Multiple sclerosis is not just a single ailment. In fact, there are so many variables in the way that the disease strikes and affects patients that it’s been divided into four broad types of the condition in order to better categorize and treat it to the best a doctor can.
While there are no cures for MS, there are ways to manage it better, and because the most common – and earliest diagnosed – type of MS is relapsing-remitting multiple sclerosis, this is where the main emphasis on understanding, diagnosing and treating is currently focused. What is RRMS? How does it differ from other types of multiple sclerosis?
What is relapsing-remitting multiple sclerosis?
The facts are clear that the most common type of MS diagnosed by far is RRMS. With the majority of patients gaining this diagnosis first, even if they progress to another form of multiple sclerosis later in life (such as secondary progressive MS), there are a lot of factors to consider in both diagnosing and dealing with RRMS.
Patients who initially experience problems that cause them to see a doctor and get diagnosed first have some or all of the following:
- Weak muscles, especially in the legs, and/or chronic fatigue
- Pain or sharp spasms, especially shooting through the legs
- Dizziness or difficulty keeping their balance when first standing up
- Sudden and urgent needs to urinate frequently
- Stiffness of the legs and muscles
- Difficulty concentrating, staying clear minded, or with depression
How do symptoms in relapsing-remitting multiple sclerosis appear?
This part is difficult to define because each individual is unique, and that means that an autoimmune disease, like multiple sclerosis, is unique to the patient. However, as a general rule, whatever symptoms are experience are intermittent. That’s why it’s called relapsing-remitting MS. The timing may vary, but typically, it goes like this:
- The symptoms will be experience – stiffness, pain, etc. – for a certain period of time lasting at least 24 hours, likely longer (days or weeks). This is called a relapse.
- Symptoms will begin to fade over some time, and the patient will reach the “status quo”, or the same level of health and wellbeing before the relapse. This is called a remission.
- Remissions will normally last at least thirty days and could last far longer, depending on the patient and severity of the symptoms and the disease itself. If a relapse occurs prior to that, it could be what is called pseudo-exacerbation. This is when it feels as though a relapse is occurring but some external factor has only caused irritation that resulted in some form of inflammation, creating symptoms of a relapse. For example, excess heat from too much time spent outdoors could cause this.
- A true relapse can occur thirty days after remission begins, or may be weeks, months, or even years away.
What causes multiple sclerosis?
Doctors and scientists have not discovered the reason for the autoimmune response that causes multiple sclerosis, but they have identified that it’s an immune response where the myelin – a substance that coats and protects the nerves found in the spinal cord and the brain – is attacked. This leads to inflammation in all affected areas, which also suffer nerve damage. Both of these conditions lead to the symptoms of relapsing-remitting multiple sclerosis.
Having a conversation with the doctor is the first step in the process of being diagnosed with RRMS. Going over medical history and potential symptoms could give clues to other possibilities. From there, the physician will choose from a battery of tests that can be run, including an MRI to see if there’s damage or inflammation to the brain and spinal cord, blood tests to eliminate other possible conditions, and a lumbar puncture to test the spinal fluid for presence of the antibodies formed in a patient with MS to attack the myelin.
Can relapsing-remitting multiple sclerosis be treated?
There is no cure for multiple sclerosis. However, RRMS has several treatment and management options available. Unlike other types of MS, RRMS has the opportunity to change the course of the disease, even slowing advancement into secondary progression MS.
The trifecta of care involves:
- Healthy living and eating habits
- Physical, occupational, speech, and other therapies
- Medications and disease modifying drugs
Maintaining a healthy, active lifestyle is crucial to reducing relapses of MS. In terms of eating right, a nutritious diet, including correct portions, and maintaining a healthy weight that doesn’t put excess pressure on the spine are crucial. Eat foods that boost your mood and energy levels to help stay active.
Physical activity is essential to health when dealing with RRMS. Start small, and choose exercise that doesn’t lead to overheating. Short five or ten minute activities once or twice a day are huge helps. Try walking, swimming, strength exercises, and stretching, all of which can help reduce the chance of inflammation.
Therapy for relapsing-remitting multiple sclerosis
To help with speech loss or difficulty with the throat, speech therapy can help. More to the point, physical and occupational therapy are often recommended to help assure the patient has a commitment to movement and remaining loose and not letting symptoms control life. In addition, physical and occupational therapies can assist with movement and strategies that can be employed long term when new symptoms arise.
Medications for relapsing-remitting multiple sclerosis
DMD’s, or disease modifying drugs, are used to “tweak” the immune system, which will reduce the number of antibodies produced to attack myelin. This type of therapy, while helping to reduce the occurrence of relapses and slow the progression of the disease, have side effects and can also weaken the immune system to other unwelcome substances so much be monitored by a physician.
During a flare up, or relapse, may be treated with steroids. A steroid is excellent for reducing inflammation and, thereby, can help shorten the relapse so that remission comes sooner and lasts longer. However, there are also some negative side effects to steroids as well, so typically, a doctor will only prescribe them for the appearance of the most severe symptoms in a case of RRMS.
Some of the other major symptoms doctors can treat in MS include depression (using medications for anxiety, depression, or bipolar disorder), pain (with anything from muscle relaxers to opioids), and fatigue (with drugs that help fight for additional energy rather than tiredness and weakness).
Relapsing-remitting multiple sclerosis is nothing to balk at. It is a serious ailment that is difficult to care for, expressly knowing that there is no cure or permanent suppression of the symptoms. One of the best ways to manage the disease is to assure the correct, healthy diet and continue to be as active as possible in order to normalize body function. When symptoms flare up, there are treatments and options to help keep them from becoming debilitating, so there those who suffer from RRMS don’t have to suffer.