triggers all types of MS. Although some people have risk factors for the disease, they may never get MS. Likewise, a person with no risk factors can still develop a form of MS.
The factors that increase the risk of getting MS include:
- gender, as more women develop MS than men
- geographical location, as MS tends to occur more frequently among populations who live further from the equator
- genetics, although a person would inherit the risk of the disease rather than the disease itself
- having certain infections, such as measles, Epstein-Barr virus (EBV), and human herpesvirus 6
The treatment for RRMS will often involve a combination of:
- medications, such as muscle relaxers, pain relievers, and steroids, to treat symptoms during relapses
- physical, occupational, speech, and psychological therapy
- medications called disease-modifying therapies (DMTs) to prevent relapses or reduce their frequency
- monitoring and reinforcing a person's ability to recognize the signs of disease progression or nerve damage
There is no cure for RRMS, but many people find some relief from symptoms by following a full treatment plan.
Ocrelizumab (Ocrevus), siponimod (Mayzent), and cladribine (Mavenclad) are medications that the FDA have approved for types of MS that progress through relapses.
No single treatment plan works for everyone with the disease. A doctor will tailor a medication and therapy regimen to suit a person's lifestyle, symptoms, and overall health status.
Lifestyle changes alone may not be sufficient to alleviate RRMS symptoms, but adopting some healthful habits can help people with the disease feel better and be more active.
These can work well in conjunction with medication, therapy, and other treatments.
Food and diet
The National MS Society do not advocate any specific diet for people with MS.
However, they note that following a healthful diet that contains a high proportion of fruits and vegetables and few processed foods can help boost energy levels and overall health.
A healthful diet may also help reduce inflammation, a key factor in RRMS.
Physical activity is important for people with MS. Gentle aerobic exercise, such as walking or swimming, can improve mood, fight fatigue, and increase strength. It can also help with bowel and bladder problems, which are common in those with RRMS.
Stretching and flexibility exercises can help reduce stiffness and make it easier for a person to move. Those with RRMS should ask their doctor or physical therapist to recommend exercises that can support recovery during a relapse.
People can try using relaxation, deep breathing, meditation, and guided imagery to reduce stress and feel better emotionally and physically.
RRMS is not a fatal disease, and with proper medical care, many people with RRMS can lead long, active lives.
However, the condition can pose both physical and emotional hurdles for the person and their loved ones. It can negatively affect a person's quality of life and cause various disabilities, especially later in its progression.
Taking medications in line with the doctor's suggestions, attending physical or psychological therapy sessions, and adopting a healthful lifestyle can make a considerable difference to the quality of life of people with this condition.
Secondary progressive MS
Many people with RRMS will go on to develop secondary progressive MS (SPMS) later in life.
SPMS typically does not have defined periods of relapse and remission. Instead, the symptoms gradually get worse and may become constant.
Only people who have already had RRMS can develop SPMS.
Some people with SPMS still have relapses, but they are usually less well-defined and fewer in number. Symptoms often persist even after the end of a relapse.
Is RRMS the most harmful type of MS?
The symptoms of MS vary greatly from person to person, but the medical community generally associates SPMS with more significant disability, particularly due to the lack of distinct periods of relapse.Seunggu Han, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.