Understanding Progression

Understanding Progression in MS

Understanding Progression in MS is supported by an educational grant from Sanofi Genzyme.

Written by: Aaron Boster, MD and Jacqueline A. Nicholas, MD, MPH
Reviewed by: Jack Burks, MD, MSAA Chief Medical Consultant
Edited by: Susan Wells Courtney
Contributing writers: Several MS experts and other professionals authored MSAA’s previously published articles and updates; excerpts from these writings were included in this booklet. Please see the Reference Section of this booklet for specific citations.

Table of Contents


Part I: Understanding Progression in MS

  • Background Information
  • Types of MS
  • The Pathogenesis of MS Progression
  • The Measures and Assessment of Progression
  • The Natural Progression of MS
  • Criteria for Diagnosis and Description Modifiers
  • Non-MS Causes of Clinical Worsening

Part II: Treating Progression in MS

  • Disease-Modifying Treatment Approaches Targeting Inflammation
  • Disease-Modifying Therapy to Delay Progression in MS
  • Rehabilitation through Physical, Occupational, and Speech Therapy
  • Symptom Management
    • Bladder Problems
    • Muscle Spasticity
    • Walking and Mobility Issues
    • Emotional Issues
    • Cognitive Issues
    • Fatigue
    • Neuropathic and Neuromuscular Types of Pain

Part III: Healthy Living with Progressive MS

  • Avoiding Comorbidities that Drive the Disease Faster
  • Avoiding Complications from Progression
  • Discussing Progression with a Healthcare Provider
  • Strategies for Wellness with Progressive MS
  • Adjusting to Change

Closing Notes


MSAA strives to provide useful, up-to-date information on matters of concern to MS patients and their families. This material is intended for general informational purposes only, and it does not constitute medical advice. You should not use the information presented as a means of diagnosis or for determining treatment. For diagnosis and treatment options, you are urged to consult your physician. Those affiliated with this booklet and MSAA cannot be held responsible for any unintentional errors in the writing of this booklet, or changes in information that may occur, possibly affecting certain details of an explanation, assumption, or treatment.

Copyright © Multiple Sclerosis Association of America, 2017. All rights reserved. This booklet is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from MSAA.

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