In general terms a relapse is thought to be the appearance of new symptoms, the return of old symptoms or maybe even a combination of both for a period of 24 hours or more and at least 30 days from the end of the last known relapse.
But a relapse doesn’t include exacerbation of symptoms which is caused by a raise in the body temperature or by things like an infection or a cold. Other things like the temperature of the weather can have a big effect on our symptoms too - for me the humidity (and the extreme cold) makes me feel absolutely terrible: the fatigue is far worse as are my cogntive issues, my legs are like they’re made of concrete and I feel like I’m dragging myself around. Everything is exacerbated
Stress can have the same or a similar effect too, as can overdoing it (amongst many other things) - hence why some days we can feel better than others.
SPMS can be diagnosed from the start and it’s thought that approximately 85% of people with RRMS go on to develop secondary progressive after some years, but just to complicate things this isn’t always the case either - again it does vary from person to person just like everything else about ms does.
Going from a dx of RRMS to SPMS can also take a while to be definate about and most neurologists won’t commit to it unless they’re sure (surprise surprise!). It’s not helped by the fact that even though a lot of people with secondary progressive don’t suffer relapses like in relapsing remmitting - some still do!
Symptoms like fatigue, neuropathic pain, sensory sensations, balance and cognitive issues can all be symptoms that we may have on a day to day basis and most of these can be helped with various medications. The vast majority of ms’ers are on medications for something or another.
In short, nothing is black or white because ms is very much a personal illness, what may affect one person may never affect another. Over time though we do begin to learn what may be the trigger our own symptoms.
Until a diagnosis of ms comes along the best thing to do is keep a brief note of your symptoms and keep your neuro up to speed because he may be happy to prescribe meds for any particularly troublesome ones in the interim period.
Hope that helps