Fatigue
MS fatigue can be one of the most disabling symptoms of MS. According to some studies, over 90% of people with MS experience fatigue. Fatigue can be a primary symptom (due to active inflammatory disease) or a secondary symptom (the result of other symptoms or conditions such as sleep disorders, depression, or muscle weakness). Fatigue can often be improved by changes in lifestyle (e.g., employing energy effective strategies), as well as with medication.
Even for people with few or no symptoms, this fatigue can be overwhelming. MS fatigue can keep people from getting out in their world, resulting in a sense of isolation. The first place to start with fatigue is a comprehensive assessment and there are many things that can contribute to worsening fatigue. Overall health plays a role as the same things that make anyone tired can affect people with MS; anemia, thyroid disease, etc must be ruled out. Depression, so common in MS, can impact fatigue and energy. Bladder symptoms with frequent trips to the bathroom day and night can be exhausting. If one doesn't get a good night's sleep, fatigue is inevitable. Poor nutrition, spasticity and leg spasms, particularly at night, can aggravate the condition. Some medications can cause fatigue, especially as they are introduced, and before one has adjusted to them. Once the potential contributing factors have been identified and dealt with, energy conservation becomes important. Consultation with an occupational therapist can be helpful in this regard. Sometimes a mobility aid such as a scooter or light weight wheelchair kept in the car trunk can be are helpful in conserving energy, and enabling someone to get back out participating in their world. There are also medications that can help with varying degrees of success. An important thing to remember is that dealing fatigue requires a multi-dimensional approach and that several small interventions may be necessary to really maximize energy and improve fatigue levels.
Fatigability
Fatigability is also common in MS. A single muscle or group of muscles becomes weaker after repetitive use and recovers with rest. This kind of fatigue is thought to be related to the effects of increased core temperature with repetitive movement (see Promoting Function through Rehabilitation and fatigue). Strategies such as using short repetitions interrupted by rest breaks can be helpful. In a neurological examination, the effects of fatigue and fatigability must be taken into consideration when testing muscle strength.
Key Healthcare Professionals:
Family physician, MS nurse, neurologist, occupational therapist, physiotherapist, social worker.
Symptom Management:
Energy conservation counseling, mobility aids (scooter), air conditioning, active cooling to lower body temp Check tax allowances for air conditioning installation. It is important to remember the impact of fatigue on muscle strength when testing and if possible test after a period of rest or inactivity.
An MS Society of Canada website that provides information on a variety of topics. Information is provided by a range of North American experts who respond to inquires from individuals affected by MS.
