Fatigue Management Strategies in Multiple Sclerosis
Summary
Fatigue is among the most pervasive and disabling symptoms in multiple sclerosis, affecting up to 80% of individuals and exerting profound effects on daily functioning, work capacity and quality of life. Its multifactorial origins encompass central demyelination, neuroinflammation, deconditioning and psychosocial factors. Effective management hinges on early identification, comprehensive assessment and a multidisciplinary team including neurologists, occupational therapists, physiotherapists and psychologists. Pharmacological options remain limited, with amantadine frequently recommended, while non-pharmacological strategies form the mainstay of treatment. These include tailored exercise regimens to enhance aerobic fitness and muscular endurance; energy conservation and activity-pacing education to optimise the balance between activity and rest; and psychological therapies such as cognitive behavioural therapy (CBT), mindfulness and relaxation training. Advances in digital health have facilitated remote and blended delivery models, improving accessibility and personalisation. Integrating patient preferences and self-management skills not only reduces fatigue severity but also bolsters autonomy, social participation and long-term well-being in diverse healthcare settings.
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Fatigue Management Strategies in Multiple Sclerosis publication trend
The graph below shows the total number of articles in fatigue management strategies in multiple sclerosis across all publications each year (not limited to Nature Index journals).
Technical terms
Fatigue Severity Scale: A self-report questionnaire quantifying the intensity of fatigue and its impact on daily activities.
Cognitive Behavioural Therapy (CBT): A structured psychological intervention that modifies unhelpful thoughts and behaviours to alleviate symptoms.
Self-efficacy: An individual’s belief in their capacity to organise and execute actions necessary to manage fatigue effectively.
Locus of Control: The extent to which individuals perceive that outcomes are determined by their own actions (internal) versus external factors.
Energy Conservation Management: A set of educational and practical strategies enabling patients to balance activity and rest in order to reduce fatigue impact.
References
- Blended versus face-to-face cognitive behavioural therapy for severe fatigue in patients with multiple sclerosis: A non-inferiority RCT. Multiple Sclerosis Journal (2023).
- Structural relations of illness perception, fatigue, locus of control, self-efficacy, and coping strategies in patients with multiple sclerosis: a cross-sectional study. BMC Public Health (2024).
- The Efficacy of Psychological Interventions for Managing Fatigue in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis. Frontiers in Neurology (2018).
- Fatigue characteristics in multiple sclerosis: the North American Research Committee on Multiple Sclerosis (NARCOMS) survey. Health and Quality of Life Outcomes (2008).
- Management of Fatigue in Persons with Multiple Sclerosis. Frontiers in Neurology (2014).
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