Multiple Sclerosis and Physiotherapy: Maintaining Function

Multiple sclerosis (MS) is an autoimmune condition where the immune system attacks the myelin sheath protecting nerve fibres, disrupting nerve signals between the brain and body. The result is a wide range of symptoms including weakness, fatigue, balance problems, spasticity, and sensory changes. While MS cannot be cured, physiotherapy plays a vital role in managing symptoms and maintaining function.

The goals of physiotherapy in MS differ depending on the type and stage of the condition. For relapsing-remitting MS, treatment focuses on recovery from relapses and maintaining function between episodes. For progressive forms, the emphasis shifts to slowing decline, managing symptoms, and adapting to changes.

Exercise is beneficial across all stages of MS. Research shows that regular, moderate exercise improves strength, fatigue, mood, and quality of life. The programme should be tailored to the individual's abilities and energy levels — MS fatigue is real and can be debilitating, so pacing is essential.

Key areas of treatment include: strengthening exercises for weakened muscles, particularly in the legs and core; balance training to address the instability that increases fall risk; stretching programmes to manage spasticity and prevent contractures; aerobic exercise to improve cardiovascular fitness and reduce fatigue; and energy management strategies (pacing, prioritising, and planning activities).

Temperature sensitivity is common in MS — heat can temporarily worsen symptoms. Exercise in cool environments and staying hydrated helps manage this.

Our neurological physiotherapy service provides specialist rehabilitation for people with MS, delivered at home where energy conservation is easier. Our falls prevention programme addresses the balance impairment that affects many MS patients, while our elderly physiotherapy service supports older adults with MS and co-existing age-related conditions.