Primary-progressive multiple sclerosis (PPMS) isn't accompanied by flare ups of symptoms like other forms of multiple sclerosis (MS). As a result, the disease is relatively easy to manage in its early stages. The progression of PPMS is a gradual one, usually taking place over a period of months or even years. People suffering from the disease generally do not notice its progression from day to day. They are more likely to identify the state of their condition relative to the way they felt at the same time a year before. Eventually, however, the disease is likely to cause a disability that may require you to use a cane or some other device to help with your mobility. Exercise and physical therapy may help.