Skip to navigation Skip to content



In this article

Symptom: Primary (neurologic)


  • Overwhelming lassitude or tiredness at any time of day
  • Not correlated with activity level or quality and quantity of sleep
  • Often exacerbated by heat

Symptom: Secondary


  • Mood disorders-depression, anxiety
  • Stress
  • Commorbidities-acute (infection, injury) and chronic (diabetes, thyroid disorders)
  • Poor diet
  • Sleep disorders
  • Nocturia
  • Pain and spasticity
  • Decreased physical activity-muscle weakness and deconditioning
  • Environmental factors-temperature
  • Medication side effects

Psychosocial implications

  • Inability to carry out activities at home and at work (a major factor in early departure from the workforce and changes in family roles)
  • Fatigue of this magnitude affects mood and quality of life
  • Invisible symptom that is easily misinterpreted by others as laziness or disinterest


  • Address secondary contributing factors first
  • Physical therapy-energy conservation; moderate aerobic exercise; mobility aids
  • Occupational therapy-work simplification/energy conservation; nap schedule; use of assistive devices at home/work; cooling strategies/devices
  • Cognitive behavioral therapy-emerging evidence for decreased fatigue; is only sustained during treatment (van den Akker et al, 2016; van den Akker et al., 2017)
  • Medications for primary fatigue-amantadine, modafinil, armodafinil

Resources for clinicians

Resources for patients


Your input is important!

We believe that people affected by MS live better lives when they're connected.  To help us provide you with the best resources, support and information, please provide your feedback in a short survey.
Take the survey