Most people, but not everyone, with relapsing-remitting multiple sclerosis (RRMS) will eventually develop Secondary Progressive Multiple Sclerosis (SPMS). Because of advances in current treatment, fewer people go on to develop SPMS than before, and it takes longer to transition to SPMS.
Multiple Sclerosis (MS) is a progressive condition that causes the immune system to mistakenly attacks the nerve cells in the central nervous system. The most common type of MS is RRMS, which is the stage before SPMS.
With SPMS, people do not notice symptom changes as drastically. Instead, they may feel as though their symptoms never really go away and gradually worsen. Relapses can also occur, but this is less likely.
SPMS also has two sets of further classifications or modifiers:Active SPMS means a person experiences relapses or evidence of new disease activity from an MRI scan. Nonactive means there is no evidence of current activity. SPMS with progression means a person experiences Worsening symptoms over time. SPMS without progression means there is no evidence of the condition getting worse.
SPMS is a secondary stage of RRMS. People tend to spend many years with RRMS before it transitions to SPMS. However, the course of the condition is different for everyone, and it is not possible to predict this change.
The National Multiple Sclerosis Society note that before modern therapies, 50% of people with RRMS would develop SPMS within 10 years, and 90% within 25 years. However, current medication has drastically changed the way doctors treat MS. It is still too early to say how the shift to new medicines affects the progression of MS as a whole.
Weakness in the legs and chronic fatigue can indicate a transition to SPMS.
The course of SPMS can be unpredictable, and each person experiences the condition in a slightly different way.fatigue weakness or stiffness in the legs tingling or numb sensations trouble with coordination trouble thinking or remembering events depression bladder or bowels issues erectile dysfunction
The transition between RRMS and SPMS is usually gradual so that diagnosis may take some time. If a person notices their condition getting worse over time, and if they are experiencing fewer flares, the doctor may do tests to look for SPMS.
The doctor will ask about the severity and frequency of symptoms and flares. They will also perform neurological exams and repeated MRI scan to work out whether a person's condition has transitioned to SPMS.
The National Multiple Sclerosis Society note that a person should undergo neurological scans and MRI at least once a year to monitor the course of the disease. If symptoms progress very quickly, doctors may recommend these tests more often.
Treatments for SPMS include:
If these drugs no longer control symptoms correctly or sufficiently, doctors may recommend a change in therapy. Additionally, these drugs can cause side effects in some people that may be difficult to manage.
Choosing the right medication to help balance treatment effectiveness and side effects can take time and requires working directly with a doctor and following up with regular testing to monitor the effectiveness of treatment.
A number of drugs can help, depending on the types of symptoms a person is experiencing. Some drugs can relieve dizziness or bladder issues, while others may focus on treating the side effects of disease-modifying drugs.
Furthermore, most doctors will recommend the person make healthy lifestyle changes to support their body. This may include eating a healthful diet to control their weight and make them feel more vital.
Exercise may also help strengthen the body and improve range of motion in the muscles. People are usually advised to aim for exercises that raise the heart rate or help stretch and strengthen the muscles.
Some beneficial low-impact exercises include:swimming cycling walking yoga
Some may find it useful to join online communities to talk to other people with shared experiences of Multiple Sclerosis.
SPMS is a secondary stage that most people with RRMS experience eventually. There is no way of knowing if or when a person will experience this transition. Doctors may make the diagnosis by comparing older records of symptoms and test results to recent results.
Doctors may recommend several therapies to try and reduce or prevent damage to the nervous system while also controlling symptoms.