Multiple Sclerosis: Dealing With Fatigue

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Coping With Fatigue, A Common Symptom of MS

Fatigue, or exhaustion, is one of the most common symptoms for people living with multiple sclerosis (MS), a chronic, autoimmune disease of the central nervous system.
To help navigate fatigue, NYU Langone neurologist Dr. Lauren Krupp suggests taking breaks and choosing a specific time of day for demanding activities.
The best time will vary from patient to patient, but many find they have more energy in the morning and should plan accordingly.
MS care must be individualized, Dr. Krupp says, with continuous adjustments over time. There is no “one size fits all” approach to care.

When it comes to managing fatigue while navigating multiple sclerosis (MS), a chronic, autoimmune disease of the central nervous system, NYU Langone neurologist Dr. Lauren Krupp suggests taking breaks and choosing a specific time of day for demanding activities.

“One aspect of fatigue is how you view things. People who feel like they’re out of control and overwhelmed, that feeling of having no control is one that leads to a sense of exhaustion. So it’s really helpful to realize that you do have control,” Dr. Krupp, who leads NYU Langone’s Multiple Sclerosis Comprehensive Care Center, tells SurvivorNet.

“What you may need to do is put things in little bits. So if you’re going to exercise, for example, you can’t continue going 30, 40 minutes without taking a break. When you have MS, you have to take more breaks, your body needs to refuel, reenergize.”

Conserving Your Energy

Dr. Krupp suggests taking simple steps to conserve energy, such as using a stool while doing activities you would normally do standing, when possible. When accommodations are not possible, frequent breaks can be helpful.

“Exercise, stay fit, stretch, but rest as you need to,” says Dr. Krupp.

She explains that people often have the most energy in the morning, so it’s helpful to plan demanding tasks for that time.

For instance, if you typically have a lot of work to get through in the morning, you can simplify mornings by doing a few things ahead of time. Preparing breakfast or showering the night before leaves more of that productive time open for larger tasks.

“For people who have control over their schedules, you should pick the more physically or mentally demanding activities in your day in the morning, if you can,” Dr. Krupp says. “If you’re one of those people whose fatigue is worse in the afternoon, that’s not true for everyone.”

“One of the keys about MS is it’s incredibly variable,” Dr. Krupp adds. “There are people who say, ‘Hey, my friend has MS … this worked for them.’ It might work for you, it might not. Everybody’s different. And that’s one of the very rewarding things in terms of working with people who have MS, is to sort of realize you have to listen.”

Patients should feel comfortable working with their doctors to find routines that work for them. Dr. Krupp stresses that there is no “one size fits all” approach.

Additionally, managing a condition like MS is ongoing and changes are often needed along the way.

“If I’m lucky, I get to work with someone from childhood to late adulthood. I haven’t had all that many in late adulthood who started in childhood, but I do have young people who are now in their thirties and fortunately are doing quite well,” she says, offering hope to patients just starting their MS journey.