RRMS – Relapsing Remitting Multiple Sclerosis

What is relapsing remitting MS (RRMS)?

Relapsing remitting MS is the most common form of multiple sclerosis, with between 65% and 70% of people with MS being diagnosed with this type. It is a pattern of new and old symptoms getting worse (relapses) followed by recovery (remission).

In MS, a relapse is the appearance of new symptoms or the aggravation of old ones, lasting at least twenty-four hours (synonymous with attack, relapse, flare-up, or worsening).

The remission period is when you have no new MS symptoms but you may still experience flare-ups of old symptoms, particularly if you have an infection or a period of stress. 

Relapsing remitting MS timeline

As you can see from our diagram, the path of RRMS can be a changeable one. You can see that with RRMS a person often experiences an initial attack of aggressive symptoms and then good or complete recovery. You might then have remission with months or years with no symptoms.

Relapses tend to become less frequent over the years, with less and less recovery after each relapse. This of course, is not the case for everyone. 

It was previously thought that up to 66% of people with RRMS develop Secondary Progressive MS after 25 years, although this figure is falling as our understanding of the condition, and treatments, improve.

Different type of RRMS

• Benign MS

• Clinically isolated syndrome

• Rapidly evolving severe RRMS (see Types of MS) 

How is relapsing remitting MS diagnosed?

RRMS can be diagnosed at any age, but as age increases other conditions can present with similar symptoms. This crossover makes diagnosing any form of MS a potentially complex process.

Like all other types of MS, RRMS is diagnosed using the McDonald criteria, which looks closely at damage to the central nervous system and advocates MRI scans for all patients.  The criteria aims to reach a diagnosis as quickly as possible, so that you can have swift access to the right treatment.

When does RRMS become secondary progressive MS?

Over time, some people with RRMS transition to secondary progressive MS (SPMS).

This happens when there is a gradual worsening of symptoms and disability over time, independent of relapses.

Key signs of transition may include:

• Fewer or no relapses
• Increasing difficulty with mobility
• Symptoms steadily worsening rather than improving after episodes

There is no single test to confirm this change — it is usually identified by neurologists based on patterns over time.

It’s important to emphasise:

• This transition often happens slowly
• Treatments are improving and may delay progression
• Not everyone with RRMS will develop SPMS

What is the difference between relapsing and progressive MS?

Understanding this distinction helps reduce confusion and anxiety.

Relapsing MS (e.g. RRMS)

• Symptoms come and go (relapses and remissions)
• Clear episodes of inflammation
• Periods of stability or recovery

Progressive MS (e.g. SPMS or primary progressive MS)

• Symptoms gradually worsen over time
• Less obvious “attacks”
• Disability accumulates more steadily

Treatment for RRMS

Every person’s course is different with RRMS — the symptoms, number of relapses, and the severity and frequency. The unpredictability can make you feel at a loss as to what to do, but there are many ways of taking back control. 

Living with RRMS can feel unpredictable, especially when dealing with relapses. But many people manage their condition successfully with the right combination of treatment, lifestyle support, and self-awareness.

Understanding your symptoms and knowing when to seek help can make a significant difference in maintaining quality of life.

Proactive treatment includes:

• Physiotherapy and occupational therapy after a relapse
• Healthy eating
• Exercise
• Relaxation techniques such as meditation
• Sunlight and vitamin D supplements
• Talking to others with MS who understand what it is like

The Overcoming MS Program combines all of the treatments above for an all-encompassing approach.