Questions to ask your doctor about SPMS

As multiple sclerosis (MS) progresses, some people transition to secondary progressive multiple sclerosis (SPMS) — a stage of MS in which symptoms gradually worsen over time, often with fewer relapses.

This shift can be emotional and confusing, especially if it feels like your body is changing in new and unpredictable ways. Talking openly with your healthcare team is one of the best ways to stay informed and empowered.

Asking the right questions helps you understand your diagnosis, treatment options, and what to expect in the future.

Understanding your SPMS diagnosis

When MS changes, it’s normal to feel uncertain. SPMS doesn’t look the same for everyone — and understanding what this diagnosis means for you personally can help you feel more prepared.

Key questions to ask:

• What does SPMS mean for my type of MS? Ask your neurologist how your disease course has changed and what evidence — like MRI findings or symptom patterns — led to the diagnosis.
• How will my symptoms likely progress? Progression varies widely. Your doctor can explain whether to expect steady changes or periods of stability.
• Is my MS still considered active? Ask whether you’re still having relapses or new lesions, because active and nonactive SPMS may require different treatment approaches.
• Should I get additional tests? Your provider may recommend follow-up MRI scans or neurological exams to monitor progression or rule out other potential causes of your symptoms.

Understanding what’s happening inside your body helps you and your care team make informed, proactive decisions about care and lifestyle adjustments.

Exploring treatment options

SPMS treatment has evolved significantly in recent years. While there isn’t a cure, there are therapies that can help slow progression, especially for people with active SPMS.

Questions to guide this discussion include:

• Which treatments are approved for SPMS, and are they right for me? Ask your doctor which therapies may help with active or progressing SPMS and whether you meet the criteria for those options.
• If I’ve been on a DMT, should I continue it? For some people, staying on their current therapy is helpful; for others, switching or stopping may make more sense based on disease activity and side effects.
• What side effects or monitoring should I expect? Each treatment has its own safety needs. Ask how often you’ll need labs, imaging, or other monitoring.
• What options exist beyond medication? SPMS care may also include physical or occupational therapy, counseling, and symptom-management strategies.

Because SPMS affects everyone differently, your doctor can help weigh the potential benefits and risks of each approach, and together you can determine what aligns best with your goals.

Managing symptoms and daily life

SPMS can affect many aspects of daily living, from walking and balance to cognition, mood, and energy levels. It’s important to bring up every symptom you’re experiencing, even if it feels small.

Ask about:

• Fatigue and mobility support: What lifestyle changes, exercise routines, or rehabilitation programs can help me conserve energy and move safely?
• Cognition and emotional health: MS can affect memory and focus, and depression or anxiety are common. Are there strategies or referrals for cognitive therapy or mental health support?
• Assistive devices: Could mobility aids, braces, or home modifications improve safety or make tasks easier?
• Rehabilitation programs: Are there local MS centers or multidisciplinary clinics that focus on progressive disease management?

Many people with SPMS find that combining medication with rehabilitation, adaptive tools, and community resources provides the best overall improvement in daily life. Don’t hesitate to ask for referrals to physical, occupational, or speech therapists as needed.

Planning for long-term care

SPMS often requires long-term planning and coordination with specialists. Preparing for possible changes early helps you and your family feel more in control and reduces stress later on.

Consider asking:

• How often should I follow up with my care team? Regular visits can help track subtle changes and allow treatment adjustments as needed.
• At what point should I consider seeing a rehabilitation specialist or physical medicine doctor? These experts can recommend exercises, bracing, and adaptive strategies to maintain function.
• What community or national resources are available for people with SPMS? Organizations such as the National Multiple Sclerosis Society can connect you with educational materials, peer groups, and local support.
• How can my family or caregivers best prepare for future needs? Discussing practical matters — such as mobility assistance, home safety, and emotional support — helps everyone adapt together.

Building a partnership with your healthcare team

SPMS care works best when you and your provider communicate openly. Before each appointment, write down your top concerns or any new symptoms you’ve experienced.

Consider bringing a trusted family member or friend if that makes you feel more comfortable. Don’t hesitate to ask your doctor to repeat or rephrase information — clarity is key to shared decision-making.

Over time, your healthcare needs may evolve. Whether you’re adjusting medications, exploring clinical trials, or simply seeking better symptom relief, remember that your voice matters.

Every question you ask is a step toward better understanding, stronger advocacy, and more personalized care.

Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.