Beating MS fatigue

Fatigue and MS often go hand-in-hand. In fact, fatigue is one of the most common and challenging symptoms of multiple sclerosis (MS), affecting around 75% of people living with the condition. But it’s more than just tiredness – MS fatigue is a persistent, often overwhelming sense of physical or mental exhaustion that can make everyday tasks much harder.

Fatigue can appear at any stage of MS and may be the most disabling symptom for some. It can affect your concentration, mobility, and even speech. But the good news is that research shows there are effective ways to manage it.

Understand your fatigue

Fatigue in MS can have different causes. Primary fatigue is linked to the disease itself and the way MS damages the central nervous system. Secondary fatigue is caused by factors such as poor sleep, bladder issues, medications, or stress.

A helpful first step is identifying your own fatigue patterns. Keeping a daily diary of your sleep, diet, activity, and symptoms can reveal useful insights and help pinpoint your personal triggers.

Scientifically backed strategies

A number of clinical studies have shown that certain lifestyle changes can significantly reduce fatigue. For instance

• Exercise A review of controlled trials published in Archives of Physical Medicine and Rehabilitation found that regular combined and resistance-based exercise can help reduce MS fatigue. NICE guidelines also recommend ongoing exercise such as yoga, stretching, or aerobic activity.
• Diet A 2022 review in BMC Neurology found that dietary interventions improved fatigue and quality of life in people with MS. A gut-friendly diet, with adequate vitamin D and omega-3 intake, was particularly beneficial.
• Mindfulness Studies have shown that mindfulness-based practices can improve emotional wellbeing and reduce fatigue in MS. One trial found people saw improvements in mood and even processing speed after just four weeks of mindfulness training.
• Supplements Some people with MS report improvements in fatigue with supplements such as coenzyme Q10, which supports cellular energy. Vitamin D and omega-3 fatty acids may also help, though more research is needed.

Always speak to a GP or MS nurse before starting new supplements or therapies.

 Pacing and planning

Pacing yourself is one of the most widely recommended tools for managing fatigue. This means spreading out activities, taking regular breaks, and avoiding overexertion. Many people use “spoon theory” — imagining they start the day with a limited number of spoons (units of energy) and budgeting them carefully.

It’s important to prioritise. Focus on what matters most and be kind to yourself about what can wait. Asking for help and planning rest periods can make a big difference.

Stay cool and manage stress

Around 80% of people with MS are sensitive to heat, which can worsen fatigue. Try using fans, cooling products, or scheduling activities during cooler times of day.

Stress and anxiety are also common fatigue triggers. Mindfulness, relaxation techniques, and good sleep hygiene all play a role in managing emotional wellbeing — and by extension, fatigue.

You’re not alone

At MS-UK, we know how hard fatigue can be — and we’re here to help. From our helpline and Choices booklets to online classes and peer support, we offer tools and understanding to help you take back control.

Learn more at www.ms-uk.org or call our helpline on 0800 783 0518.