Multiple sclerosis behaves differently in almost everybody who has it, which is why a programme copied from somebody else is rarely much use. Physiotherapy for MS starts from what your MS is actually doing to you now.
Commonly that means walking that has become harder or less reliable, weakness in one or both legs, stiffness and spasticity, balance problems, and fatigue that does not behave like ordinary tiredness. Frequently it also means a period after a relapse when function has dropped and needs building back.
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Exercise and fatigue, which is the difficult part
The instinctive response to MS fatigue is to do less, and that leads to deconditioning, which produces more fatigue. NICE guidance on managing MS recommends supervised exercise programmes, and there is good evidence that appropriately pitched exercise improves mobility and fatigue rather than worsening them.
The skill is in the pitching. Too little achieves nothing and too much provokes a bad few days, so we work out where your ceiling actually is and build underneath it. Heat sensitivity matters too, since exertion that raises body temperature can temporarily worsen symptoms for some people, and that is manageable once you know about it.
After a relapse
This is a good moment to have physiotherapy rather than wait and see. Function often recovers further and faster with a structured programme than without one, and knowing what is a lasting change and what is still recovering is genuinely useful.
Working with your MS team
We will write to your neurologist, MS nurse specialist or GP with your permission. Where you are already under NHS therapy we would rather coordinate than duplicate, and we will tell you if we think you are better served by the team you already have.
Frequently Asked Questions
Will exercise make my MS fatigue worse?
Should I have physiotherapy after a relapse?
Does heat affect what I can do?
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