Relapsing-remitting multiple sclerosis: Symptoms, treatment, and outlook
A healthy immune system is designed to attack invaders, such as viruses, bacteria, and fungi. With multiple sclerosis (MS), the immune system attacks something it shouldn't - a special coating on the nerves known as myelin.
In MS, inflammation causes damage to the myelin and this damage interrupts or confuses messages to and from the brain.
What is relapsing-remitting MS?
People can have one of several different types of MS. The way the symptoms occur determines what type of MS a person may have.
Numbness or tingling of the hands can be a symptom of multiple sclerosis.
The most common type of MS is known as relapsing-remitting MS (RRMS). About 85 percent of people with the disease will first be diagnosed with RRMS.
This type of MS is most often diagnosed in people who are in their 20s and 30s, though it can occur in children or people in their 40s and beyond. Autoimmune diseases, including MS, occur most often in women. RRMS, in particular, may be 2 to 3 times more common in women than men.
RRMS is characterized by periods of relapses when symptoms, which may be mild to severe, flare. The symptoms during a relapse may last a few days, weeks, or months. They may be the same ones a person has had in the past, or they can be new symptoms.
A relapse is followed by a period of remission, when symptoms go away.
When the MS goes into the remission phase, a person will usually have no symptoms of MS. But, over time, increasing damage to the myelin can cause problems even during remission.
The myelin may become more scarred with each relapse, resulting in nerve damage that doesn't go away. This can result in disabilities or other symptoms when a person isn't having a relapse.
Symptoms of MS
MS symptoms are very individual. No two people will have the same symptoms, and even the same person's symptoms can change over time. Some of the most common symptoms of MS include:
- Severe fatigue
- Numbness and tingling in hands and feet
- Vision problems
- Balance problems
- Trouble with moving or mobility
- Difficulty concentrating
- Slurred speech
- Problems with bowel or bladder control
Treatment for RRMS involves several areas:
- Medication to treat symptoms during relapses, such as muscle relaxers, pain relievers, and steroids to reduce inflammation
- Physical and emotional therapy
- Medications to prevent relapses or reduce their frequency
- Tracking a person's ability to think to look for signs of disease progression or damage to nerves
There is no cure for RRMS, but many people find some degree of relief with a full treatment plan. There is no single treatment plan that works for everyone. A person's medications and therapies depend on their individual symptoms, lifestyle, and health status.
Lifestyle tips for those with RRMS
A healthful, low-fat diet with fish oil supplements may be recommended to reduce inflammation for people with MS.
Lifestyle changes alone may not be enough for relief from RRMS symptoms, but adopting some healthy 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 does not advocate any specific diet for people with MS. However, following a healthful diet that includes plenty of fruits and vegetables and little to no processed foods can help boost energy levels and overall health.
A healthful diet may also help reduce inflammation, a key factor in RRMS. A study in Prostaglandins, Leukotrienes, and Essential Fatty Acids suggests that a low-fat diet supplemented with fish oil or olive oil may be beneficial for those with MS.
Physical activity is important for people with MS. Aerobic exercise such as walking 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 reduced stiffness and make it easier to move. Those with RRMS should ask their doctor or physical therapist for exercise recommendations.
Though stress alone has not been shown to trigger MS, there appears to be a link between stress and MS activity in the brain.
Using relaxation, deep breathing, meditation, and guided imagery are just a few of the ways people can reduce stress and feel better emotionally and physically.
Physical therapy alongside some lifestyle changes may help a person with MS lead a long life.
RRMS can pose both physical and emotional hurdles for the affected person and their family. With proper medical care, many people with RRMS can lead long, active lives.
Taking medications as prescribed, attending physical or psychological therapy sessions, and following lifestyle changes can make a considerable difference in the lives of those who face this often challenging 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 relapses and remission. Instead, the symptoms gradually get worse and may be present all the time.
Only people who have already had RRMS can develop SPMS.
Some people with SPMS will still have relapses, but they are usually less clear and fewer in number. Symptoms often remain even after a relapse ends.
Experts don't know why some people get MS and others do not. There appears to be a combination of factors that trigger all types of MS. Though some people have risk factors for the disease, they may never get MS. Likewise, a person with no risk factors can still get it.
The factors that are believed to increase the risk of getting MS include gender, living in a colder climate, ethnicity, genetics, and having certain infections.
MS is not considered a fatal disease. Most people with MS have a long life expectancy. However, MS can affect quality of life and cause various disabilities, especially as it progresses.