Secondary Progressive Multiple Sclerosis: What You Need to Know
If you or someone you know has been diagnosed with secondary progressive multiple sclerosis (SPMS), you probably have a lot of questions. SPMS is the stage of MS that follows relapsing‑remitting MS (RRMS) for many people. It means the disease keeps getting worse over time, even if attacks (relapses) become less frequent. Below we break down the main signs, treatment choices, and practical steps to keep life as normal as possible.
How SPMS Looks Different From Other MS Types
In RRMS you get clear flare‑ups followed by periods of recovery. In SPMS the nervous system damage builds up, so you notice a steady decline in function. Common signs include:
- Gradual worsening of walking or balance
- Increasing muscle stiffness (spasticity)
- New or stronger fatigue that isn’t linked to a relapse
- Blurry vision or more frequent eye problems
- Cognitive changes such as slower thinking or memory slips
These symptoms often appear slowly, so it can be hard to tell when RRMS turns into SPMS. Your neurologist may use MRI scans and disability scores to confirm the shift.
Treatment Options That Actually Help
Even though SPMS is considered progressive, several disease‑modifying therapies (DMTs) can slow the pace. The most common ones are:
- Ocrelizumab (Ocrevus) – approved for primary and secondary progressive forms, it targets B‑cells that fuel inflammation.
- Siponimod (Mayzent) – works on specific immune pathways and has shown benefits in delaying disability progression.
- Cladribine (Mavenclad) – an oral option that reduces immune activity for a few months after a short course.
If you’re not a candidate for DMTs, symptom‑focused treatments still matter. Physical therapy can keep muscles flexible, while medications like baclofen or tizanidine help control spasticity. Fatigue can improve with low‑dose amantadine or modafinil, but always discuss dosing with your doctor.
Beyond meds, lifestyle tweaks make a measurable difference. Regular low‑impact exercise (swimming, cycling) boosts mobility and reduces fatigue. A balanced diet rich in omega‑3 fatty acids, fruits, and vegetables supports overall nerve health. Managing stress through meditation or simple breathing exercises can lower relapse‑triggering inflammation.
Living with SPMS also means planning for the future. Talk to a rehab specialist about assistive devices—canes, walkers, or braces—before you need them urgently. Home modifications like grab bars, non‑slip mats, and better lighting reduce fall risk. Keep a symptom diary; note when you feel worse and what you were doing. That record helps your care team fine‑tune treatment.
Support networks aren’t optional. Join an online forum or local MS group. Sharing tips on coping strategies, medication side effects, or insurance paperwork can save you hours of frustration. Many charities also offer financial aid for therapy or equipment—don’t skip looking into them.
Bottom line: SPMS is a slower, steady progression, but you still have tools to slow it down and maintain quality of life. Stay proactive with your doctor, keep up on approved treatments, and build a daily routine that protects your mobility and mental well‑being. With the right mix of medicine, exercise, and support, you can keep moving forward despite the diagnosis.
