Relapsing-remitting multiple sclerosis is a type of multiple sclerosis in which you experience relapses of the disease with periods of remission occurring in between.

Relapsing-remitting multiple sclerosis (RRMS) is the most common type of multiple sclerosis (MS), making up about 85% of diagnoses.

RRMS involves periods known as relapses, during which symptoms worsen, followed by periods of symptom stability, which are known as remission. During MS relapses, new symptoms may appear and existing symptoms may worsen. During remission, new symptoms typically resolve or improve.

MS is a chronic, progressive condition of the central nervous system (CNS) in which your immune system attacks myelin, the protective layer around nerve fibers. When myelin is damaged, nerves become inflamed, making it difficult for your brain to communicate with the rest of your body.

Continue reading to learn how RRMS compares with the other types of MS, what symptoms it may cause, and how it’s treated.

There are four types of MS. Let’s briefly explore each one and how it relates to RRMS.

Clinically isolated syndrome (CIS)

CIS may be an isolated incident or the first occurrence of a neurological condition. While the symptoms are characteristic of MS, the condition doesn’t meet the diagnostic criteria for MS unless it recurs.

RRMS

RRMS is marked by relapses of new or worsened symptoms separated by periods of remission, during which symptoms go away completely or improve.

However, people with RRMS may experience increasing disability over time. RRMS may also progress to secondary progressive MS.

Primary progressive MS (PPMS)

In PPMS, symptoms get progressively worse from the onset of the disease. There are no periods of complete remission.

Secondary progressive MS (SPMS)

SPMS follows an initial pattern of relapses and remissions and then gets progressively worse. RRMS can eventually transition to SPMS.

RRMS involves defined relapses of new or worsening MS symptoms. These relapses can last for days or months until symptoms slowly improve, with or without treatment.

The symptoms of MS vary from person to person but may include:

Between RRMS relapses, you will experience periods of remission with no clinical evidence of disease progression. Sometimes these remission periods can last for years.

In RRMS, your immune system attacks myelin, a layer of tissue that insulates and protects your nerves. These attacks affect the function of the nerves, and the resulting damage causes MS symptoms.

The exact cause of RRMS and other types of MS is currently unknown. A combination of genetic and environmental factors, such as smoking, vitamin D deficiency, and certain viral infections, may increase the risk.

There are no specific diagnostic tests for RRMS. However, scientists are hard at work to develop tests that identify specific markers associated with MS. Neurologists currently diagnose MS through multiple tests that also rule out conditions other than MS that could be causing your symptoms.

Typically, a doctor will start the diagnostic process by taking your medical history and performing a thorough physical examination.

They may also use tests such as:

  • MRI: This imaging test can help healthcare professionals find demyelinating lesions on your brain and spinal cord.
  • Blood tests: The results of blood tests can help rule out other conditions that may be causing your symptoms.
  • Lumbar puncture: Also called a spinal tap, this procedure involves collecting a sample of cerebrospinal fluid. Healthcare professionals can use this sample to look for immunoglobulins associated with MS or to rule out other causes of your symptoms.
  • Visual evoked potential tests: These tests involve using electrodes to collect information about the electrical signals from your brain that your nerves make when reacting to a visual stimulus.

A diagnosis of RRMS is based on the pattern of your symptoms and the presence of lesions in multiple areas of your nervous system.

Concrete patterns of relapses and remissions indicate RRMS. Symptoms that steadily get worse from the onset of the condition indicate a progressive form of MS.

There’s no cure for MS yet, but treatment can help manage symptoms, treat relapses, and slow the progression of the disease.

A variety of medications and therapies are available. For example, medications can help treat symptoms such as fatigue and muscle stiffness. A physical therapist can help with mobility issues or muscle weakness.

Relapses are often treated with medications called corticosteroids, which help reduce inflammation. If your relapse symptoms are severe or don’t respond to corticosteroids, a treatment called plasma exchange (plasmapheresis) may be used.

Medications called disease-modifying drugs can help limit the number of relapses you experience and slow the formation of additional MS lesions.

Medications to treat RRMS

There are many disease-modifying drugs for RRMS. They can come in oral, injectable, or intravenous (IV) form. They include:

Some of these medications can have side effects. A doctor typically works with you to select a therapy that takes into account how long you’ve had MS, how severe your disease is, and any underlying health conditions you have.

Your doctor will usually monitor your condition at regular intervals. If your symptoms are worsening or your MRIs show progression of lesions, your doctor may recommend trying a different treatment strategy.

The outlook for RRMS varies from person to person. The condition may progress quickly in some people, while in others may remain stable for years.

Tissue damage from RRMS can add up over time. In one study published in 2012, researchers found that 62% of people with RRMS transitioned to SPMS by 75 years of age.

On average, this transition can occur after about 15 years. However, according to the National MS Society, it is still too early to show the effects of newer disease-modifying therapies. It’s possible that the percentage may become lower as time passes and researchers have access to more long-term data.

In SPMS, symptoms gradually worsen without the presence of obvious attacks. One 2016 study that included almost 800 people with RRMS found that progression to SPMS was an important factor in predicting more severe disability.

Most people with MS have a typical life expectancy.

Tips for living with RRMS

These tips can help you improve your quality of life while living with RRMS:

  • Try to stay active: Regular exercise can help with a variety of abilities that RRMS may affect, including strength, balance, and coordination.
  • Eat healthy: Although there’s no specific diet plan for MS, eating a nutritious, well-balanced diet may help.
  • Avoid extreme cold or heat: If you experience heat sensitivity as an MS symptom, avoid heat sources and avoid going outside when it’s hot. Cold compresses or cooling scarves may also help.
  • Try to reduce stress: Since stress may make your symptoms worse, look for ways to de-stress. You might consider trying massage, yoga, or meditation.
  • If you smoke, try to quit: Not only is smoking a risk factor for developing MS, but it may also increase the progression of the condition.
  • Find support: Coming to terms with an RRMS diagnosis can be difficult. Be honest about your feelings. Let those close to you know what they can do to help. You might even consider joining a support group.

RRMS is a type of MS that involves specific relapses of symptoms. Periods of remission occur between these relapses.

RRMS develops when your immune system attacks and damages the myelin sheath that surrounds your nerves, impairing nerve function. The exact cause of this immune system dysfunction is still unclear.

Although there’s no cure for RRMS yet, a variety of treatments are available to manage symptoms. These treatments also focus on relieving relapses and preventing progression.

In some cases, RRMS may transition into SPMS, a progressive form of MS.