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Overcoming MS pattern

Relapsing Remitting (RRMS)

This is the most common form of MS — about 65-70% of people with MS are diagnosed with relapsing remitting MS (RRMS). It helps to know more about RRMS to understand how to manage it — by making some lifestyle changes, there is no reason why you can’t continue to live out your hopes and dreams.

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. 

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

RRMS Symptoms

Symptoms vary, depending on where lesions occur in the brain or spinal cord.

‘Relapsing-remitting’ is actually a misnomer, as damage can continue between attacks during periods of so-called remission, unless the disease is stabilized. This may be visible on MRI scans, and reflects the “iceberg phenomenon” associated with MS. The clinical symptoms don’t always give the complete picture, with often as many as 10 new lesions for each relapse.

Common symptoms of RRMS include:

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.

What happens after relapsing remitting MS diagnosis?

After being diagnosed with MS you are likely to experience many feelings, ranging from relief to disbelief. It’s important to give yourself time to process these and to assess your treatment options. Your individual symptoms will determine exactly what happens after diagnosis, but at an early stage there may be certain administrative tasks you need to carry out. These may include notifying the relevant driver licensing authority or informing your employer.

Here at Overcoming MS we are here to give you support whenever you need it. If you are struggling to come to terms with a diagnosis, we would advise speaking to your GP as early as possible, as they may be able to refer you for counselling or to other services in your area, helping you to adjust and come to terms with your diagnosis.


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. You can often improve your symptoms by making some lifestyle changes with determination and support. This can also help to slow progression.

Medications are designed to reduce relapse rates and some slow disease progression.

Relapsing remitting medication can include

  • Steroids – during acute relapses 

  • Ocrelizumab (which is a recent drug to be prescribed — there are always others in the pipeline)

  • Other drugs including injections, intravenous infusion, or tablets

Proactive treatment includes

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