Fatigue

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Everybody can experience fatigue from time to time, but the fatigue which occurs in MS is unique. It can be an overwhelming sense of weakness, physical and/or mental. When fatigued, you may feel exhausted, tired, weak, and void of energy. Fatigue makes carrying out the tasks of daily living much more difficult.

Of the many symptoms associated with MS, fatigue is the most common and potentially most disabling symptom, affecting between 75% and 90% of people who have MS.  About half of people with MS say that fatigue is the one symptom that has the greatest impact on their daily life. It is also one of the symptoms most responsible for people deciding to leave the workforce.

How does fatigue affect a person with MS?

One of the challenges in discussing fatigue in general is that there are many possible causes of fatigue.  Fatigue can result from sleep disturbances related to nocturia, a form of bladder dysfunction which increases the need to empty one’s bladder often during the night. Muscle weakness, balance problems, or spasticity can contribute to fatigue as everyday tasks, such as dressing, cooking, or bathing, may be more difficult to accomplish. Depression, a common symptom in MS, can lead to fatigue as well.

Besides the normal causes of fatigue, people with MS experience a unique form of fatigue, sometimes called lassitude or MS-related fatigue. MS-related fatigue does not necessarily result from muscles weakness, loss of sleep, or depression. The cause of MS-related fatigue is unknown, however research is leading to a greater understanding of how this form of fatigue is different from others.

  • What are signs of MS-related fatigue
  • Generally occurs on a daily basis
  • May occur early in the morning, regardless of a good night’s sleep
  • Tends to get worse throughout the day
  • Comes on suddenly and without warning
  • May interfere with daily responsibilities
  • May become worse with increased exposure to heat and humidity
  • Is more severe than normal fatigue

How can I manage my fatigue?

The first step in successfully managing your fatigue is to determine its cause(s). A variety of tools are available to combat fatigue once the cause has been identified. For example, if sleep disturbances contribute to your fatigue, work with your doctor to address the underlying cause. Fatigue which occurs as a side effect of medication can also be managed by working closely with your doctor.

If deconditioning, loss of strength or endurance due to lack of exercise, is the cause of fatigue, work with a physical therapist to design an exercise program aimed at building strength and endurance. A physical therapist can also help you find ways to accomplish daily tasks if weakness or stiffness are contributors.  Finally, medications are available to counter the effects of fatigue caused by the disease itself.

Type of fatigue
Causes

Fatigue from extra effort it takes to do daily activities

MS symptoms such as weakness, balance problems, stiffness, and vision problems can make daily activities energy-intensive

Fatigue as a side effect of medications

Fatigue or drowsiness is common after:

  • Injections of disease-modifying treatments, such as Avonex, Betaseron, Rebif
  • Treatments for spasticity: baclofen, Zanaflex, Valium
  • Treatments for pain: Neurontin, Tegretol, Klonopin, Cymbalta
  • Some anti-depressant treatments: Zoloft, Paxil, Effexor

Fatigue linked to sleep disturbances

  • Corticosteroids (used to treatment some attacks) may make sleep difficult
  • Frequent nighttime urination
  • Spasms
  • Periodic limb movements
  • Depression or anxiety

Fatigue from lack of exercise

When you get out of shape, your muscles are weaker, your heart doesn’t pump as efficiently, and you get out of breath more easily

MS Fatigue (also called lassitude)

This type of fatigue is unique to people with MS and may happen because of nerve damage
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