No two people experience MS the same way. Some notice symptoms that come and go, while others experience a steady progression from the start, and others experience both. That’s because there are several multiple sclerosis types, and understanding yours can make a big difference in how you manage it.
Today, we’ll walk through the different types of multiple sclerosis and how each one can affect your body over time. Learning about these variations can help you make sense of your symptoms and feel more confident talking with your healthcare team about next steps.
By the way, have we met? I’m Dr. Gretchen, an MS-Specialized Physical Therapist and founder of The MSing Link – a research-based online program for people with MS, podcast, and book that helps people with MS build strength, confidence, and mobility. My goal is to turn complex research into practical, empowering tools you can use every day.
MS is a complex condition that affects every person differently, and doctors classify it based on how your symptoms appear, change, and progress over time. Traditionally, MS has been grouped into four main types:
These categories help doctors describe the pattern of your symptoms and guide treatment decisions. Some specialists now describe MS using simpler terms like relapsing or progressive, but the four-type model is helpful in understanding how MS can feel from person to person.
Learning about the different multiple sclerosis types can feel overwhelming at first, especially if you’re still coming to terms with your diagnosis. But understanding them helps you see patterns and feel more in control of your care.
Remember: no matter which type you have, there are tools and resources that can help. For now, let’s walk through each one together so you can better understand what sets them apart.
This is the most common type of MS, affecting roughly 85% of people diagnosed with MS – according to the National MS Society. RRMS is marked by periods of new or worsening symptoms, followed by stretches of partial or complete recovery.
During remissions, your symptoms may improve fully or partially, and disease activity often appears stable between episodes. Many people with RRMS respond well to early treatment, which can help reduce relapses and slow long-term progression.
Why it’s different → RRMS involves distinct relapses and recovery periods (even if you don’t recover 100%), unlike progressive forms, which steadily worsen over time.
This type usually begins as RRMS but shifts over time: instead of having clear relapses and remissions, symptoms gradually progress with fewer recovery periods. Some people with SPMS still experience occasional flare-ups, but their overall function slowly declines between them.
This transition can be subtle and happens differently for everyone. Many people find that staying active and consistent with MS-specific physical therapy helps maintain their strength and mobility, even as the condition progresses.
Why it’s different → SPMS starts like RRMS but evolves into a steady progression of symptoms with less recovery in between.
In PPMS, symptoms gradually worsen from the very beginning – without the ups and downs of relapses and remissions. You might notice a slow change in your walking ability, balance, or muscle strength that continues to progress over time.
Because there are no clear relapses, PPMS can be more challenging to diagnose. Treatment focuses on managing symptoms, preserving mobility, and supporting nervous system health through movement and lifestyle strategies.
Why it’s different → PPMS progresses from the start, without the temporary improvements seen in relapsing forms of MS.
As the rarest type of MS, PRMS is defined by a steady progression of symptoms from the onset. It’s similar to PPMS, but with occasional relapses or flare-ups along the way. These relapses can temporarily worsen your symptoms before returning to the previous progression level.
While PRMS is less commonly diagnosed today (and sometimes grouped with PPMS in newer classification systems), understanding it helps show the full range of how MS can behave.
Why it’s different → PRMS combines the continuous progression of PPMS with the occasional flare-ups typical of RRMS.
While CIS isn’t officially considered MS, it’s often seen as the first warning sign. It refers to a single episode of neurological symptoms caused by inflammation or demyelination in the central nervous system – such as vision loss, numbness, or weakness.
Some people with CIS never experience another episode, while others go on to develop RRMS. Doctors often use MRI scans to look for brain lesions that could suggest a higher likelihood of developing MS later on.
Why it’s different → CIS involves one isolated event rather than an ongoing or confirmed MS diagnosis.
Neurologists rely on a combination of tests to assess disease activity and progression. This could include MRIs, neurological exams, and sometimes lumbar punctures. They use a system called the McDonald Criteria, which helps confirm MS by showing evidence of lesions in different parts of the central nervous system that occurred at different points in time.
As research around MS diagnosis continues to evolve, so do the McDonald Criteria. In late 2024, updates introduced new imaging markers and expanded how certain parts of the nervous system are evaluated. I broke it all down for you on The MSing Link podcast. For a clearer explanation of how MS is diagnosed today, I highly recommend listening to the episode below.
Yes, and this is one of the most important things to know about MS. Many people start with Relapsing-Remitting MS (RRMS) and later transition into Secondary-Progressive MS (SPMS) as their symptoms become more consistent.
The good news is that staying proactive with your care (through treatment, physical therapy, and lifestyle strategies) can help delay or slow this progression. MS-specific movement, in particular, is one of the best tools for protecting your mobility and balance over time.
No matter what type of MS you have, there are always ways to improve your strength, energy, and quality of life. The key is understanding your body and working with your care team to create a treatment plan that meets you where you are.
As an MS-Specialized Physical Therapist, I’ve helped people with every form of MS regain confidence, move with more ease, and feel empowered in their daily lives. Progress might look different for everyone, but it’s always possible.
Understanding the different types of multiple sclerosis can make your diagnosis feel a little less overwhelming. It helps you recognize what’s happening in your body, communicate better with your care team, and take control of your next steps.
If you’re feeling overwhelmed by all the info out there, my MS Research Made Simple course can help you cut through the noise. Inside, I break down 26+ hours of complex research from 2025 into 10 easy-to-follow modules that help you understand what the science really means for your health.
Have any questions about the multiple sclerosis types? Send me a DM on Instagram @doctor.gretchen – I’m always here to help in any way that I can!
As a physical therapist & Multiple Sclerosis Certified Specialist, I have spent the last 10 years teaching people with MS how to feel more confident & empowered through MS-specific exercises and strategies.
If you want support and encouragement, plus a healthy dose of tough love, come follow me on Instagram (@doctor.gretchen) or on YouTube @DoctorGretchenHawley. It's where I share daily tips, tricks, and information about new offers — plus, you’re bound to feel more empowered, hopeful, & motivated after watching each post and video!
Questions? Email me at Hello@DoctorGretchenHawley.com
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Dr. Gretchen Hawley's The MSing Link offers a comprehensive guide to taking control of your MS symptoms and improving your mobility through MS-specific exercises and strategies.
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