If you or your loved one has been diagnosed with Multiple Sclerosis (MS), you’ll likely think of it as a condition that sometimes flares up and then (hopefully) quietens. Because this is the form of MS with which people are most commonly diagnosed, it’s often (and very easily) thought of as a continual cycle which will keep following this pattern1. In fact, MS changes over time, with symptoms appearing in different ways.
Each person’s MS journey is unique, and that isn’t just because of the types of symptoms that can appear, but also because there are 3 different types of MS. All types of MS across the spectrum come with potentially differing symptoms but also different ways of progressing.
The type of MS you have is usually determined by your:
⦁ Pattern of relapses (flare-ups or exacerbations of MS symptoms that can last a few days, weeks, or even months).
⦁ Rate of disability progression (the speed with which physical or cognitive tasks become more difficult over time).
Most people are diagnosed with RRMS, which is the flare-based phase of MS. However, being initially diagnosed with RRMS doesn’t mean that the categorization won’t change over time and that it won’t move into the next phase of the disease. It’s easiest to think of MS as a spectrum which people often move along throughout their life, and many will, over time, transition to SPMS.
This change from RRMS to SPMS means a gradual transition to symptoms that are potentially getting worse and that can last even between relapses. It may also mean increased disability, such as difficulty walking or fatigue-related problem. SPMS is also associated with increased cognitive problems such as short-term memory issues or difficulty concentrating.
The science behind the symptoms
So, we now know that there are three different phases of MS. But what’s actually happening inside the body?
Spotting changes in symptoms
Changes to multiple sclerosis (MS) symptoms can be subtle and over a long period of time, so may go unnoticed if you aren’t specifically looking out for them. Your symptoms may become more challenging and, while it might seem strange, you may even experience fewer relapses—not more. Experiencing fewer relapses can be a sign that your MS is changing and potentially transitioning to another phase of the disease. It’s important to look out for changes in symptoms because different phases of MS require different treatments13. By monitoring changes and communicating anything unusual to your neurologist or nurse, you can get ahead of MS progression, working with them to find the right treatment, before small changes become big ones.