Fatigue is often confused with tiredness. Tiredness happens to everyone. It is an expected feeling that occurs after certain activities or at the end of the day. Usually, you know why you are tired, and a good night’s sleep solves the problem.
Fatigue is a daily lack of energy; an unusual or excessive whole-body tiredness that is not relieved by sleep. It can be acute (lasting a month or less) or chronic (lasting from one month to six months or longer). Fatigue can prevent a person from functioning normally, and it has an impact on a person’s quality of life.
Multiple sclerosis and fatigue
What can I do to combat fatigue?
The best way to combat fatigue is to treat the underlying medical cause. Unfortunately, the exact cause is often unknown or there might be multiple causes.
Assessment
1. Evaluate your level of energy. Think of your personal energy stores as a "bank." Deposits and withdrawals have to be made over the course of the day or the week to balance energy conservation, restoration, and expenditure.
Keep a diary for one week to identify the time of day when you are either most fatigued or have the most energy. Note what you think might be contributing factors.
2. Be alert to your personal warning signs of fatigue. Fatigue warning signs might include tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety, or impatience.
Energy conservation
- Plan ahead and organize your work.
- Change storage of items to reduce trips or reaching.
- Delegate tasks when needed.
- Combine activities and simplify details.
- Schedule rest.
- Balance periods of rest and work.
- Rest before you become fatigued. Frequent, short rests are beneficial.
- Pace yourself.
- A moderate pace is better than rushing through activities.
- Reduce sudden or prolonged strains.
- Alternate sitting and standing.
- Practice proper body mechanics.
- When sitting, use a chair with good back support. Sit up with your back straight and your shoulders back.
- Adjust the level of your work. Work without bending over.
- When bending to lift something, bend your knees and use your leg muscles to lift, not your back. Do not bend forward at the waist with your knees straight.
- Carry several small loads instead of one large one, or use a cart.
- Limit work that requires reaching over your head.
- Use long-handled tools.
- Store items low.
- Delegate activities whenever possible.
- Limit work that increases muscle tension (isometric work).
- Breathe evenly, do not hold your breath.
- Wear comfortable clothes to allow for free and easy breathing.
- Identify the effects of your environment.
- Avoid extremes of temperature.
- Eliminate smoke or harmful fumes.
- Avoid long, hot showers or baths.
- Prioritize your activities.
- Decide which activities are important to you, and what could be delegated.
- Use your energy on important tasks.
Nutrition
Fatigue is often made worse if you are not eating enough or if you are not eating the right foods. Maintaining good nutrition can help you feel better and have more energy.
Exercise
Decreased physical activity, which might be the result of illness or of treatment, can lead to tiredness and lack of energy. Scientists have found that even healthy athletes forced to spend extended periods in bed or sitting in chairs develop feelings of anxiety, depression, weakness, fatigue, and nausea.
Regular, moderate exercise can decrease these feelings, help you stay active, and increase your energy.
Stress management
Managing stress can play an important role in combating fatigue. The following are suggestions:
1. Adjust your expectations. For example, if you have a list of 10 things you want to accomplish today, pare it down to two and leave the rest for other days. A sense of accomplishment goes a long way to reducing stress.
2. Help others understand and support you. Family and friends can be helpful if they can "put themselves in your shoes" and understand what fatigue means to you. Support groups can be a source of comfort as well. Other people with MS understand what you are going through.
- Relaxation techniques such as audio tapes that teach deep breathing or visualization can help reduce stress.
- Activities that divert your attention away from fatigue can also be helpful. For example, activities such as knitting, reading, or listening to music require little physical energy but require attention.
- If your stress seems out of control, talk to a health care professional. They are here to help.
Talk to your health care providers
Although MS-related fatigue is a common, and often expected, symptom, you should feel free to mention your concerns to your health care providers. There are times when fatigue might be a clue to an underlying medical problem. Other times, there might be medical interventions to assist in controlling some of the causes of fatigue. Finally, there might be suggestions that are more specific to your situation that would help in combating your fatigue.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 6/2/2006
