CHECK-UP: Sometimes fatigue is the most prominent symptom of multiple sclerosis, writes MARION KERR
My sister has had multiple sclerosis (MS) for many years but it has not interfered with her life to any great extent. Lately however, she is experiencing profound tiredness and I wonder if this is related to the condition?
Fatigue is one of the most common symptoms of MS, occurring in about 80 per cent of people. It can significantly interfere with a person’s ability to function and may be the most prominent symptom in a person who otherwise has minimal activity limitations.
Several different types of fatigue can occur in MS.
As some sufferers experience bladder problems that result in night-time awakening or nocturnal muscle spasms, sleep disturbance can result in fatigue. In addition, fatigue may also be a symptom in those who are depressed. And anyone who needs to expend considerable effort just to accomplish daily activities may suffer from additional fatigue as a result.
However, there is another kind of fatigue – sometimes referred to as lassitude – that is unique to people with MS.
In what way is it different?
Generally speaking it occurs on a daily basis, often early in the morning, even after a restful night’s sleep. It can increase as the day progresses and is often aggravated by heat and humidity.
In addition, it can come on suddenly and its severity is more likely to interfere with day-to-day activities. This form of MS-related fatigue does not appear to be directly correlated with either depression or the degree of physical impairment.
Can fatigue be treated?
Fatigue can also be caused by other conditions such as depression, thyroid disease or anemia, or as a side effect of various medications. It is important that a person with MS who develops fatigue be medically assessed to identify the cause and to initiate treatment of factors that may be contributing to their fatigue.
Occupational therapy intervention can provide a range of strategies to cope with fatigue. These include advice on the simplification of tasks at work and home, advice on fatigue and stress management, relaxation training and the provision of assistive technology.
Physiotherapy can help by teaching energy-saving ways of walking and helping to develop a regular exercise programme.
Sleep regulation, which may include the use of medications on a short-term basis, may be required.
Psychological interventions, including attending a local MS support group, also play an important part in the management of fatigue.
This article appears in the print edition of the Irish Times
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