Living with Multiple Sclerosis (MS) is different for each individual. MS has no known cause, affects different parts of the central nervous system and at different rates.
And so, it is important that an MS diagnosis is made by a neurologist, and that treatment is supported by the neurologist, MS specialist nurse and a specialists from multiple disciplines (eg physiotherapy) to help address the range of treatment options and difficulties which may arise.
Physiotherapy for Multiple Sclerosis
An obvious and common symptom of MS is weakness in the limbs and trunk muscles. Although this is not the same as weakness caused by rest or lack of exercise, some of the same training principles can be applied. A physiotherapist will demonstrate and assist with an exercise program adapted to allow the MS sufferer to "strengthen" the working muscles and neural pathways available. The exercise program will be selected to maximise efficiency and minimise the effect on any fatigue symptoms. This in turn improves movement and function.
Spasticity is a complex secondary complication which results in the tightening of muscles in the affected limb/s. Once the source and causes have been identified, spasticity can be managed with regular positioning, stretches and sometimes medication or splinting. Spasticity can sometimes disguise available movement and function, so these can improve when the spasticity is controlled.
Less visible but equally disabling are changes to the sense of touch, pressure, joint position etc.
This makes it more difficult to detect where a limb is or what it is pressing on. A lack of sensation can leave a person at risk of burns, pressure sores or other injury, as well as difficulty in function.
Physiotherapeutic techniques can directly improve rehabilitation of the sensory system and a physiotherapist can also give advice about prevention of secondary injuries.
Fatigue is an overwhelming sense of tiredness, which can come on suddenly and not always with a recognisable trigger. There is some evidence that fatigue is caused by a mis-match in sensori-motor processing.
Using this information, and a solid fatigue diary, you and your therapist can start to understand your fatigue and manage it so that it interferes less with your daily life.
Exercise is an important part of fatigue management, the right kind and timing of exercise can improve the experience of fatigue.
Fatigue is an independent factor in predicting the likelihood of return to work, the importance and impact of fatigue must not be underestimated!
Whether it is in returning to work or just getting to the toilet, the physical and perceptual problems caused by MS can affect your ability to function in a progressive and/or variable way.
Physiotherapists can work with you to adjust the environment, the approach to a task or tailor your treatment to improve the strength or movement needed to achieve your target.
For example, if you could get to the toilet, but it's not on the same floor level, your therapist could help you learn how to manage the stairs. Alternatively you could work on how to transfer to a stair lift, or how to access a commode chair with the help of your carer.