Rethinking MS Fatigue: 3 Ways You Can Approach Energy Management

Woman walking on the beach with walking sticks

2 Mar 2022 | ~4:10 Engagement Time


Roz Kalb , Psychologist


Do any of these feel familiar? 

I’m so tired, I can’t even think.” 

“I get myself up and dressed and then I need a nap!” 

“I feel like a limp noodle.” 

“I just wanted to get one thing done today, and I’ve already hit a wall.” 

“I feel like I’m slogging through mud all the time.” 

It can be overwhelming and baffling, but fatigue is manageable.  

First, it’s helpful to understand what, exactly, this symptom is. Then, consider ways to rethink fatigue and manage your energy.

What makes MS fatigue so unique and challenging?

MS lassitude is the type of fatigue that is unique to people with MS. Its cause is not completely understood, but it seems to result from impaired nerve conduction in the central nervous system. This type of fatigue: 

  • Feels overwhelming and overpowering 
  • Can come on suddenly and worsen over the course of the day 
  • Is commonly aggravated by temperature changes – most often heat and humidity 
  • Is unrelated to the amount of sleep a person has had and may occur first thing in the morning 

What other factors contribute to fatigue in MS?

  • Disrupted sleep can increase fatigue. Pain, repeated trips to the bathroom, anxiety, depression, sleep apnea, or other primary sleep problems unrelated to MS can prevent you from having a restful night’s sleep. 
  • The extra effort and exertion required to carry out everyday activities can drain your batteries very quickly. 
  • Muscle fatigue caused by working weakened muscles can stop you in your tracks. 
  • Cognitive fatigue can occur during periods of intense focus or concentration. It may force you to stop, rest, and refocus. 
  • Mood changes, including depression, anxiety, and stress can increase your feelings of tiredness. 
  • Medication side effects also contribute to feelings of sleepiness and fatigue. 

With an understanding of what factors can impact your fatigue, now, let’s consider ways you can reframe this symptom to better manage it in your everyday life.

1. Managing fatigue is really about managing your energy bank.

Energy is a valuable commodity – as precious as money in the bank. So, the trick is to manage it as carefully as you manage your dollars and cents.  

Keep up with deposits and withdrawals in your energy bank. It’s as simple as this – if the funds aren’t deposited into your account, you can’t make a withdrawal. And you can’t take more energy out of your energy bank than you put in. 

You make deposits with adequate rest, a healthy diet, stress management, and physical activity. And then you plan your withdrawals carefully so that you don’t use all your energy up too quickly. You want to arrange your life in ways that help you get the most “bang for your buck.” 

If you push too hard on a “good day,” you’ll find yourself paying back into your account for the next several days. For example, if you pour all your energy into your job, there will be nothing left for enjoying your family at the end of the day.  

To best manage your energy account, use the 4 P’s. 

2. Remember the 4 Ps of managing your energy.


Plan your day and your week so that you balance activity with rest, work on the hardest tasks when you’re at your freshest, and take a break before you hit a wall 


Take a look at how you spend your time and energy. Does it align with your priorities or someone else’s? Are you getting the things done that matter most? If something really doesn’t matter, take it off your list. Give yourself grace – it’s OK to not do it all! 


Slow down, take rest breaks, don’t try to do everything at once. If you need to put a task off until tomorrow, that’s OK. 


How you carry out your everyday tasks determines how much energy you use. Don’t stand when you can sit. Consider using a motorized scooter to go long distances so that you still have energy left to enjoy yourself when you get to your destination. Arrange your environment so that there’s less bending, reaching, lifting as you go about your daily tasks.

3. Don’t forget, just like any other MS symptom, your healthcare team can help you with fatigue.

Your healthcare team is here to help you understand the factors affecting your energy and manage your fatigue. Here are the members of team and the ways each of them can help you. 

MS Provider (Neurologist, Nurse Practitioner, Physician Assistant)

They’ll help you pinpoint the sources of your fatigue or determine which medications might be contributing to your fatigue. They can also help manage pain or spasms caused by spasticity and prescribe medication to help relieve MS lassitude. 

Physical Therapist 

A PT can recommend a physical activity and exercise program to increase your energy, plus tools and mobility aids to help you conserve energy.

Occupational Therapist 

Meanwhile, an OT can teach you energy conservation strategies for daily activities. This can include ways to modify your environment, simplify tasks, and make the most of the energy you have. 

Mental Health Professional 

Psychologists, therapists, and other mental health professionals can identify and treat mood changes that may be affecting your energy level and your sleep. 

Sleep Specialist 

A sleep specialist can diagnose and treat any primary sleep problems such as sleep apnea that are interfering with your sleep. 


And finally, a urologist is an unexpected but important member of your fatigue-fighting team! They can diagnose and treat urinary problems that are disrupting your sleep. 


Fatigue is a reality when you live with MS, but there are ways to manage it! You can reduce fatigue, manage the energy you have more effectively, and get the things done that matter to you.  

Utilize your healthcare team, your support system, and additional resources found on our website to better fight fatigue.