Managing fatigue

Dr Anita Rose is a Consultant Neuropsychologist who works across the globe. She created a list on how to manage MS fatigue and this is something to live by. Dr Rose is well-known for her clinical work, research and consultancy to different MS groups. She travels the world speaking of patient, as well as health professional empowerment.

Fatigue is not only a debilitating symptom of MS; it also is the most common symptom. Those living with it speak of it in various strength and terms, and only have one hope: to one day be relieved of a symptom that upsets daily routines and causes people to retire from work.

Managing fatigue top tips, by doctor and author Anita Rose

Always remember you should never accept fatigue as an inevitable consequence of MS!

There are many management options available:

Discover your triggers:

  • How you manage your fatigue will depend partly on whether other MS symptoms and lifestyle factors are having an effect.
  • Analysing these can be a valuable first step in identifying how to minimise the problem.

Fill in a fatigue diary:

  • Rate your fatigue levels at different times of the day, and in relation to different activities, you might start to see patterns.
  • Perhaps you notice your fatigue is worse after large meals
  • Perhaps in the afternoon,
  • Is it better after an hour’s rest.
  • Do certain activities make you more tired than others?
  • Is it when you are hot or cold?

Take frequent rests:

  • Listen to your body. Don’t be tempted to overdo it if you are having a good spell – you might pay the price in a day or two!
  • It can be helpful to divide the day into three parts: be active in two of them and rest well in the third
  • If you have a big event coming up, prepare for it by getting as much rest as possible beforehand – and remember that rest means doing nothing at all


  • Choose a quiet place free from distraction.
  • Body temperature drops during relaxation, so ensure the room is warm enough or cover yourself with a light blanket.
  • You may want to loosen clothing and/or remove glasses or jewellery.
  • Find a comfortable position, either sitting or lying. If sitting, have your head supported.
  • Close your eyes to avoid distraction.
  • Practise your chosen technique – some people use tapes, soothing music or meditation. Like anything new, it may take a few sessions to achieve the desired result.
  • Maximise benefits of relaxation by doing at least 20 minutes every day.
  • ENJOY!

Prioritise activities:

  • Prioritise tasks into those that are essential and those that can wait
  • Save your energy for what you can do rather than struggling with tasks you find difficult – delegate these to other people!
  • Conserve your energy whenever possible. If you have to go upstairs to use the bathroom, save up other chores that need doing upstairs, to avoid having to make separate journeys. Also, keep duplicate cleaning materials upstairs and downstairs
  • Explore the possibility of working from home or cutting down your hours to part-time work

Time management:

  • Make a daily or weekly timetable of activities that need to be done and try to put activities in order of priority so that those that must be done are done before you run out of energy. Break large complicated tasks into smaller stages that can be spread throughout the day, e.g. peel potatoes in the morning to cook in the evening. Set yourself realistic targets. An important word in time management is NO.

Myths about time:

  • Those who are the most active get the most done
  • If I do it myself it will be done faster and better than if anyone else does it
  • The harder one works, the more work is done
  • Time can be ‘saved’

Lead a healthy lifestyle/exercise:

  • Try to keep generally fit. Exercise is essential, but remember to balance the exercise with rests. Eat a well-balanced diet. Excess weight, alcohol and smoking can all have a negative effect on fatigue.
  • Remember the saying ‘Use it or lose it’. Keep mobile, even if it only sitting in the garden – fresh air does wonders for depression. If possible, stand up and have a walk round every so often, to prevent stiffness in your legs
  • Take regular exercise if you are able. Swimming is a good option. Even if you are not a strong swimmer, spending time in warm water can be beneficial and relaxing
  • Exercising with a friend can be fun and can help to keep you motivated

Adopt a good posture:

  • Try to maintain an upright and symmetrical posture during all tasks. If necessary, rest on a perching stool while carrying out tasks. Avoid excessive twisting and bending and remember to rest in order to reduce strain on your joints and soft tissue.

Keep cool!

  • Some people with MS find that changes in temperature can cause them to become fatigued. This can be triggered by the weather, hot baths or showers, hot drinks or meals or feeling feverish as a result of infections. These effects are usually quickly reversed when steps are taken to cool down or when the temperature falls.
  • Take cool baths and showers,
  • Have regular cold drinks or suck an ice cube.
  • Some people find that air conditioning systems are helpful, especially during the summer.
  • There are cooling garments available commercially that can help with heat sensitivity. These range from relatively inexpensive collars or wrist bands through to more expensive cooling jackets.

Sleep “zzzzzzzzzzz”

  • Sleep is a very important part of healthy living. During sleep there are many complex processes going on in the body that allow people to wake up the next day feeling refreshed.

Get a sleep routine in place:

  • Have a warm milky drink.
  • Take a bath – the drop in temperature after a warm bath encourages the body to relax into sleep.
  • Read.
  • Listen to quiet music.
  • Do some gentle stretches.
  • Do a relaxation exercise
  • Use aromatherapy techniques.
  • Ensure that the room is a comfortable temperature; ideally, this should not be more than around 60°F (15°C).
  • If noise is a problem, try earplugs.
  • Reduce the light in the room. Light is a strong time cue to the body. If this is a problem, eye covers, as used on aircraft, are an easy way to reduce light stimulus and promote relaxation.

©Anita Rose

For more on Dr Rose, please visit these sites:

Community Therapists Network

Living with the effects of MS, part one

Living with the effects of MS, part two

Living with the effects of MS, part three

© Willeke Van Eeckhoutte and Ireland, Multiple Sclerosis & Me, 2011-2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Willeke Van Eeckhoutte and Ireland, Multiple Sclerosis & Me with appropriate and specific direction to the original content.

4 thoughts on “Managing fatigue

  1. Thanks for this… I just had surgery and I am tired as my body heals. I know it is not the same as MS, but still good advice. I may be returning to work this week (surgery almost 2 weeks ago) and I can see how easy it is to get caught up in the frantic pace of a busy time. If I am at work then others assume it means I can work full pace. I know my doctor will place me on restrictions and my goal will be to follow them! Thanks again for this and helping me put everything into perspective.

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