MS Fatigue: What to Know

Stuart SchlossmanMultiple Sclerosis (MS) Symptoms

Medically reviewed by Seunggu Han, MD —
Written by Jacquelyn Cafasso on March 14, 2019

While most people associate multiple sclerosis (MS) with muscle weakness, numbness, and pain, fatigue is actually the most common symptom of the condition.
Nearly 80 percent of people diagnosed with MS experience fatigue at some point, according to the Multiple Sclerosis Association of America.
Fatigue is defined as extreme tiredness or unrelenting exhaustion. The fatigue associated with MS can be difficult to cope with, and is also difficult to explain to other people. Although it’s an invisible symptom, fatigue is very real for those living with the condition.
The first step to treating fatigue is to find out what’s causing it. Fatigue may be a result of nerve damage caused by MS. Sleep problems, depression, and medication side effects could also be part of the problem.
The good news is that it’s possible to manage fatigue with the right combination of medications, lifestyle changes, and energy-saving tips.

Scientists currently don’t fully understand the exact cause of MS-related fatigue. Some think that fatigue may be related to the constant activation of the immune system, sort of like having the flu virus at all times.
Others theorize that fatigue is related to the need for the brain to work harder in people with MS.
MRI scans have shown that people with MS fatigue use a larger area of the brain to perform tasks than people without fatigue. In response to nerve damage, the brain of a person with MS may be finding new routes for sending messages. This is thought to take more energy.
The feeling of fatigue may also be a result of the muscle weakness associated with MS.
Certain complications of MS can also induce fatigue. This may be referred to as a secondary cause. Complications of MS that may also cause fatigue symptoms include:
Fatigue can also be a side effect of certain medications, such as those used to treat spasticity, pain, and bladder dysfunction.
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