Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. It damages the myelin sheath that protects nerve fibers in the brain, spinal cord and optic nerves. This damage slows down or blocks messages between the brain and body, leading to MS symptoms.
While MS is a highly individual condition, many people describe feeling generally unwell or under the weather as part of living with the disease. MS fatigue is one of the most common symptoms, experienced by about 80% of people. Cognitive changes or brain fog are also very common.
Other MS symptoms like pain, vision problems, muscle spasms, weakness, walking difficulties, numbness, dizziness, bladder problems, sexual problems and depression can all contribute to you not feeling your best overall.
What causes the unwell feeling with MS?
There are a few key factors that cause MS to make you feel unwell or under the weather:
– **Inflammation** – The immune system attacks trigger inflammation in the central nervous system. This directly contributes to many symptoms.
– **Myelin damage** – Destruction of myelin slows nerve impulses and communication between the brain and body. This disrupts normal function.
– **Nerve damage** – Inflammation and myelin loss eventually causes damage or scarring to the nerve fibers themselves. This leads to additional symptoms.
– **Brain atrophy** – Over time, progressive brain shrinkage or loss of volume is common with MS. This affects cognitive skills.
– **Lesion location** – Where lesions develop in the central nervous system determines which functions are impacted.
– **Disease progression** – Worsening disability and accumulating damage over time increases symptoms.
– **Comorbidities** – Other conditions common with MS like depression, chronic pain and sleep disorders amplify symptoms.
– **Medication side effects** – Some MS medications have side effects like fatigue, nausea or flushing that can make you feel unwell.
MS symptoms that contribute to feeling unwell
Many different MS symptoms can converge to leave you feeling under the weather, rundown or not your usual self. Common culprits include:
– **Fatigue** – Debilitating exhaustion is the most frequent MS symptom. Normal activities may trigger fatigue or make it worse.
– **Cognitive changes** – MS brain fog involves problems with memory, attention, processing speed and other thinking skills that disrupt your abilities.
– **Vision problems** – Blurred or double vision is common with MS and can significantly impact daily function and quality of life.
– **Numbness and tingling** – Numbness, pins and needles, a squeezing sensation or reduced sensitivity to touch frequently occurs.
– **Muscle weakness** – Weakness in the extremities or trouble walking due to weak legs is very common with MS.
– **Spasticity** – Muscle stiffness and involuntary spasms produce pain and mobility challenges.
– **Dizziness and vertigo** – Balance problems, lightheadedness and the sensation of spinning are common MS symptoms.
– **Pain** – Many people with MS experience chronic neuropathic nerve pain or back pain that affects their comfort.
– **Bladder dysfunction** – Urinary urgency, frequency and incontinence are highly prevalent in MS.
– **Bowel problems** – Constipation, diarrhea and loss of bowel control may occur and limit activities.
– **Sexual problems** – Reduced libido, genital numbness and inability to orgasm are frequent issues.
– **Emotional problems** – Rates of anxiety and clinical depression are elevated with MS.
MS complications that make you feel unwell
In addition to direct MS symptoms, complications of the disease can develop over time that leave you feeling wiped out or sickly, such as:
– Sleep disorders like insomnia, sleep apnea and restless leg syndrome
– Chronic pain conditions, especially neuropathic pain from nerve damage
– Loss of mobility from muscle weakness, spasms, tremors or balance issues
– Bladder and bowel incontinence or frequency impacting sleep and activity
– Poor nutrition from MS symptoms affecting eating or food absorption
– Side effects of medications used to treat MS symptoms
– Infections like the flu or UTIs that are worse due to a weakened immune system
– Stress, loneliness, worry and depression resulting from MS challenges
– Deconditioning and reduced fitness levels amplifying fatigue and weakness
When to see your doctor
Feeling generally unwell and rundown is unfortunately common with MS, but new, worsening or severe symptoms always warrant medical attention. See your doctor promptly if you experience:
– Sudden onset of new MS symptoms
– Significant worsening of existing symptoms
– Severe fatigue or weakness that limits self-care
– Numbness or tingling accompanied by pain
– Clumsiness, trouble walking or loss of balance/coordination
– Severe bladder or bowel incontinence
– Vision loss, double vision or eye pain that doesn’t improve
– Confusion, disorientation or slurred speech
– Seizures or loss of consciousness
Getting relief when you feel unwell with MS
While some variability in how you feel is to be expected with MS, there are ways you can help manage symptoms and feel better:
– Keep all medical appointments and discuss concerning new or worsening symptoms
– Take all prescribed medications reliably for optimal effect
– Maintain a healthy diet and nutritious meals despite appetite changes
– Stay hydrated and drink adequate fluids daily
– Get enough rest and sleep by maintaining good sleep habits
– Set priorities and pace yourself to balance rest and activity
– Exercise as much as possible within your limits to reduce fatigue
– Make time for enjoyable hobbies, socializing or relaxing activities
– Utilize mobility aids or accessibility tools to conserve energy
– Treat related conditions like anxiety, depression or pain aggressively
– Consider massage, acupuncture or meditation for natural symptom relief
– Communicate openly with loved ones about your limitations
When to seek emergency treatment
Most MS symptoms can be managed on an outpatient basis. However, a few scenarios require urgent medical help at the emergency room, such as:
– Loss of vision in one or both eyes
– Sudden weakness or numbness on one side of your body (stroke-like symptoms)
– Slurred speech, confusion or difficulty understanding others
– Dizziness combined with trouble walking or loss of balance/coordination
– Severe, persistent headache accompanied by confusion or vomiting
– Severe worsening of MS symptoms, especially after starting or changing DMTs
– Suicidal thoughts (from severe depression)
– Signs of a significant infection like high fever, cough, vomiting or severe pain
Adapting your lifestyle to manage MS symptoms
Living with MS often requires making thoughtful changes to your routine to prevent symptom flares and feel your best. Important lifestyle measures include:
– Pacing your activities and rest periods. Don’t overexert yourself.
– Planning adequate time for sleep and naps.
– Making time for stress management and self-care.
– Asking for help from others when needed.
– Using mobility aids (wheelchair, cane, walker) to conserve energy.
– Wearing cooling clothing and staying hydrated.
– Eating smaller, more frequent meals if digestion is affected.
– Clearing living spaces of clutter/obstacles.
– Adjusting schedules to maximize high energy periods.
– Working from home or modifying work duties if possible.
– Joining a support group to discuss coping strategies.
Helpful tips to manage specific symptoms when you feel unwell
You can also target troublesome MS symptoms individually when they arise to minimize their impact:
**For fatigue:**
– Take short rests and naps as needed.
– Include gentle stretching or light exercise.
– Use ice packs/cooling products and fans.
– Drink plenty of fluids.
– Take fatigue-fighting medications if prescribed.
**For cognitive changes:**
– Make lists, notes and reminders.
– Focus on one task at a time.
– Use alarms, timers and calendars.
– Practice memory exercises.
– Reduce distractions when focusing.
**For vision problems:**
– Use sunglasses outdoors.
– Increase font sizes when reading.
– Use audiobooks and screen readers.
– Install adequate lighting.
– Request large print documents.
**For numbness/tingling:**
– Apply cold/warm packs to affected areas.
– Perform range of motion exercises.
– Massage or rub numb areas.
– Wear loose clothing over affected skin.
**For muscle weakness:**
– Exercise within your limits to maintain strength.
– Use mobility aids like braces or canes.
– Eliminate fall risks at home.
– Take frequent rest periods and avoid straining.
**For spasticity:**
– Take medications to reduce muscle tightness.
– Apply warm towels or heating pads to tense areas.
– Gently stretch and massage spastic muscles.
– Maintain proper posture and move stiff joints slowly.
Treatment options for managing MS symptoms
Doctors have many medical treatments available to help manage MS symptoms so you feel less drained, fatigued or unwell overall:
**Medications**
– Disease modifying therapies (DMTs) to slow MS progression and reduce flares
– Fatigue-fighting drugs like amantadine or modafinil
– Muscle relaxants like baclofen for spasticity
– Antidepressants for mood symptoms or pain
– Medications to treat bladder dysfunction
– Steroid drugs to reduce acute symptom flares
**Rehabilitation Therapies**
– Physical therapy to build strength, balance and mobility
– Occupational therapy to maintain functionality
– Speech therapy for swallowing/communication issues
– Cognitive rehabilitation to manage thinking changes
**Complementary Therapies**
– Osteopathic manipulative medicine for pain or muscle tightness
– Acupuncture to reduce spasms, fatigue and discomfort
– Biofeedback training to control symptoms
– Mindfulness meditation for mental health
– Yoga and Tai-Chi tailored for people with MS
**Assistive Equipment**
– Canes, walkers or wheelchairs to aid mobility and conserve energy
– Orthotics like braces or splints for foot drop or joint instability
– Hand rails, ramps and grab bars to prevent falls
– Urinary catheters or adult briefs for bladder symptoms
– Memory aids and electronic organizers for brain fog
When feeling unwell becomes a medical emergency
Most of the time, you can manage flares in MS symptoms at home with rest, medications and adaptations to your routine. But occasionally worrisome changes require prompt medical attention at an ER or urgent care clinic, such as:
– Sudden loss of vision or double vision
– Acute weakness or paralysis on one side of the body
– Slurred speech or inability to speak
– Confusion, disorientation or memory loss
– Difficulty walking or loss of coordination/balance
– Repeated falls or immobility
– Severe fatigue causing inability to care for yourself
– Overwhelming depression with suicidal thoughts
– New MS symptoms combined with high fever
– Severe pain, numbness or tingling that does not improve
Don’t delay seeking emergency care if you experience these red flags because early treatment of flare ups can prevent permanent nerve damage. Call an ambulance immediately if your symptoms are sudden and severe.
When to call your neurologist
For worrying MS symptoms that are not as sudden or debilitating as those requiring an ER visit, call your neurologist promptly to discuss management options. Examples include:
– Moderate worsening of fatigue, weakness or spasticity
– Numbness, tingling or burning pain in a new location
– Vision changes like blurriness or partial loss of sight
– Cognitive difficulties like forgetfulness or confusion
– Depression, anxiety or mood swings that persist
– New instance of slurred speech or difficulty swallowing
– Increase in urinary/bowel accidents or urgency
– Dizziness, vertigo or lack of coordination that led to a fall
– Difficulty recovering from common illnesses or infections
– Any symptom negatively impacting sleep, self-care or quality of life
Don’t delay contacting your MS providers about concerning symptom changes or problems managing your daily activities. They can help determine if medication adjustments, physical therapy or other interventions could help you feel better.
Lifestyle changes to improve feelings of unwellness
Along with medical treatment of symptoms, making a few key lifestyle adjustments can greatly enhance your overall well-being with MS:
– Get adequate sleep and rest
– Eat a balanced, nutritious diet
– Exercise and remain active at a moderate pace
– Reduce stress through yoga, meditation, counseling
– Join a support group to share coping strategies
– Limit overheating from hot weather or baths
– Avoid smoking, alcohol and other unhealthy habits
– Drink plenty of fluids to stay hydrated
– Take breaks to engage in hobbies you enjoy
– Maintain social connections that energize you
– Adapt home environment and work duties as needed
– Seek mental health support for depression or anxiety
While MS can certainly make you feel under the weather at times, focusing on rest, health behaviors, social support and symptom management can go a long way toward helping you feel your best. Don’t hesitate to seek medical help when needed. With the right lifestyle measures and treatment, you can minimize MS symptoms and continue enjoying life.
Conclusion
MS is a challenging condition that often leaves those affected feeling generally unwell, run-down or under the weather. Fatigue, cognitive issues, pain, vision changes and mobility limitations take a toll on your overall well-being. Acute flares in symptoms, complications like depression or side effects of treatment can also make you feel sickly or wiped out. While some variability in how you feel is to be expected with MS, focusing on symptom management, listening to your body, adopting a healthy lifestyle and getting adequate rest can go a long way toward helping you feel better overall. Don’t hesitate to seek prompt medical attention if your symptoms suddenly worsen or prevent you from functioning. Your providers can help determine if medication adjustments, physical therapy or other interventions are needed to get you feeling like yourself again. With the right self-care strategies, support system and treatment, you can minimize the unwellness of MS and continue pursuing a full, enjoyable life.
