Fatigue limits the lives of 85% of people with multiple sclerosis. It is important that fatigue is taken seriously and its management is carefully considered.
MS fatigue is different for everyone, for some it causes overwhelming tiredness, whilst in others it worsens symptoms like visual disturbance, difficulties with concentration, memory, mobility and muscle spasms. Fatigue may make dealing with everyday activities that much more difficult.
Primary fatigue is experienced as a direct result of damage to the central nervous system. The body responds to this damage by slowing down reactions and thus causing fatigue. People with MS experience different types of fatigue including:
- Lassitude: an overwhelming tiredness not directly related to participation in activity or exercise.
- ‘Short circuiting’ fatigue: occurs in specific muscle groups e.g. the hand, after writing for a short time.
- Heat sensitivity fatigue: a rise in body temperature can cause fatigue. This kind of fatigue can occur due to the seasonal changes in the weather but may also be triggered by other things e.g. taking hot baths or eating hot meals.
Secondary fatigue can be experienced as a result of other factors that are not necessarily directly related to your MS. These can include:
- Sleep disturbance: this is often due to symptoms that can be alleviated or lessened, for example spasms, pain, urinary urgency at night, depression or anxiety.
- Infection: may cause a number of symptoms that could bring on specific MS fatigue e.g. having a cold or flu may raise your body temperature.
- Exertion: the increased effort required by the body, if mobility or coordination is affected, can cause fatigue.
- Medication: there are many medications that may cause tiredness or drowsiness as a side-effect. It is important to be aware of this. If you notice that there is a correlation between a change in fatigue levels and a change in medication, tell your GP.
- Depression: may be due to nerve damage or because of the emotional impact of adjusting to MS.
- Local Environment: The lighting and temperature within a work area is crucial, as poor lighting increases visual effort and heat frequently exacerbates fatigue.
Fatigue management requires a co-ordinated approach that involves active participation and involvement from family and colleagues, as well as health professionals.
You may feel that your personal relationships are affected because people do not understand how fatigue affects you.
Rest and relaxation If there is a regular pattern to your fatigue, it is ideal to take the rest before it is at its worst, as this enables the body to recuperate more quickly.
Relaxation techniques are available on compact discs or audiotape and are an effective method of complete relaxation.
The relaxation method used must not require active contracting and relaxing of muscles, as this can increase muscle spasm.
Prioritisation of daily activities, if you make a list of your regular habits and routines, some activities will be an obvious priority. Others can be shared, altered or even eliminated. Some changes will require the cooperation of others, it is important that everyone understands why the changes need to be made and the benefits they will have to you.
