The Concept of Fatigue in Multiple Sclerosis

Susan L. Johnson


J Neurosci Nurs. 2008;40(2):72-77. 

In This Article

Abstract and Introduction

Fatigue is one of the most common symptoms of multiple sclerosis (MS), and it can have a major impact on health-related quality of life. Therefore, it is imperative that healthcare practitioners regularly assess fatigue in their patients with MS. Fatigue can be caused either by the disease process (primary fatigue) or by other problems such as insomnia, infections, or depression (secondary fatigue). Because the causes of secondary fatigue are generally amenable to treatment, it is important that health-care practitioners distinguish between the two types of fatigue when assessing and treating fatigue. Because fatigue is a subjective experience, it can be difficult to measure. Tools such as the Fatigue Impact Scale and the Fatigue Severity Scale can be used to help clinicians and researchers measure fatigue. The Symptom Management Model can be used to guide healthcare practitioners in the assessment and treatment of fatigue. A variety of treatment options are available for MS-related fatigue, and it is important that patients and their support systems are made aware that fatigue can be managed.

The majority of people with multiple sclerosis (MS) will experience severe, debilitating fatigue at some point during the course of their illness (Egner, Phillips, Vora, & Wiggers, 2003; Mathiowetz, 2003). Fatigue impacts a person's health-related quality of life and ability to work (Bakshi, 2003; Forbes, While, Mathes, & Griffiths, 2006). Healthcare pro-fessionals need to include assessments of fatigue in their routine care of patients with MS and should be able to offer strategies to help them deal with any fatigue they might experience (Bakshi).

This article explores fatigue in the population with MS. The starting point is the definition of fatigue. The scope of the problem, the risk factors for developing fatigue, and the consequences of fatigue in persons with MS are examined. Depression as it relates to fatigue is discussed. A description of the manifestations of fatigue in the patient with MS is offered, as well as a tool that can be used to evaluate fatigue. Several evidence-based management strategies for dealing with fatigue in the patient with MS are presented. Finally, the Symptom Management Model is explored as a useful model that can be used for future studies on fatigue in this population.


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