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Physical Therapy as a Treatment Option

Reviewed by: HU Medical Review Board | Last reviewed: April 2023

There are many different types of treatments used for multiple sclerosis (MS). Many people use physical therapy along with options like disease-modifying drugs.

What is physical therapy?

Physical therapy (PT) is a form of strategic exercise. It is meant for people who have trouble moving. The goals of PT are to improve mobility and function and to reduce pain.1

A physical therapist is trained in creating sets of exercises and stretches. These vary in intensity and duration. Every person’s plan is tailored to their needs. The therapist considers which muscle groups need to be addressed, limitations to movement, and goals. A young athlete who just had knee surgery has one plan. An older non-athlete with arthritis may have a very different plan.1

In most cases, a person sees their physical therapist regularly for supervised exercise and stretching. They leave each session with instructions for exercises to do at home until next time. The length of time between sessions can vary. Even among those with MS, plans can be different depending on symptoms.1

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Benefits of exercise in MS

Exercise can be helpful in MS. It can increase balance, mobility, mood, and overall health. It may also reduce inflammation and protect your nervous system from damage. More research is needed to figure out the full relationship of exercise and MS. But so far, the findings are positive.1,2

Role of physical therapy in different stages of MS

PT can take on different roles depending on how long a person has had MS. When MS is first diagnosed, physical therapists can assess your baseline mobility. They can also help create an exercise plan and set goals.1

If your MS is stable, you can keep up your exercises at home. Regular check-ins can be spaced out. However, after a relapse, plans may need to be adjusted. Physical therapists note new mobility challenges after a relapse and set new goals. They also adjust plans to make sure all exercises are safe and helpful.1

Regular check-ins can continue throughout MS progression. As more time passes, a physical therapist can help decide whether assistive devices are needed. These include shower chairs, walkers, and scooters.1

Over time, you may need more in-person visits. Plans may need to be adjusted for symptoms like fatigue or cognitive challenges. If MS progression makes you unable to walk, PT can still be helpful. A physical therapist can still work on trunk (torso) strength and upper arm exercises. This will help keep as much function as possible.1

Things to know about physical therapy

Talk to your doctor before you start any new exercise plan. There may be some things you cannot do because of MS. For example, you may not be able to exercise during an exacerbation or while on certain drugs. Also, health conditions besides MS may keep you from certain activities.

PT should only be done with a licensed physical therapist. Your doctor can place a referral to a certified PT center. Once you are paired with a physical therapist, follow their instructions. Pushing the limits too far can be dangerous and lead to more damage.

Finally, some people with MS may experience Uhthoff’s phenomenon. This is a brief increase in symptoms while you exercise. This is not an exacerbation and does not usually prevent a person from exercising. Talk with your doctor or physical therapist if you have brief increases in symptoms.1,2