Types of MS

Types of MS

Types of MS
The majority of people living with multiple sclerosis (about 85%) are diagnosed with relapsing remitting MS (RRMS), but there are a few other types of MS you may hear about. 10% of people living with MS are diagnosed with a type called primary progressive MS (PPMS). If RRMS is left untreated 50-60% of people can progress to a type called secondary progressive MS (SPMS). Some people living with MS are told they have a type called benign multiple sclerosis. 

The type of MS you have can affect how often you experience symptoms as well as when and how disability develops. It can also impact the options you have for managing your MS. Below we have an overview for each of the three different types. 

Quick facts

Take a quick look at the differences between the different types of MS:

Relapsing remitting MS (RRMS)

People living with RRMS experience periods of symptoms (relapse) followed by periods where their symptoms disappear or improve (remission). About 85% of people with MS are diagnosed with RRMS


Secondary progressive MS (SPMS)

Some people living with RRMS progress to SPMS where they don’t experience relapses but can find that their disability gradually worsens over time


Primary progressive MS (PPMS)

About 10% of people are diagnosed with PPMS. People living with PPMS don’t experience relapses but find that their disability gradually continues to worsen over time

What is relapsing remitting MS (RRMS)?

When you have multiple sclerosis, your body’s immune system mistakenly attacks parts of your central nervous system, specifically the covering (called myelin) around your nerves. 

Amazingly though, your body is able to repair some of the damage to the myelin in a process called remyelination. However, the repaired myelin isn’t the same as it was before the damage took place, so messages may not travel along your nerves as quickly as they did before. Take a look at the diagram below to see how damaged myelin affects the signals that travel along your nerves: 

Types of MS - damaged Myelin

It’s this damage that results in the MS symptoms you may experience. You can find examples of these here

These periods of damage can result in a relapse of symptoms, which are then followed by periods of remission due to the body’s repair processes. It is because of these periods of relapses and remissions that this type of multiple sclerosis is called relapsing remitting MS (RRMS). 

These symptoms may be reversible but they can become permanent as the disease progresses. Over time, damage can build up and can become too difficult for the brain to repair. This can lead to permanent symptoms. RRMS can progress to a type of MS called secondary progressive MS (SPMS), especially if it is left untreated. 

What is secondary progressive MS (SPMS)?

Most people living with MS are diagnosed with RRMS. Some people with this initial diagnosis find that over time they experience fewer relapses but that their disability gradually increases. This type of MS, which follows an initial RRMS phase, is known as secondary progressive MS (SPMS). 

People with SPMS may still have an occasional relapse but most don’t experience relapses. Disability tends to increase gradually in people living with SPMS. However, the rate at which this happens can vary a great deal from one person to another. 

What is primary progressive MS (PPMS)?

About 10% of people living with multiple sclerosis are diagnosed with a form in which disability increases from the beginning of their MS disease. This is known as primary progressive MS (or, less commonly, chronic progressive MS). 

The experiences of people living with PPMS can vary a great deal. People may experience a continuous increase in disability, but people can experience this at different rates. Some experience a more gradual worsening of symptoms, while others may find that their symptoms stop worsening for long periods of time. No matter what type of MS you have, it can have an impact on your day-to-day life. Take a look at our Daily life section for tips and advice here.

There are some people who have experienced a progressive form of MS since their diagnosis but also occasionally experience a relapse. This type of MS is sometimes called progressive relapsing MS. If you have PPMS and want to learn about your options it’s a good idea to talk to your doctor or MS nurse.

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