Fatigue and Multiple Sclerosis (MS)

Fatigue is very common with many Neurological and long-term conditions and is one of the most frequently reported symptoms in MS. We all experience physical and mental tiredness as part of our normal daily lives; however fatigue can feel very different from the normal sensation of tiredness. People living with MS describe fatigue as an “overwhelming tiredness” or a “sudden loss of energy,” often for no apparent reason.
Fatigue can limit or affect the ability to complete essential daily activities, such as getting dressed, going to work or walking the dog. Additionally, it might affect your thinking processes, speech, physical movements, or a combination of these. Some patients living with MS, additionally experience worsening of their other symptoms temporarily, due to fatigue. This is normal.
Fatigue affects each person living with MS differently. Symptoms may fluctuate over a daily, weekly and monthly basis and change in response to different activities. This can make fatigue challenging to manage, difficult to predict and complicated to explain to family, friends, colleagues and health professionals. Fortunately, there are lots of helpful and practical ways to help you manage your fatigue and minimise the effects on you.

Why do I suffer with fatigue?

Fatigue in MS is thought to be caused by different factors. In the literature, it is described as primary and secondary fatigue.

What is primary fatigue?

Primary fatigue describes the fatigue symptoms associated with the inflammatory processes occurring within the brain, spinal cord and nerves, due to the MS itself, essentially the tiredness you might feel just living with the changes going on in your body. When these plaques or blockages form in the brain, spinal cord or nerves your body tries to find ways around them, creating new pathways, this can also take up energy.

What is secondary fatigue?

Secondary fatigue is due to related factors of living with MS. These can include:

How do we measure fatigue?

We can measure fatigue using several tools. Visual analogue scales can be a simple way of measuring how we are feeling during the day, such as the two diagrams below.
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It can also be helpful to keep a fatigue diary, listing activities and scoring your tiredness on the scales above at the start and end of each day. This will give you a good idea of what impacts you the most.

How do we measure fatigue?

There are lots of simple ways that can help to manage fatigue. Considering these strategies into two main aspects may help. Firstly, we can manage fatigue by aiming to have the most energy available for your day.

How can I ensure I have the most energy available for my day?

How can I manage my energy in the most efficient way?

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