Fatigue is the most commonly reported symptom of multiple sclerosis (MS). In fact, more than 80 percent of people with MS experience fatigue as their most debilitating symptom. Fatigue in MS affects both physical and mental energy, and it can severely impact quality of life.

In this article, we’ll share what MS fatigue feels like, what causes it, and six ways to manage MS fatigue to reduce its impact on your life so you can feel more like yourself.

How Is MS Fatigue Different From Normal Fatigue?

Fatigue in MS is different in many ways from the tiredness people may ordinarily experience after a long day at work, a late night out, or a tiresome chore. MS fatigue is also different from sleepiness, although staying in bed may be the only thing that seems to help at times.

According to the National Multiple Sclerosis Society, people with MS commonly experience fatigue that persists daily — even after a good night’s sleep — and worsens as the day goes on. Fatigue in MS can also come on suddenly, get worse with humidity and heat, and take longer to ease.

When fatigue affects people with MS in these ways, it may also be referred to as lassitude. MS fatigue is typically more severe than normal fatigue and can interfere with work, school, and the responsibilities and tasks of daily life. Many people struggle with how to explain MS fatigue to others because fatigue causes invisible symptoms. MS fatigue is the No. 1 reason people with MS have to reduce their work hours or stop working altogether.

What Does MS Fatigue Feel Like?

Members of MyMSTeam have discussed chronic (ongoing) and extreme fatigue that doesn’t generally improve with a nap or a cup of coffee, the same way normal fatigue does.

Here’s what members say about their MS fatigue symptoms:

• “My brain and body just stop working.”
• “Utter weariness.”
• “Everything just feels slow.”
• “Like taking three sleeping pills and still trying to function normally.”
• “I’ll crawl at times, sit on the floor, then I can get up and take a few more steps.”
• “Bone-crushing fatigue.”
• “Fatigue is a never-ending battle.”

MyMSTeam members have said that MS fatigue affects their relationships with friends, family, and romantic partners. Members have also shared that loved ones often don’t understand how severe and unrelenting their fatigue from MS can be.

Causes of Fatigue in Multiple Sclerosis

Why is MS so exhausting? Neurology researchers don’t fully understand what causes MS fatigue. However, there’s evidence that primary fatigue in MS is due to damage in the spinal cord and brain. In people with MS, dysfunction in the immune system causes it to mistakenly attack nerve fibers. Lesions (damage) in the brain and spinal cord may cause the central nervous system to work harder and use more energy.

People with MS can also experience secondary fatigue from symptoms of MS, such as pain or sleep disturbance. MS fatigue can also take a toll on mental health. About half of people with MS experience depression at some point, and depression can cause or worsen MS fatigue. Other MS symptoms, including weak legs, weak muscles, and spasticity (muscle spasms) can add to the burden of MS fatigue. Fatigue can also be a side effect of certain medications.

6 Ways To Fight MS Fatigue

You can take steps to help manage your MS-related fatigue and improve your overall well-being. Medication may help some people. Fatigue management strategies, such as regular exercise, energy-conserving techniques, and other healthy habits, may also help relieve your fatigue and improve your daily life.

1. Talk to Your Doctor About Medications To Treat MS Fatigue

Several kinds of medication are sometimes prescribed to help people with MS manage fatigue. Members of MyMSTeam report that these treatments have varying degrees of effectiveness. Like all medications, drugs prescribed for MS fatigue can also cause side effects.

Medications used to treat other medical conditions such as viral infections, narcolepsy, Parkinson’s disease, and attention-deficit/hyperactivity disorder (ADHD) are sometimes used as stimulants (substances that increase energy) for MS fatigue. Drugs such as modafinil (Provigil) and amantadine have been shown to help reduce fatigue in some people with MS, although research about their effectiveness is inconclusive. Antidepressants may also help some people with MS fatigue.

You can talk to your neurologist to determine if a medication may be appropriate for treating your MS fatigue.

2. Get Regular Exercise

Regular exercise and physical activity — along with a balanced diet — can have many benefits for people with MS, including improved energy levels and mood. It can also improve strength, flexibility, balance, cognition, and bladder function. Tai chi, yoga, and water-based exercises are among the physical activities that health care professionals recommend for people with MS.

Remember to stay hydrated and exercise in a cool room or outside during the cooler parts of the day. Always talk to your doctor before beginning a new exercise program. As the National Multiple Sclerosis Society recommends, “Start low and go slow.”

3. Keep Cool

Some people with MS find that fatigue and other symptoms worsen with heat and humidity.

Keeping cool as much as possible can help with MS fatigue from heat. Some people with MS find special cooling scarves and vests to be helpful. A fan or air conditioning can also help. The Multiple Sclerosis Association of America offers a program to distribute cooling equipment to some people with MS for free.

Conversely, some people with MS experience sensitivity to cold. Now matter how temperature affects you and your MS symptoms, do your best to stay within your comfort zone.

4. Avoid Smoking or Get Help Quitting

Some members of MyMSTeam report that their fatigue is worse when they smoke cigarettes. According to the National Multiple Sclerosis Society, smoking can also affect the way MS medications work and speed up the shift of relapsing MS to a progressive type of MS. Quitting smoking is one of the few modifiable factors that will actually make a difference in your MS, so if you smoke, talk to your doctor about support with stepping away from cigarettes. This will improve not only your lung health but also your MS fatigue. There are a wide range of interventions that can help make the process easier.

5. Talk With Your Doctor About Supplements

Although some MyMSTeam members say they feel better when they take nutritional supplements, such as vitamins or herbal products, it’s important to talk to your doctor before adding new supplements to your diet. Some supplements can cause dangerous interactions with medications.

6. Try Energy-Conserving Techniques

Many people with MS fatigue adopt energy-conserving techniques that help make daily activities easier. The Multiple Sclerosis Association of America recommends energy conservation habits such as:

• Scheduling tasks for the time of day when you have the most energy
• Breaking tasks up into smaller chores and handling them one at a time
• Planning ahead and making lists so you have supplies such as food staples, batteries, or toiletries available when you need them

Ask your health care team to refer you to an occupational therapist who can teach you techniques for managing daily tasks more comfortably. Saving even a little energy throughout the day can make a difference. Eventually, these tactics may become habits that save you more energy over time.

MyMSTeam is the social network for people living with multiple sclerosis and their loved ones. On MyMSTeam, more than 216,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Is a daily struggle with fatigue part of your life with MS? How do you manage your MS fatigue? Share your experiences with fatigue in the comments below or by posting on MyMSTeam.