Why do I have RRMS when my symptoms are persistent?

Question:
I'm a 48 year old male recently diagnosed with RRMS. I have not even started on a drug regimen. My question is this...why do I have RRMS when my symptoms are persistent? I had a numbness across my mid-section beginning 3 years ago which still remains. For about 4 months now when I move my head down or to the left I feel a numbness/tingling in my back and legs. This has not gone away. My MRI shows I have one lesion in my thoracic spine and one in my cervical spine and none on the brain. Spinal tap results indicated MS. But shouldn't these symptoms come and go and not be persistent if I have RRMS? Thanks.

Answer:
Relapsing remitting does not mean that symptoms disappear after a relapse; it only means that symptoms improve to some extent after a relapse. Otherwise, having MS would be no more severe than a case of the flu. 

The entire concept of relapsing remitting MS is even more complicated than this answer implies. For instance, we define a relapse as neurological symptoms accompanied by matched findings on examination both consistent with inflammatory demyelination that usually develops without improving over several days (minimum of 24 hours) before stabilizing and improving to some extent, usually over several weeks.  So what if you develop abnormal symptoms consistent with demyelination or scaring in your nervous system without evidence of inflammation? These are usually odd or abnormal sensations without an accompanying abnormality on examination. These symptoms would not be considered a relapse and tend to be more persistent, although they still fluctuate from day to day. The whole point is that areas of inflammatory demyelination rarely recover completely and can often cause recurrent, usually intermittent symptoms over time.
I hope this helps.

Revere (Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego