Why do I have so many symptoms if my MS is inactive and I have no new lesions?

Here is My Question:
Hi I have posted a lot in the past and finally saw an MS specialist/neurologist. In France i was diagnosed in 2012 as inactive. They classified me as RRMS and told me I had MS since 2002/2003. My first attack was an MS hug. In 2012 I had my second attack of optic neuritis and my diagnosis of MS. What I don't understand is my neurologist told me my progression is a mild course and I had no new lesions in December 2016 and nothing since 2012. How can I have so many symptoms and difficulty in every day house tasks? My symptoms are right leg pain after activity including my right arm and hand. Fatigue, cog fog, concentration problems, spasticity, etc.

I had breast cancer, had a masectomy and I also have MS RRMS. I had surgery two months ago, and have lived with MS for 8 years. Recently the two drugs that I have tried to suppress estrogen causes me extreme itching. Are the two drugs Tysabri and Letrozole cause an reaction resulting in itching. I asked my Neurologist before my infusion he stated he didn't know and told me to take my Tysabri for MS.

Answer:
MS can be quite inactive, at least as far as we are able to determine clinically and by standard imaging, and still cause persistent problems. These problems can be direct or indirect effects of the disease. Direct problems are attributed to chronic demyelination and scaring; These problems can include spasticity, unpleasant sensations, weakness, gait problems, forgetfulness, depression and the list goes on.

​Indirect problems are usually maladaptive or adverse responses to more direct effects of the disease. These indirect problems can include chronic pain syndromes, depression, anxiety, contractures, infections, medication side effects and the list goes on

This is why we always separate disease management and symptom management. Even a person with inactive and relatively benign disease requires symptom management
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