Living with MS > Managing Fatigue

What is Fatigue?

Fatigue is described as an overwhelming feeling of physical or mental tiredness that does not improve with rest.

In MS, fatigue can fluctuate during the day and is often worsened by heat. Fatigue is common in the general population and is also one of the most frequently reported symptoms of MS. It is sometimes referred to as the 'invisible' symptom, because while many people with MS may look well, fatigue can cause a great deal of distress to those who experience it.

It is not known what causes fatigue in MS, but it is thought that damage to myelin and nerves in the central nervous system may play a role. However, because fatigue is also present in the general population and in different medical conditions, there are likely to be other factors that contribute to the experience of fatigue in MS. It is known that sometimes our behaviours in response to fatigue may make it worse, but fatigue can improve and it can be successfully managed.

Ways to Manage Fatigue

Managing fatigue means finding ways to control its effect on your life, so that you can continue to maintain your commitments or take part in the things you enjoy. Considering the following areas in your day-to-day life may help you to reduce the impact of your MS fatigue.

More information on fatigue in MS is available from our Library. Contact your MS Field Worker for advice on how to manage your fatigue and for referral to other health professionals who can help.

Medication and treatment

Unfortunately there is no cure for fatigue, but there are some medications and treatments that may help in some situations. If you are concerned about high fatigue levels, your MS Nurse can discuss medication options with you as well as give you advice on other ways to help manage this symptom.

Balance rest and activity

When you have fatigue it is tempting to want to sleep whenever you feel tired and put off or avoid activities until a time when you have more energy. While rest is important, getting too much rest can be counterproductive, as can trying to do everything when you have more energy!

This kind of pattern of behaviour can easily make you feel like your fatigue is overwhelming you or getting out of control. By resting frequently at the same time as avoiding activity you can quickly become less fit (or unconditioned) and any exertion can make you more tired than you are used to.

It can be difficult to find a balance between resting enough and having the energy to keep up with planned activities. Everyone is different, but whether you have mild or more severe fatigue establishing a regular daily routine of appropriate rest and moderate activity will help to manage your energy levels more consistently.

A healthcare professional, such as your MS Nurse, Field Worker, Occupational Therapist or Physiotherapist may be able to help you make a plan to reduce your fatigue at a pace that is safe and suited to you.

Exercise

Many people with MS and fatigue feel that they should avoid exercise – this is definitely not true! In fact, regular moderate exercise has been shown to improve fatigue in people with MS, and it has a number of other benefits as well.

There are certainly issues that need to be taken into account when considering a programme of exercise, especially the potential for overheating resulting in increased fatigue or MS symptoms. However, activities like hydrotherapy and yoga can be safely tailored to suit any individual’s level of ability.

Healthcare professionals, such as a Physiotherapist, will be able to help you plan a programme of activity to fit your individual needs. There may also be special exercise groups or a gym membership option for people with MS in your local area.

Prioritise

Many people who have fatigue find it helpful to prioritise the demands on their energy so that they can focus on the activities that are important to them. Sometimes trying to do too much can mean you don’t have the energy to spend at work or with your family.

Taking steps such as organising help with the housework or adjusting your workload around your energy levels can make a big difference. Your MS Field Worker or an Occupational Therapist can discuss with you and your family or employer the types of changes or support that may be available to help you prioritise your activities.

Save your energy

People with greater levels of fatigue often find that it helps to use techniques to save energy, even when they don’t feel especially tired. Saving energy when you are carrying out everyday activities can prevent you from feeling more tired later in the day. Such techniques may involve changing the way you do things, or using specially designed assistive devices.

There are some simple things that can be done in your home or workplace to help you save energy, so that you can keep up with your routine without the need for any new equipment. For example, using a seat or stool in the kitchen while you prepare food, or re-organising or re-locating your work area so that you don’t need to move about as much during the day.

There is also a range of assistive devices that may help you to do some activities in the most energy-efficient manner. An Occupational Therapist is able to assess your needs at home or at work and recommend changes to your environment to help you manage your energy levels more effectively.

Keep cool

Feelings of fatigue can increase when your body temperature is raised. The heat and humidity of summer or taking a hot bath may make your fatigue worse. Using strategies to keep your body cool throughout the day will help you to maintain a consistent level of energy, even on the warmest days.

Recommended ways of keeping cool include wearing light clothing made from natural, breathable fibres such as cotton, and using a personal fan or air conditioning where it is available. Drinking plenty of fluids will help your body to perspire and to avoid dehydration. When it is very hot it may be helpful to apply a damp cloth to your skin, such as around the neck, or use a cold pack.