Exhaustion and fatigue (fatig) seen in MS can be defined as a state of lack of physical and/or mental energy that prevents the patient from performing daily tasks or tasks. Fatig, like pain, is a subjective concept and is a condition that seriously negatively affects the patient's quality of life. Fatig is a condition different from fatigue in healthy individuals.
How Frequently Is Fatig Seen in MS?
Fatig is very common in MS. In one study, its frequency was found to be over eighty percent. It can be seen in all types and stages of MS. It is the most complained about by MS patients and, according to the patients' statements, the most annoying symptom.
Fatig disrupts mental and physical activity and therefore the quality of life. Fatig causes disability regardless of the patient's other neurological symptoms. Fatig causes disruption of activities at work, in social environments and in leisure time.
What Causes Fatig in MS?
Fatig is seen in MS. The exact cause is unknown. Among those being investigated as possible causes:
-Immune system disorder
-Incompatible functioning of the nervous system and endocrine (hormonal) system
-Nerve conduction disorders
-Low metabolic activity of some parts of the central nervous system
-Inability of the nervous system to fully perform its functions due to myelin damage.
MS That Can Lead to Fatig What are the Other External Causes?
Fatig is a condition that can be directly caused by MS disease. However, some accompanying conditions cause the development of fatig or its severity to increase. When evaluating the presence and severity of fatig in MS patients, other contributing factors should also be questioned. These factors;
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All medications the patient is using should be questioned. The presence of medications that may cause sedation and sleep should be investigated and, if any, discontinued.
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The presence of depression should be questioned, if present, it should be evaluated by a psychiatrist experienced in MS and effective treatment should be arranged.
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Detailed laboratory examination should be performed to exclude chronic medical conditions that may cause or increase Fatig's condition. (such as B12 deficiency, urinary tract infection, anemia, hypothyroidism, liver or kidney disease)
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It should be investigated by the neurologist who follows the patient in terms of new disease activity with a detailed examination and evaluation. Fatig may be the initial symptom of MS exacerbation.
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Lifestyle and habits should be questioned in detail. (alcohol, cigarette use, insomnia, drug use, etc.)
Is there a non-drug treatment for Fatig?
Non-drug treatments are approaches that should be evaluated before starting medication for the patient.
There are publications showing that aerobic exercise is beneficial in reducing fatig. Therefore, exercise is recommended in patients with fatig. However, the type, duration and frequency of exercise should be tailored according to the patient's current condition. The patient should be evaluated in detail by a physiotherapist experienced in MS, and home exercise programs most appropriate to the patient's current condition should be organized. Patients should be informed that they will begin to benefit from exercise programs only after a few weeks.
Effective energy use strategies can help patients determine how to use their energy most effectively throughout the day. These strategies are usually organized by an occupational therapist. The goal is mostly to ensure that patients spend their limited energy on the most meaningful and important activities, and to prevent them from wasting too much energy on unimportant and useless tasks.
Recommendations;
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Use of assistive devices
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Improving environmental factors
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Planned naps or rest breaks
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Activity keeping a diary
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Recommendations for improving sleep hygiene
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Use of methods to cope with stress
Cooling devices can be used to reduce fatig, which occurs due to sensitivity to temperature. These devices can be used in hot weather or during exercise. It can also be used in sleep.
Effective and appropriate sleep hygiene should be emphasized. Additionally, cognitive behavioral therapy and other behavioral or relaxation techniques can be considered as other recommended methods for dealing with fatig.
Caffeine is generally not recommended in the treatment of fatig seen in MS patients. The reasons for this include the fact that caffeine may increase this situation in patients who already have or tend to have urinary incontinence due to its diuretic effects. Another reason is the potential to cause sleep disorders due to its effects that can last for approximately 9 hours.
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