What Are RMS
Symptoms?
Relapsing multiple sclerosis (RMS) has a variety of symptoms that can range in severity from serious to mild. Because RMS can present so differently from patient to patient, it’s important to understand its different symptoms and keep track of how they’re impacting your life.
Defining visible and invisible symptoms
There are a lot of ways to help manage RMS symptoms—the first step is understanding them. Select a symptom on the body to learn about its impact. If you’d prefer to view the symptoms in a list, simply click "List View."
Vision
RMS can cause something called optic neuritis, which occurs when the optic nerve becomes inflamed. RMS can also affect your eyes by causing problems with the movement of the eye.
Speech & Swallowing
Between 25%-40% of people living with RMS experience speech difficulties at some point. Speech difficulties can range in severity from mild to severe and are caused by lesions, most notably in the brainstem. Similarly, damage to nerves that control muscles in the mouth and throat can cause weakness that leads to swallowing problems.
Spasms & Stiffness
Stiffness can make your muscles feel more rigid and difficult to move. You may find it difficult to carry out smaller, delicate movements, or you may have trouble with larger ones such as walking. Muscles can also jerk in an uncontrolled way, known as a spasm. This can happen repeatedly and sometimes causes pain.
Tremors
Many patients with RMS experience involuntary movements of the head, body, and extremities. These are known as tremors, and they can make simple tasks like getting dressed or brushing your teeth very challenging. Patients with tremors may also experience speech and swallowing issues, since the neural pathways that impact those muscles also impact tremors.
Muscle Weakness
Living with RMS, you may experience muscle weakness (a lack of strength) in any part of the body. Muscle weakness in your legs and feet can make it difficult to walk, whereas weakness in your upper body can make daily tasks and self-care more challenging. Muscle weakness can be mitigated by a combination of physical exercise, assistive devices, and medication.
Difficulty Walking
A number of symptoms — such as muscle stiffness, fatigue, balance, and muscle weakness — can affect your ability to walk and increase your risk of falling. Not only can falls cause injuries, but the resulting broken bones or damaged muscles may cause further mobility issues and reduce independence.
Cognition
Problems with thinking, memory, and concentration (sometimes grouped together as cognitive problems) are common in people living with RMS. As we age, some of our cognitive abilities start to decrease. But, when living with RMS, there’s about a 50% chance you will develop problems with cognition at some point in your life.
Emotional & Psychological
It’s important not to overlook your emotional well-being or to dismiss how you’re feeling as a reaction to your RMS diagnosis, as this can be caused by RMS itself. RMS can interfere with the transmission of signals that affect mood. Studies have suggested that depression is more common among people living with RMS than it is in the general population.
Pain
Pain is a common symptom of RMS that has a significant impact on the lives of patients. It can be caused directly by RMS itself, since the condition attacks and damages nerves along the central nervous system. It can also be a secondary symptom resulting from another RMS symptom. For instance, if RMS-caused leg weakness forces a patient to walk differently, it may put a strain on their back or hips.
Bladder
Sometimes bladder and bowel problems can limit daily activities and make leaving the house a stressful experience that requires a great deal of planning and preparation. Your bladder may struggle to store urine, which can leave you feeling like you need to urinate frequently and sometimes with little warning. It may also not be able to empty fully, which can make you need to urinate more frequently, as well.
Sexual Dysfunction
From lack of interest to loss of sensation, RMS could affect your sex life and possibly put a strain on your relationships. There are a range of symptoms including: decreased sex drive, erectile dysfunction, and a change in genital sensations. But you may experience sexual problems because of other RMS symptoms. For example, fatigue can lower sex drive, and depression can cause sexual dysfunction.
Fatigue
Fatigue, which is an overwhelming sense of tiredness, is one of the most common symptoms of RMS. It has a significant impact on an RMS patient’s ability to carry out standard functions both at work and at home. This extremely prevalent RMS symptom is the main reason why patients exit the workforce early.
Managing types of RMS symptoms
Symptoms can be managed with different approaches, and each should be adjusted to your individual needs. Remember: everyone living with RMS experiences it differently, so tracking your symptoms is one of the best ways to help you and your healthcare provider continue the journey of managing RMS. Talk with your doctor about what you can do to manage your RMS symptoms.
Your doctor may suggest types of therapy:
- Physical therapy — may include an exercise program, training patients to use mobile aids, and walking training.
- Occupational therapy — energy conservation training, adaptive training, and training in other techniques that simplify daily life.
- There are also a range of devices that can help mobility, such as wheel chairs, walking sticks, and even bionic legs.
If optic neuritis and problems with eye movement are particularly severe, your doctor may prescribe a course of steroids that can help inflammation subside.
Wearing a patch or glasses with lenses that realign 2 images can help with double vision, too.
Ask your doctor about treatments for involuntary eye movements.
A speech language therapist can help achieve your goals with exercises that improve movement of the jaw, tongue, or lips.
If you are experiencing bladder issues such as hesitancy during urination, an inability to hold urine, or frequent urination, your doctor may propose lifestyle changes and management techniques including:
- Diet modifications
- Change in fluid intake
- Bladder training
Your doctor may also suggest some changes to help with bowel issues like diarrhea, constipation, and bowel spasticity. These may include:
- Increasing fiber in your diet
- Drinking adequate liquids
- Engaging in physical activity
- Taking remedies such as stool softeners
If you’re uncomfortable discussing bowel and/or bladder issues with your doctor, take a look at our Doctor Discussion Guide for ideas.
For pain, your doctor may recommend over the counter or prescription pain relievers, exercise, massage therapy, cognitive behavioral therapy, or relaxation techniques.
For fatigue, sleep problems might be improved with physical exercise, occupational therapy, stress management or psychotherapy, and more.
If you find your fatigue gets worse at certain times or after certain activities, track your symptoms and discuss them with your doctor.
It’s important to remember that an unsatisfactory sex life does not have to be part of living with RMS and that support is available. Working with your doctor to understand and address the cause of any problems you’re experiencing is an important step to help you find a solution that might help.
REMINDER: Many people with RMS feel uncomfortable when discussing these concerns. If your RMS has been having a negative effect on your everyday life, talk to a doctor. Our discussion guide could help.
Patients experiencing issues with thinking and cognition can take simple steps to keep their mind sharp. These include:
- Taking more breaks—if you find that you can’t concentrate, take regular, short breaks.
- Keeping reminders—make to-do lists, use checklists, and set alarms to keep yourself on top of daily tasks.
- Prioritizing tasks—start with the ones that require the most attention and concentration and leave the easier ones for when you are likely to be more tired.
- Keeping your mind active—reading, journaling, playing board games, learning a new language, and similar activities can help keep your mind sharp.
- Making your memory work—engage in memorization exercises. Repeat things that you hear and verify that they are correct to improve both memory and attention.
RMS has been shown to cause depression, generalized anxiety and distress, mood changes, and stress. Here are a few ways to nurture emotional wellbeing, even in the face of RMS:
- Try meditation or relaxation exercises – managing the stress associated with RMS is essential for staying emotionally healthy.
- Focus on the positive – put your happiness and personal growth first by focusing on your goals and criteria for success.
- Monitor your mood – depression is a serious, and treatable, symptom of RMS. As such it needs the same careful assessment and treatment as other RMS symptoms. Keep track of your moods and seek professional help.
- Build and nurture relationships – forming and maintaining meaningful relationships can provide RMS patients with support, intimacy, and connection.
Is it a symptom or aging?
Symptoms like fatigue, memory loss, brain fog, and bodily changes can be a little bit difficult to interpret because they match the typical signs of aging. You may be asking yourself, “Am I having difficulty remembering where I put my keys because of my RMS? Or am I just getting older?”
It’s important to keep track of how your symptoms change over time and to communicate those changes with your healthcare provider. Understanding your symptoms and monitoring your condition’s progression via MRI will allow you and your doctor to make better treatment decisions.
What I wish I’d known
“When I overcome a hurdle RMS throws at me, I just feel alive. I could write a thousand and one words to describe how I feel, but the truth is that I feel alive and nothing else matters.”
- Telma, living with RMS
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Next up: Symptoms vs relapses
Distinguishing between a symptom of RMS and a relapse can be difficult. Read on to learn the difference.
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