SECTION A: Understanding Relapsing Remitting Multiple Sclerosis

RRMS is the main type of Multiple Sclerosis (MS). MS is a life-long condition caused by a person’s immune system attacking their central nervous system, including the nerve cells and myelin sheaths protecting nerve fibres. When attacked the sheaths and nerves can become swollen and damaged. This damage can slow down or stop the signals travelling along the nerves in the brain and spinal cord.

Changes to these signals means different parts of the body can stop working.

People get symptoms when these signals do not work as usual, such as blurred vision, numbness, pain, fuzzy thinking, extreme tiredness, weakness and poor balance.

People with RRMS get immune system attacks called relapses or episodes. The symptoms people get with RRMS depend on which nerves are damaged and which signals are changed. The symptoms can last days, weeks, months, or never go away. Some symptoms can come back, or new symptoms appear. Relapsing and remitting means the symptoms people get from the immune system attacks come and go, and fluctuate over time. About 85% (85 out of 100) of people with MS have RRMS [13, 18-21].

RRMS symptoms affect people’s health in two ways:

• Symptoms that happen often like pins and needles, numbness or bladder problems. Some people may take over-the-counter treatments to cope with these symptoms. These symptoms are not relapses.
• A part of the body suddenly stops working as well as it did. For example, a person may experience worse vision in an eye, less grip in their hand or unsteadiness when walking, over a few days or weeks. MS professionals call these symptoms a relapse. Some relapses may be treated with a course of steroid medications; some people may be left with a long-term disability.

People cannot tell when a relapse will happen, how long it will last, and how many relapses will happen in a year. For many people, their RRMS will get worse over time and may change to Secondary Progressive Multiple Sclerosis (SPMS). SPMS means symptoms are less likely to go away and people are more likely to be left with a disability.

Medications known as Disease Modification Treatments (DMTs) slow down MS activity , and make it more likely people with RRMS have fewer relapses and live longer without disability[16-26].

People manage their RRMS, relapses and other symptoms with support from health professionals, who know about illnesses caused by damage to the nervous system such as the brain and spinal cord. A neurologist is the name given to doctors who treat people with nerve damage. Specialist MS teams include neurologists, nurses, pharmacists, physiotherapists, occupational therapists, psychologists and others who deliver care, and help people get on with their lives.

Community health professionals such as general practitioners (GPs), community nurses and pharmacists give advice about treatments to manage people’s daily symptoms.

Treatment decisions can be difficult to make because of the way RRMS and symptoms change, the different types of RRMS medications, and changes in what people think is important to them.

The prompts in this website help people note down what is important to them when managing their RRMS.