Understanding and Overcoming MS Fatigue

Strategies to help reduce this common but frustrating symptom of MS.

Medically reviewed in April 2022

Fatigue is described as a feeling of tiredness, weariness, low motivation, and low energy. It is different than simply being tired or drowsy, though these feelings may accompany fatigue. In some cases, fatigue is a normal response to physical activity, stress, or getting too little sleep. In other cases, fatigue results from a health condition or occurs alongside a health condition.

Fatigue is one of the most common symptoms reported by people with multiple sclerosis (MS), an inflammatory disease that damages the brain and spinal cord.

Primary and secondary fatigue
The relationship between MS and fatigue is not fully understood. One theory is that fatigue occurs as the result of higher levels of immune activity and inflammation in people who have MS. Other theories speculate that fatigue is related to the nerve damage caused by MS—that it’s the added strain of performing normal functions with a damaged nervous system, or a reduction in nerve signals that are exchanged between the brain and body. These examples would be considered primary fatigue because MS is the primary cause.

Other causes of fatigue would be considered secondary fatigue, as they are indirectly caused by MS. For example, some people with MS have difficulty sleeping because of pain, depression, sleep disorders, or bladder dysfunction—all of which can occur as a result of MS. People with MS may also become fatigued more easily because it takes more time and energy to perform everyday tasks, such as preparing a meal or running an errand. For others, medications used to treat MS may contribute to fatigue.

It is important to keep in mind that fatigue can have many causes, such as nutritional deficiencies, too little physical activity, and stress. These may be related to having MS or may be related to other aspects of a person’s life. Also, fatigue may not have a single cause, but can be the result of several different factors.

There is another term that is used to describe the fatigue experienced by people with MS—lassitude. The word is derived from the Latin term for “weary” and refers to a state of physical or mental weariness, and an overall lack of energy.

Lassitude is used to describe a specific type of fatigue sometimes experienced by people with MS. It has a few characteristics that make it different when compared to other types of fatigue. It can have a sudden onset and be more likely to interfere with normal activities. It tends to occur daily, can begin early in the morning (even when a person has slept well), and may worsen throughout the day. Heat and humidity can make it worse, and it can be severe, even when other MS symptoms are not severe.

What you can do
The most important thing a person with MS can do is work with healthcare providers who understand the condition. While there is no cure for MS, there are a number of treatment options available, which can treat and prevent attacks and slow the progression of the disease.

An important aspect of treating MS is addressing the specific symptoms that impact a person’s life. This includes fatigue. As mentioned above, fatigue can have numerous causes. It is important to identify what is causing your fatigue so that you and your healthcare provider can find the best way to address it.

Some strategies that may be used to manage fatigue include:

  • Avoiding MS triggers and following your treatment plan.
  • Exercise and/or physical therapy, which can help improve strength, stamina, and energy levels.
  • Occupational therapy, which can help you find ways of making everyday tasks less taxing and strenuous.
  • Strategies to avoid overheating, such as how you dress and what temperature you keep your home.
  • Eating a diet that meets your nutritional needs.
  • Taking care of mental and emotional health, which can include managing stress, joining a support group, and taking part in counseling or therapy.
  • Improving sleep and treating MS symptoms that interrupt sleep.
  • Using strategies to conserve energy, such as prioritizing the most important tasks and scheduling breaks throughout the day.
  • Getting help from a friend of loved one when you need it.

MedlinePlus. "Fatigue."
Mayo Clinic. "Symptoms: Fatigue."
Fary Khan, Bhasker Amatya, and Mary Galea. "Management of Fatigue in Persons with Multiple Sclerosis." Frontiers in Neurology, 2014. Vol. 5, No. 177.
Cleveland Clinic. "Multiple Sclerosis: Fatigue."
MS Society. "Causes of Fatigue."
Tiffany J. Braley and Ronald D. Chervin. "Fatigue in Multiple Sclerosis: Mechanisms, Evaluation, and Treatment." Sleep, 2010. Vol. 33, No. 8.
Medical News Today. "What does MS fatigue feel like?"
Medical News Today. "What causes fatigue, and how can I treat it?"
Merriam-Webster Dictionary. "Lassitude."
National Multiple Sclerosis Society. "Fatigue."
UpToDate. "Patient education: Multiple sclerosis in adults (The Basics)."

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