Fatigue is one of the most common (75-85% of cases) and hard-to-treat complaints for patients with MS. It is described as a constant feeling of lethargy, tiredness as soon as you awake, or a total lack of energy. Simple domestic tasks can require more effort. Sometimes fatigue is present for years before there is any ‘tangible’ medical proof. Physical exhaustion can restrict professional and social activities.

A distinction can be made between primary and secondary fatigue. Primary fatigue is an overwhelming fatigue independent of activity, heat sensitivity or environmental factors. Secondary fatigue is the result of factors that are indirectly or not linked to MS, such as an impaired gait, sleep disorders, infections, medication, depression, heat and/or other medical problems (thyroid, anaemia). Regardless of the cause of the fatigue, it usually requires a multidisciplinary approach with some essential general tips and energy management.