Relapsing-Remitting vs. Progressive Multiple Sclerosis

When a person is diagnosed with multiple sclerosis (MS), one of the first questions that usually arises is: what type of MS do I have? There are several types, but the two most common are relapsing-remitting MS and progressive MS . 

Although both affect the central nervous system, the course of the disease is very different in each. What are those differences? Read on to find out.

Relapsing-Remitting Multiple Sclerosis (RRMS)

Relapsing-remitting multiple sclerosis ( RRMS) is the most common form of the disease, accounting for about 85% of initial diagnoses. People with RRMS experience periods of exacerbation, or flares, where symptoms worsen or new problems arise. These flares are often followed by remissions, during which symptoms may partially or completely improve.

• Flares and remissions : Flares can last from a few days to several weeks or even months. In the remission phase, the patient may feel a significant improvement or even complete disappearance of symptoms.
• Slow progression : During periods of remission, the disease does not actively progress. Although there may be some after-effects from flare-ups, many people lead relatively normal lives between episodes.

Who is more prone to RRMS?

RRMS usually appears in young people, usually between the ages of 20 and 40. Women are more likely to develop this form of MS than men, although the exact reason is not entirely clear.

How does it affect daily life?

In general, people with RRMS can have long periods without debilitating symptoms, allowing them to maintain an active life. However, the unpredictability of flare-ups can cause anxiety and difficulty planning long-term activities.

Progressive Multiple Sclerosis (Progressive MS)

Unlike RRMS, progressive MS follows a continuous course, with symptoms steadily worsening and no clear remission phases. This type of MS is subdivided into two main forms: primary progressive multiple sclerosis (PPMS) and secondary progressive multiple sclerosis (SPMS).

Primary Progressive Multiple Sclerosis (PPMS)

PPMS affects approximately 10-15% of people with MS. From the onset of the disease, symptoms gradually worsen without obvious flare-ups .

• Steady progression : There are no clear phases of remission, although in some cases there may be periods of stabilization. Symptoms worsen continuously and progressively affect mobility and other functions.
• Late onset : It usually appears in people over 40 years of age and affects men and women equally.

Secondary Progressive Multiple Sclerosis (SPMS)

In many cases, SPMS develops from relapsing-remitting multiple sclerosis. After years of flares and remissions, the disease may enter a progressive phase in which symptoms steadily worsen.

• Progression from RRMS : Many people with RRMS eventually develop SPMS, often 10 to 20 years after initial diagnosis.
• Fewer flares, more progression : At this stage, flares are less frequent, but disability accumulates more rapidly.

Key Differences Between RRMS and Progressive MS

1. Course of the Disease

• RRMS : Characterized by acute episodes of worsening symptoms, followed by periods of recovery or stabilization.
• Progressive MS : It has a more constant course, with a gradual and progressive worsening of symptoms without phases of clear remission.

2. Frequency of Outbreaks

• RRMS : Flares are common, but followed by remissions, where the person may improve or even have no symptoms for a while.
• Progressive MS : Flare-ups are rare or non-existent, and the disease progresses steadily.

3. Severity and Accumulation of Disability

• RRMS : Disability tends to accumulate over time, but in many people this happens more slowly because of periods of remission.
• Progressive MS : Disability accumulates more rapidly as the disease follows a continuous course.

4. Age of Onset

• RRMS : It is usually diagnosed between the ages of 20 and 40.
• Progressive MS : Tends to be diagnosed later, from age 40 onwards.

What Type of MS Is Most Serious?

It cannot be said that one type of MS is more “severe” than another, as severity depends on many factors, such as the speed of progression and response to treatment. However, Progressive MS tends to generate a greater accumulation of disability in a shorter period.

On the other hand, although RRMS may be less aggressive at first, some people develop Secondary Progressive MS , which can change the course of the disease in the long term.

Knowing the difference between relapsing-remitting MS and progressive MS is crucial for people living with the disease and their loved ones. Understanding how MS can progress helps you better prepare for the challenges of the future and work with your doctors to find the most appropriate treatments.

While both types have significant differences, early diagnosis and proper intervention can make a big difference in long-term quality of life. If you have more questions about MS or how it can affect your life, don’t hesitate to consult with a specialist.