MS Society of Canada - Calgary Chapter

Symptom Management

Page 14

Fatigue

Fatigue is one of the most common symptoms of MS, occurring in about 90% of people with MS. Fatigue can significantly interfere with a person's ability to work and it may be the most prominent symptom in a person who otherwise has minimal disease.

What Makes MS Fatigue Different?

Researchers are beginning to outline the characteristics of MS fatigue that make it different from fatigue experienced by persons without MS.

MS-related fatigue generally occurs on a daily basis.
It tends to worsen as the day progresses.
It tends to be aggravated by heat and humidity.
It comes on more easily and suddenly.
It is generally more severe than normal fatigue.
It is more likely to interfere with daily responsibilities.

MS-related fatigue does not appear to be directly correlated with either depression or the degree of physical impairment. It may occur first thing in the morning even if the person has had a restful full night’s sleep.

The cause of fatigue in MS is currently unknown. Ongoing studies are seeking to find an objective test that can be used as a marker for fatigue as well as precise ways to measure it. Some people with MS say that family members, friends, co-workers, or employers sometimes misinterpret their fatigue and think the person is depressed or just not trying hard enough.

Because fatigue can also be caused by treatable medical conditions such as depression, thyroid disease, anemia, or may occur as a side effect of various medications, persons with MS should consult a physician if fatigue becomes a problem. A comprehensive evaluation can help identify the factors contributing to fatigue and develop an approach suited to the individual.

Options for dealing with fatigue include:
Occupational therapy to simplify work tasks.
Physical therapy to learn energy-saving ways of walking (with or without assistive devices) and performing other daily tasks, and to develop a regular exercise program.
Sleep regulation, which might involve treating other MS symptoms and using sleep medications on a short-term basis.
Psychological interventions, such as stress management, relaxation training, membership in a support group, or psychotherapy.
Heat Management: how to avoid overheating and how to cool down.
Medications may be prescribed. They are useful to some, but not all people with MS and cannot totally relieve fatigue. Since a side effect of both drugs is insomnia, they work best if taken in the morning and at noon.