MS Fatigue: 9 Tips to Help You Feel Better

While we don’t know what exactly causes fatigue in MS, the triggers could be directly and indirectly related to the disease. The fatigue could stem from the muscles, or it may originate from problems in the nervous system itself.

Research suggests that disruption to neurotransmitters in the brain and the circadian rhythm may play a role in it as well.

In addition, certain complications of MS could also cause fatigue problems with sleep or chronic pain.

Before learning how to beat fatigue, it’s useful to understand the types of fatigue you may face when you have MS.

Researchers have started to identify a number of distinct characteristics specifically associated with MS. They define it as quite different from garden-variety tiredness:

• Onset: It can begin suddenly.
• Frequency: It often occurs every day.
• Time of day: It can occur in the morning, despite sleeping the night before.
• Progression: It commonly worsens throughout the day.
• Sensitivity to heat: Heat and humidity may aggravate it.
• Severity: It tends to be more severe than other types of fatigue.
• Effect on activities: It’s more likely than regular fatigue to disrupt your ability to perform everyday tasks.

Tip 1: Exercise often

Research shows that regular physical activity — including both aerobic and resistance training — can help alleviate fatigue related to MS.

Sticking with a consistent exercise program can help with endurance, balance, weight management, and general well-being — all important for people with MS.

That said, exercising can also lead to fatigue when living with MS. It’s a good idea to experiment and see what kind of exercises make you feel less fatigued and better overall and what time of day is most effective to perform them.

For example, you could exercise close to your bedtime if you find that morning exercise incapacitates you for the entire day.

In general, speak with your doctor before starting a new fitness program. Also, remember that the goal of exercise is to give you more energy, not make you feel more tired.

Tip 2: Conserve your energy

Energy conservation isn’t just important for the environment. It’s also a key principle for those with MS.

What’s your best time of day to get things done (i.e., the time when you feel the most energetic)?

If you notice less fatigue in the morning, take advantage of your extra energy to complete tasks such as shopping and cleaning. You can conserve your energy later when you feel more fatigued, knowing you’ve already accomplished key daily tasks.

This also includes considering when and how much you exercise, as stated above. Research shows that considering exercise within your overall energy conservation strategy is probably the most effective for helping reduce MS-related fatigue. That said, the research on this isn’t conclusive.

Tip 3: Stay cool

About 60–80% of people with MS are especially sensitive to heat. As a result, they may experience more fatigue when they become overheated or are in a warmer environment. Try these techniques to cool down:

• Use air conditioning as needed, especially in the summer months.
• Wear a cooling vest.
• Wear lightweight clothes.
• Take a cool shower.
• Jump in a swimming pool.
• Drink icy beverages.

Tip 4: Try occupational or physical therapy

With occupational therapy, a trained specialist helps you simplify activities in your work or home environments. This may involve using adaptive equipment or changing your environment to help increase your physical and mental energy.

With physical therapy, a trained professional helps you perform daily physical tasks more effectively. For instance, you may use techniques or devices that can help you conserve energy while walking.

While physical or occupational therapies can help reduce fatigue, research shows they’re most effective when combined with other strategies.

Tip 5: Regulate your sleep

Sleep problems are often behind the fatigue that people with MS experience.

Whether you have trouble falling asleep, staying asleep, or getting the amount and type of sleep you need to awaken feeling refreshed, the result is the same: You feel tired.

To help prevent these problems, it’s important to regulate your sleep. This might involve identifying and treating other MS symptoms that cause sleep problems — for example, urinary dysfunction.

You can often manage sleep problems by making lifestyle changes like making sure the room temperature is comfortable or avoiding looking at lights before bed. Sometimes medication may also help, such as pain medication if the pain is interfering with your sleep or prescription sleeping medication for certain sleep problems.

Tip 6: Limit certain drinks

Certain behaviors may seem to help with fatigue, but ultimately, they may cause more problems than they solve.

Drinking a hot beverage may sound like a good way to wind down if you’re having trouble sleeping, but coffee and tea typically contain caffeine.

In addition, while many people consider warm drinks pleasant in the evening, many people with MS can be sensitive to heat, which means that even warm herbal tea could potentially trigger symptoms.

Be sure to check whether your drink contains caffeine. It can prevent you from falling asleep, leading to fatigue the next day.

Similarly, while alcohol may help you feel sleepy after you first drink it, it can make it harder to get a restful night’s sleep later.

Consider behaviors that may be contributing to poor sleep habits and fatigue and try to take steps to adjust them. For example, if drinking before bed is causing you to experience frequent urges to use the bathroom, you might want to reduce liquid consumption right before bed. You can stay hydrated by drinking a few hours earlier. It may take some trial and error to determine what works best for you.

Tip 7: Eat right

Poor nutrition can make anyone feel tired or fatigued; the same may be even more true for people with MS.

Your diet can affect your symptoms and how you feel. It may even affect the progression of your disease.

Good nutrition advice for most people includes eating many fruits and vegetables, lean protein, and whole grains. This advice holds for people with MS too.

Some tips, such as ensuring you consume enough healthy fats and vitamin D, may be especially important if you have MS.

If you have questions about what you should be eating, talk with your doctor. They can help advise you. They can also refer you to a nutritionist who can help create a personalized healthy eating plan.

Food Fix: Foods that Beat Fatigue

Tip 8: Keep stress in check

Just like a poor diet may affect a person with MS more than someone without it, stress could have a bigger effect on you than on your friend without MS.

Anyone with stress can experience insomnia, which can lead to fatigue.

However, if you have MS, stress can worsen your condition. Stress does not cause new brain lesions, but stress could cause worsening of MS symptoms, including fatigue.

Advanced disease can increase your symptoms, including fatigue.

You can reduce stress by eating well, exercising, and listening to music. Meditation is also a proven way to help you relax and ease stress. For more ideas, talk with your doctor.

Don’t stress about it, though. Stress is a part of everyday life, so your goal should be simply managing it, not getting rid of it entirely.

Tip 9: Manage your medications

If you’re taking medications for other symptoms, check their side effects to make sure they aren’t adding to your fatigue.

Talk with your doctor about each medication you take and work together to determine whether you can stop taking those that can cause fatigue.

In terms of medication to help ease fatigue, your doctor can help you decide what’s right for you. Possible medications include amantadine (Gocovri) and modafinil (Provigil), two drugs used off-label.

A meta-analysis of 11 studies found only limited evidence that amantadine is effective for treating fatigue, and more research is needed to determine the effectiveness of other medications.

However, everyone’s MS symptoms are different. Some people may be more resistant to such medications because of the neural brain dysfunction caused by MS.

These medications are also still being studied as a treatment for MS fatigue, so your insurance may not cover them for this purpose. For more information about these drugs, talk with your doctor.

OFF-LABEL DRUG USE

Off-label drug use means a drug that’s FDA approved for one purpose is used for a different purpose that it hasn’t yet been approved to treat.

However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients.

However, sometimes a drug is known to have benefits beyond the FDA-approved indications, and your doctor may prescribe a drug that they think is best for your care.

Can MS fatigue be cured?

Fatigue caused by MS cannot be cured. However, it can be managed with treatment.

How long does MS fatigue last?

There isn’t a cure for primary fatigue in MS (that is, fatigue caused by the disease itself). That said, you can manage it with various lifestyle strategies. You may eliminate fatigue caused by certain co-existing conditions, such as anemia, by getting treatment.

Why is my MS fatigue so bad?

It’s possible that there are multiple causes of the fatigue you are experiencing.

You may feel tired because of the way MS affects your brain, your nerves, or your muscles. If you aren’t already aware of having any MS-related complications, it’s a good idea to see your doctor to eliminate additional causes that could be treated.

Fatigue from MS can profoundly affect your life for many reasons, both at work and home. It may severely limit the types of activities you can do and may even result in you having to leave your job. It’s worth it to learn how to manage MS-related fatigue.

If you have questions or concerns about your fatigue or energy level, ask your doctor for guidance. They’ll work with you to find ways to address your fatigue and help you have more energy in your daily life.