Hi Sally, I am new here and this is my first reply. I was dx. SPMS when I changed to a new neurologist after being tired of 5min. visits with the neuro that dx. me in 2000 with RRMS, even though it was determined that I have had MS since I was 19 and I am 47 now. I had started having nerve pain in both hands and both feet and my old neuro would only give me one vicodin per day after maxing me out on neurotin was not working then sent me to pain control. I explained all my symptoms to my new neuro and he changed my dx to SPMS at my 1st visit. He said that since I had not really had improvement, but constant pain and fatigue issues, along with a few years of getting IV and by mouth steroids for what seemed to be exacerbations but no improvement that it was obvious that I had moved on to SPMS. I have not noticed massive changes, maybe small things cognitively and have not had IV steroids except once for an active lesion since around 2010 I think. My memory is poor, and my husband that was my "memory" among so many other things, passed away this past March 2014, so I can't ask him the date sadly. I hope this helps some. Love, Hugs and Prayers, Linda