How To Manage Ms Fatigue

Factors That Contribute To Your Fatigue

The fatigue thats unique to MS is called lassitude.

80 percent of people with MS experience this overpowering feeling of tiredness in body and mind.

We dont know the exact cause of lassitude, but we have identified many factors that can add to your feeling of fatigue.

• Insufficient sleep, which can be related to other MS symptoms like bladder urgency, muscle spasms, or pain. You might also be getting too much screen time before bed, or facing an underlying sleep problem like sleep apnea or restless leg syndrome.
• Depression or anxiety, which are common in people with MS. These mental health challenges can be draining for anyone, but they may lead to a vicious cycle for someone with MS. Your depression leads to feelings of fatigue, which amplifies your feelings of depression, and so on.
• Muscle stiffness or weakness, which requires you to use extra energy to move around.
• Certain medications taken for MS or other conditions
• Heat exposure, such as sitting outside on a warm day.

Once youve begun to manage all the issues that contribute to your tiredness, you can tackle MS fatigue.

With the help of your healthcare team, you can identify which factors contribute to your fatigue, and what tools and strategies can be of aid. You can also use the 4 Ps to make daily activities easier and less draining. Well explore both approaches below.

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Changes To Bladder And Bowel Function With Ms

Issues with bladder and bowel function can be a common problem for people with MS at some stage in their life. These issues may be related to other conditions, so it is important to report any changes, so the right assessments can be made.

Issues with bladder and bowel function may include:

• Incontinence â an accidental or involuntary loss of urine from the bladder or bowel motion, faeces or wind from the bowel . It is a widespread condition affecting many Australians, so you should not feel alone.
• Bladder dysfunction symptoms â including greater or less frequency of passing of urine, urgency, incontinence, urinary tract infections and the need to urinate frequently overnight.
• Bowel issues â including severe constipation, faecal incontinence and diarrhoea.

With the right advice, you can manage these symptoms and prevent complications or associated illnesses.

You can also make small changes that could make a big difference, including:

Feeling It: Tips For Talking To Others About Ms Fatigue

If you have MS, chances are really good that you have MS-related fatigue about 80 percent of people with MS do according to the National Multiple Sclerosis Society of America.

Like almost everything else about MS, the symptoms and severity of fatigue vary from person to person. Though you may feel like youre wearing a lead blanket or walking in quicksand, to family, friends, coworkers and others, you probably look just fine.

But theres a big difference between being tired and having MS-related fatigue. The result can be troubling as others may suggest that you simply need to get more sleep, take a nap or worse, believe that youre being lazy or just arent trying hard enough.

Describing how your fatigue makes you feel x physically, mentally and emotionally may help them better understand the often unavoidable role it plays in your life and how it may find its way into their lives, too.

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Here are some tips that may help you do that:

First, know your fatigue. Just as no one knows what causes MS, no one knows for sure whats behind MS fatigue. According to the National Multiple Sclerosis Society, there is currently no test that accurately measures fatigue, let alone one capable of making any objective conclusions about it.

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Medications To Treat Ms Fatigue

There are several types of medications that are sometimes prescribed to help manage fatigue in people with multiple sclerosis. Members of MyMSTeam report varying degrees of effectiveness. Like all medications, drugs prescribed for MS fatigue can also cause side effects.

More than 2,400 members of MyMSTeam indicate that they have taken Symmetrel . Amantadine is used to treat influenza and Parkinsons disease, and researchers are unsure how it works to manage MS fatigue. Provigil is a wakefulness-promoting drug often prescribed for those with narcolepsy. Nuvigil is a very similar medication that is usually taken once a day.

Stimulants like Adderall , Ritalin , and Concerta can also be used to treat MS fatigue although there is not good evidence that these work long-term.

Organise Your Living And Work Spaces

You might find there are practical changes that can be made to the places you work and live. Maybe re-organising desks or cupboards, or adjusting the temperature or lighting to suit you better.

Sometimes, the simplest of changes can make the workplace or home more energy efficient for you.

An occupational therapist can help you assess the spaces you use at work and at home – and may suggest adaptations or equipment that could help. For more information about the support that occupational therapists can offer, and how to find one, download or order our leaflet Occupational therapy and MS.

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What Causes Ms And Ms Fatigue

Its unclear why someone develops multiple sclerosis . Its not linked to any specific health practice, and its unclear whether it is avoidable. So far, research reveals that a mix of hereditary and environmental variables contribute to the cause.

MS fatigue is among the most unpleasant symptoms of the disease. MS fatigue may be distressing, and it can interfere with job and family life, mental and physical health, and social and recreational activities for some people. Fatigue can be a major symptom of the active inflammatory disorder, or it can be a secondary sign of other medical disorders.

So what exactly causes this fatigue? Cytokines are a large group of tiny proteins that play a key role in cell signalling. The central nervous system interacts with inflammatory cytokines, neurons, and cells. Cell signals in these sensory neurons can cause fatigue and discomfort. However, a changed neuroendocrine system may be able to control inflammation and excessive stimulation.

How Ms Fatigue Is Different To Other Types Of Fatigue

Ordinary fatigue is described as a sensation of muscular tiredness and weakness. It is the tired feeling everyone experiences after an excessively busy day or a lack of sleep. It is the type of fatigue that is usually managed by rest and a good nights sleep. Ordinary fatigue is quite different to the fatigue experienced in MS.

Fatigue associated with MS is described as an overwhelming sense of tiredness that can occur at any time of the day without warning. MS-fatigue usually occurs more rapidly, lasts longer and takes more time to recover from than ordinary fatigue.

MS-fatigue can occur for no apparent reason or after relatively mild exertion, such as a short period of walking, writing or reading, with an immediate need to rest.

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Motor Symptoms And Ms

Difficulty with walking or a change in walking style can be one of the first MS symptoms noticeable to others, for example beginning to stumble or trip.

Nerve demyelination can cause damage to the nerves that direct the affected muscles, causing incoordination. In some people, balance may also be affected, if special areas of the brain are demyelinated, and can lead to feeling off-balanced and leaning to one side, or difficulties in perception of where the body is in space .

Balance and walking problems vary considerably from one person with MS to another and may include:

• tripping, stumbling or falling
• unsteadiness when walking or turning
• needing support from walls, furniture or other people
• a heavy feeling in the legs when stepping forward
• leg weakness when weight bearing
• difficulty placing the foot squarely on the ground
• taking slower, shorter steps
• loss of confidence when walking.

Spasticity is a symptom of MS that causes your muscles to feel stiff, heavy and difficult to move. A spasm is a sudden stiffening of a muscle which may cause a limb to kick out or jerk towards your body and can also cause pain.

Not all motor problems are caused by MS, so it is important to seek professional advice. A health professional, such as a neurologist, an MS nurse, GP or physiotherapist can work with you to determine the cause of your walking and balance problems and advise on management.

Psychological Aspects Of Ms

Mood issues can be very common in MS, not just around the time of diagnosis, but at various stages of life. The most common mood disturbances are depression and anxiety which can be short or long term.

The most important thing to remember is to talk to your MS healthcare team as soon as you start to notice symptoms, so that you can access appropriate help, to improve your quality of life.

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What Causes Fatigue In Patients With Multiple Sclerosis

The exact cause of MS-related fatigue is still unknown. There are several theories on the subject:

• One theory is that fatigue is related to the general activation of the immune system. Chemical messengers are called cytokines these levels are higher in patients with MS and may be higher still in patients with fatigue. One way of describing this is that you may feel like you have a virus all of the time.
• Another theory is that people with MS may have to use more parts of their brain to do the same task as someone without MS in essence, they are working harder.
• Another theory is that fatigue is related to reduced electrical transmission of signals in the brain.

Whatever the theory, we know that fatigue from MS is a very real part of the disease.

You Can Experience Flare

When a person receives a diagnosis, you may think that chronic fatigue syndrome dooms you to a lifetime of days with little to no energy to accomplish anything. However, this is not the case. Once you learn how to manage your symptoms, you may be able to have days or even weeks between flareups. What can you do right now to try and increase the time between your flareups?

Learning to pace yourself is crucial. When you have a good day, it can be tempting to try and get through your entire to-do list. However, learning your limits for physical and emotional strain can help you to reduce your workload, even on good days, so that you can help remissions to last as long as possible.

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Regaining Control Of Your Energy

Feeling better begins with tackling the issues over which you have the most control.

The 4 P’s for Fighting Fatigue

Plan

• Plan your days so that you get the most challenging tasks done when you have the most energy.
• If youre not sure exactly when your best times are, keep a daily diary for a week or so to track your peaks and valleys of energy.

Prioritize

• It’s a fact of life: you can’t do it all. So, take the time to figure out whats most important.
• Think about what really needs to get done today or this week. Then identify what can wait.
• Remember, your time, interests, and priorities are just as important as everyone elses. Be sure to save some energy and time for yourself.

Pace

• Just because youre having a good day doesnt mean you should push to get everything done. Exerting yourself that hard will just cause you to hit a wall faster and youre likely to pay the price for a couple of days after.
• Slow but steady is your best bet, with plenty of brief rests along the way as you need them.
• Remember, listen to your body and let it guide you.

Position

• Dont do things the hard way when you can do them an easier way. It’s easier said than done, considering you may need to break some old habits. Here are some examples to get you started:
• Sit for tasks like showering or preparing a meal.

• Use a motorized cart for shopping or an electric scooter for traveling.
• Arrange things in your house or office so the things you use most often are easy to reach.

Creating an Exercise Routine

How To Treat It

If youre experiencing fatigue, make an appointment with your doctor to discuss possible treatment options. A doctor will likely want to run some tests to find out more about what may be causing your fatigue.

Based on the results of these tests, your doctor may prescribe medications or recommend counseling, physical therapy, and occupational therapy.

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What Does Ms Fatigue Feel Like

Members of MyMSTeam describe chronic, profound fatigue that does not usually improve with a nap or a cup of coffee. Here are some descriptions of MS fatigue from members in their own words:

• My body just shuts down.
• Utter weariness.
• Like taking three sleeping pills and still trying to function normally.
• My brain and body just stop working.
• I’ll crawl at times, sit on the floor, then I can get up and take a few more steps.
• Bone-crushing fatigue.
• Fatigue is a never-ending battle.

MyMSTeam members also discuss how MS fatigue affects their relationships with friends, family, and romantic partners. Members describe disappointment and resentment from loved ones who do not understand how severe and unrelenting their fatigue from multiple sclerosis can be.

Make Sure To Get Good Sleep

Practicing good sleep habits like keeping to regular bedtimes and cooling down your bedroom can help with sleep problems. Alcohol, caffeine, and some foods might interfere with your sleep. Avoid these and any other triggers that can interfere with your sleep.1

For MS symptoms that make it hard to sleep, like urinary problems or spasticity, ask your doctor what to do.1

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What Causes Ms Fatigue

“There are many reasons someone with MS experiences fatigue, Dr. Cohen says. Some are directly related to MS, and some are not.”

Some of the types of fatigue that may affect people with MS are:

• Indirect Fatigue Stress, trouble sleeping due to muscle spasms, side effects from medication, and depression that may go along with a chronic illness like MS can all cause fatigue. “Doctors should also rule out unrelated causes of fatigue, such as anemia or thyroid disease,” Cohen says.
• Neurologic Fatigue “MS symptoms, like tremors, muscle weakness, and muscle spasms, use up a lot of energy and can lead to fatigue, Cohen says. Damage that has been sustained over time along nerve pathways can be aggravated by stress, activity, fever, and heat exposure. All of these factors contribute to MS fatigue.”
• Autoimmune Fatigue “Persistent tiredness, or lassitude, is common in many autoimmune diseases and is probably the most common type of MS fatigue,” Cohen says. “It is very similar to the type of fatigue experienced in chronic fatigue syndrome.”

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Take Care Of Your Mental Health

Depression and anxiety can lead to fatigue. People with MS often experience these mental health conditions. Mental health is just as important as physical health. If you have looked at other reasons for your fatigue and are still feeling it, consider seeing a mental health professional. Your doctor can refer you to someone.1

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Allow Yourself To Rest

While being productive matters, resting when you need to is more important.

Efficiency, not intensity, is the goal. Knowing how to deal with chronic fatigue mostly centers on being gracious with yourself and honoring what your body needs!

A spin on the classic Pomodoro Technique for productivity is a good idea. Switch it up to do what works best for your body!

When a full day of work is too much, focus on just 20 minutes of productivity. By making those 20 minutes truly productive and then resting, youll probably accomplish even more than you would have in pushing through for 3 hours.

After 20 minutes of work, check in with yourself. If you need to rest, set a timer for an hour and rest. Once the hour is up, try to work again for another 20 minutes. If you can still only accomplish 20 minutes, thats fine! Or, if you can accomplish an hour, thats even better.

Resting guilt-free prevents burnout and keeps your work consistent.

On that same note, dont forget to reward yourself!

Whether you have worked for 20 minutes, hours, or not at all, rewarding yourself makes rest feel like a celebration and not something to be ashamed of.

Be gentle to yourself! Youre dealing with something overwhelming, and showing up to make an effort is something to be proud of.

When youre wondering how to deal with chronic fatigue and be productive, these tips are absolutely essential!

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You Are Not Alone With Ms Fatigue

On MyMSTeam, the social network and online support group for those living with multiple sclerosis, members talk about a range of personal experiences. Coping with MS fatigue is one of the most popular topics.

Is a daily struggle with fatigue part of your life with MS? How do you manage your MS fatigue? Share your experiences with fatigue in the comments below or by posting on MyMSTeam.

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How To Cope With Ms Fatigue

Fatigue is one of the most common and persistent symptoms of multiple sclerosis . Whatever type of MS you have you will certainly suffer from fatigue at some point or another.

Fatigue is one of the most common symptoms of MS, affecting around 80% of MS sufferers. It is also reported by 40% to 60% of people with MS as their worst symptom, and it is the major reason why people give up work.

MS fatigue is also one of the most challenging symptoms for friends and family to understand, as it is not visible and people think they can relate to it, mistaking it for tiredness. Well-meaning people say to me, Oh, I get tired too, we all do! I smile in agreement, but I know the difference!

Ive written a lot about fatigue in MS over the years as it is one of the most common and debilitating symptoms we can suffer from. I have a friend with MS who had to give up work as she found herself hiding in the restrooms, unable to function as the fatigue got so bad.

Id always thought of myself as lazy and was told often enough by those around me to get up and get on with things, but now I wonder where laziness ends and fatigue begins. I wonder if the laziness I felt in my late teens and early 20s was just a manifestation of MS fatigue that I didnt recognize as a symptom.