Fatigue is, perhaps, the most common symptom of multiple sclerosis, with the majority of people with MS experiencing it at some point in the course of the disease.
It may be that the fatigue is a permanent feature of your MS, or it may come and go without plausible explanation. Generally MS fatigue can be classified as mental fatigue or physical fatigue.
The physical fatigue, I think, is fairly self-explanatory. You do some physical labour, you get tired, you lie down and rest – sorted! However, apparently, for reasons not fully understood, the efficiency of demyelinated nerves deteriorates very rapidly with use. If you were to go out for a walk, you may begin in a sprightly manner, but very quickly you slow down and begin to find it increasingly difficult to lift you feet or coordinate your leg movements. The nerve function has begun to fail. This will recover with rest.
When thinking about the operation of my CNS, I like to make the analogy with electrical wiring. If an electric circuit is working too hard, the wires will overheat, the insulation may start to melt and break down, the connection may burn out. All, potentially, catastrophic failures. Something of this ilk is happening when you over-tax your body and your nerves are handling too many signals.
Much of the physical fatigue can be attributed to disturbed sleep patterns caused by urinary urgency or nocturnal spasms (myoclonus).
One of the most noticeable symptoms that I experience; is my eyesight. This starts well in the morning but deteriorates as the day progresses. My Optician called it old-age (Cheeky young whippersnapper, I’m only 48). However, it was my MS nurse who made the fatigue connection. The muscles that focus the eyes are becoming tired and not working as they should.
Mental fatigue is not so clear-cut. It is often, but not exclusively, associated with depression. A word I try to use sparingly. In my experience mental fatigue seems to manifest itself as a lack of motivation, or an “I can’t b bothered” attitude.
My local rehabilitation centre places great store on Fatigue Management, but what this entails I have yet to discover, as I am still on the waiting list for the classes.
- Occupational therapy to simplify every-day tasks
- Physical therapy to find more energy-efficient ways of daily tasks
- Relaxation training
- Heat management
- Medication (Amantadine and Modafinil are two oft used)
If you do suffer from fatigue in any way do not feel guilty about resting, at any time day or night. I know I did for a while, and was frequently accused of being lazy which I take great offence at. I think most of the criticism came from myself. I would be lying of the settee having a rest, but knowing that I had things to do.
Multiple Sclerosis Society UK Overwhelming sense of tiredness