Physical Therapy for MS
For many years it has been advised that physical therapy for MS (multiples sclerosis) is not good and that exercise can make symptoms worse. Sufferers are encouraged to get as much rest as possible, and while we know rest is essential for managing fatigue, we do not need to rest all the time.
However, recent research has found that physical therapy (PT) for MS is of great benefit to people with MS. Healthcare professionals now say that PT can help with balance, core strength and general limb strength, as well as helping ease muscle spasms, spasticity and other related complications.
MS has left me with numerous disabilities, including balance, spasticity and walking problems. PT is usually the last thing I feel like doing, so it is ironic that it is likely to make a vast improvement to how I feel.
I’m guilty of finding numerous reasons why I cannot manage exercise, usually convincing myself I need to rest after a busy day at work or time with my family. People with MS do need to pace ourselves and rest more often than other people, but we should also find a way to incorporate as much PT as we can manage into our weekly routine, as the benefits far outweigh any negative impact.
What Is Physical Therapy?
According to Healthline, PT for MS involves muscle strengthening exercises that improve your ability to walk, your coordination and balance. It can also include stretching to help maintain mobility and prevent muscle spasms. Another essential aspect of PT is training to use mobility aids correctly, such as a cane or walker. It can also help those of us who can no longer walk by improving seated posture and upper body strength.
PT can be helpful with all types and stages of MS, but an early referral can help you learn how your body might change due to progression and it can help you cope with these changes. It can also be critical in recovering back to full strength after a relapse and it can help you develop stamina and strength to increase your chances of staying free from disability.
What Does PT Involve?
Unfortunately, what you can expect from PT often depends on where you live. In the U.K., what level of PT you can expect can vary from place to place and it is often called a post code (zip code) lottery. Someone in the south coast of the U.K. can have a different experience from someone in the north, Scotland, or Wales. This is mainly due to NHS funding, and although I find this frustrating and unfair at times, at least our healthcare is free, and we do not need insurance to be able access some level of PT.
I’ve been referred for physiotherapy a few times by my neurologist, but overall, I found it exhausting trying to get to appointments. I was using two walking sticks at the time and the therapy room was so far to walk from the parking bays that I would be on my knees by the time I got there. I felt this outweighed any benefits I gained and in an ideal world where money was no barrier, a therapist would visit me at home where I felt safe and supported, but this is unlikely to happen in the U.K.
Usually you will be referred for PT by your healthcare team and you will get an assessment. This will involve a physical examination to determine what your needs are, and a care plan will be established.
Different Levels of MS
Diagnosis
If you are newly diagnosed and do not have a lot of mobility issues you will be encouraged to maintain your strength and mobility. At this stage, a baseline evaluation of physical ability and functioning should be performed, followed by education and suggestions for how to manage the disease.
Relapse
The goal when recovering from a relapse should be a return to baseline functioning where possible. Exercises should be tailored with this goal in mind depending on the relapse. It’s suggested you wait a few weeks after relapse before having PT, as side effects from steroid medication can have an impact.
Progressive Stage
PT at this point therapy needs to be proactive, and goals should include introducing aids and using them correctly, as well as preventing muscle wasting and deconditioning.
Advanced Stage
If the patient is no longer walking at this stage, PT will focus on posture when seated, upper body/arm strengthening exercises and standing devices.
Where Does PT Take Place?
PT can be performed in a hospital outpatient setting, an MS treatment center or at home, and it is important you ask your healthcare team if you have not had an assessment.
A few years ago, I paid for private Pilates lessons at my house. It was so beneficial as I felt safer at home and did not have the pressure of trying to get anywhere. I found it too expensive though.
Other forms of PT that people with MS have found useful include massage, physiotherapy and yoga, so there may be forms of PT that would suit you better.
Make inquiries with your healthcare team and get referred straight away if you have not done so already. It’s important to feel proactive and that we have some control over our own disease. There’s always something you can do to improve how you feel.