Relapsing-Remitting Multiple Sclerosis (RRMS) Patient Education

What Is RRMS?

Multiple sclerosis (MS) is a disease that affects the brain and spinal cord. In RRMS, people have times when symptoms get worse (called relapses or flare-ups), followed by times when symptoms get better or go away (called remissions). It is called “relapsing-remitting” because of this pattern.

Causes and Risk Factors

The exact cause of MS is not known. Scientists think it happens when the body's immune system attacks the protective covering (myelin) of nerve fibers in the brain and spinal cord. This damages the nerves and causes symptoms.
Risk factors include:

Being between 20 and 40 years old
Being a woman (more common in women)
Having a family member with MS
Living in cooler climates
Smoking
Certain infections

Signs and Symptoms

Symptoms can vary, but may include:

Fatigue (feeling very tired)
Numbness or tingling in arms, legs, face
Weakness in muscles
Problems with walking or balance
Vision problems, like blurry or double vision
Difficulty with thinking or memory
Dizziness or trouble with coordination
Early warning signs: feeling very tired, numbness, vision changes, or muscle weakness

Complications If Untreated or Noncompliance

If MS is not treated or if patients don’t follow their care plan:

Symptoms can get worse and more frequent
Permanent nerve damage can occur
Difficulty walking or using arms
Increased risk of infections or other illnesses
Greater chance of hospital visits and longer recovery

Treatment and Self-Care Measures

While there is no cure, treatment can help control symptoms and reduce relapses. Self-care is important to stay healthy.

Common Types of Medications

Disease-Modifying Therapies (DMTs): These help slow down the disease and reduce relapses. Examples: interferons, glatiramer acetate, fingolimod.
Steroids: Used to reduce inflammation during flare-ups.
Symptom medications: For fatigue, muscle spasms, pain, or bladder problems.

Purpose and Side Effects of Medications

DMTs reduce relapses but may cause flu-like symptoms, injection site reactions, or increased risk of infections.
Steroids help quickly reduce symptoms but may cause mood changes, increased appetite, or trouble sleeping.

Self-Care Tips

Get plenty of rest and sleep.
Stay physically active with gentle exercises like walking or swimming.
Eat a healthy diet with fruits, vegetables, whole grains, and lean protein.
Avoid smoking and limit alcohol.
Manage stress with relaxation techniques.
Avoid overheating (hot baths or weather) as it can worsen symptoms.

Dietary Needs

No special MS diet is required, but healthy eating supports the immune system and overall health. Drink plenty of water and eat balanced meals. Some patients benefit from vitamin D supplements after discussing with their doctor.

Lifestyle Changes and Safety Considerations

Use assistive devices if needed for walking or balance.
Prevent falls by removing tripping hazards at home.
Plan for fatigue by pacing activities and resting when needed.
Avoid infections by washing hands and staying up to date with vaccines.
Tell your doctor about any new or worsening symptoms right away.

Prevention and Maintenance Tips

Take medications as prescribed.
Attend all medical appointments and lab tests.
Monitor symptoms and report relapses early.
Avoid smoking and maintain a healthy weight.
Manage stress and stay socially connected.

When to Call for Help

Situation

Who to Call

Mild symptoms or questions about meds

Home Health Agency or Doctor

Symptoms that worsen or new symptoms

Doctor

Sudden weakness, vision loss, severe pain, difficulty breathing, or severe confusion

Emergency Room (Call 911)

Patient Homework / Assessment

Instructions: Read each statement below. Choose True or False for each. If you choose False, please write the correct statement.

True or False: RRMS means symptoms come and go in flare-ups and remissions.
True or False: Only men get multiple sclerosis.
True or False: Smoking can increase the risk of MS symptoms getting worse.
True or False: Fatigue is a common symptom of RRMS.
True or False: If you stop taking your medicine, the disease will not get worse.
True or False: Steroids can be used during flare-ups to reduce symptoms.
True or False: Eating a balanced diet can help support your health with MS.
True or False: Overheating can make MS symptoms worse.
True or False: Physical exercise should be avoided completely by MS patients.
True or False: You should call the emergency room if you suddenly lose vision or cannot walk.
True or False: MS can cause problems with memory and thinking.
True or False: DMT medications cure MS completely.
True or False: Rest and pacing activities can help manage fatigue.
True or False: It is safe to stop taking your medication without talking to your doctor.
True or False: Smoking does not affect MS at all.
True or False: You should keep all your doctor appointments even if you feel fine.
True or False: Stress management is important for people with MS.
True or False: Infection prevention is important because infections can worsen MS symptoms.
True or False: It is okay to ignore new or worsening symptoms if they seem mild.
True or False: Vitamin D might be recommended by your doctor to help with MS.

ASSESSMENT of WELL-BEING INDIVIDUALIZED PATIENT HOMEWORK

Individualized Questions for You

Please answer these questions to help your healthcare team understand your care better:

What medications are you currently taking for your MS? Have you noticed any side effects?
When was your last lab test or MRI? Do you know the results?
How often do you have flare-ups, and what symptoms do you notice first?
Are you following a specific diet or taking vitamin supplements?
How do you manage your daily activities and fatigue?
Have you had any falls or balance problems recently?
When was your last appointment with your neurologist or MS specialist?
Do you have any questions or concerns about your medications or treatments?
How do you handle stress or emotional challenges related to MS?
Do you have support at home or from caregivers when symptoms get worse?

Relapsing Remitting Multiple Sclerosis (RRMS) Answer Key

False — RRMS is not a condition where symptoms steadily worsen without remission; it involves flare-ups (relapses) followed by periods of improvement (remissions).
True — MS is an autoimmune disease where the immune system attacks the protective covering (myelin) of nerves.
True — Early signs of MS include vision problems, numbness, and fatigue.
False — MS is not caused by a virus, but by the immune system mistakenly attacking nerve coverings.
True — Untreated MS can lead to permanent nerve damage and disability.
True — Disease-modifying therapies help reduce the number and severity of relapses.
False — Steroids are used short-term to treat relapses but are not a long-term cure.
True — Fatigue is one of the most common symptoms patients with MS experience.
True — Maintaining a healthy diet, regular exercise, and stress reduction can help manage symptoms.
False — MS is not contagious or inherited directly, but genetics can increase risk.
True — Safety measures, such as avoiding extreme heat and injury, help prevent symptom worsening.
True — Some medications used for MS can have side effects like flu-like symptoms or injection site reactions.
True — Early treatment and medication adherence can slow disease progression.
False — MS cannot be completely prevented, but lifestyle changes may reduce risk or delay onset.
True — Patients should report new or worsening symptoms promptly to their healthcare provider.