Multiple sclerosis (MS) is an autoimmune condition that damages the protective lining around nerve fibers called the myelin sheath in the central nervous system (CNS). The CNS is made up of the brain and spinal cord. People with MS can have severe fatigue, depression, bowel and bladder dysfunction, vision problems, muscle weakness or stiffness, tremors, and pain.
A healthy lifestyle is an important part of living with MS and can complement your medical care. While no single lifestyle change can fix your MS, lifestyle changes and medical interventions together can improve your symptoms and quality of life.
The following is a list of research-based lifestyle modifications to help manage the symptoms of MS.
Lifestyle Tips for MS
There are a number of measures you can take to make living with MS more manageable.
Maintain a Healthy Diet
Maintaining a healthy diet can have a big impact on your MS symptoms. One study found that better diet quality was associated with less disability and lower symptom severity. To determine diet quality, the researchers examined participants’ intake of:
- Legumes (such as peas, beans, and lentils)
- Whole grains
- Added sugars
- Red or processed meats
Another study examined the impact of a low-fat, plant-based diet on people with MS for one year. While the diet did not impact disability or relapse rates, people on the diet showed significant improvements in fatigue, body mass index (BMI), and metabolic biomarkers compared to the non-diet group.
More research needs to be done to determine the ultimate MS diet. For the time being, it does appear that a well-balanced diet full of fruits, vegetables, and whole grains has the potential to improve MS symptoms. It’s wise to speak to a dietitian or nutritionist before significantly altering your diet.
Exercise Your Body
Exercise is one of the most researched lifestyle measures for MS. According to the National MS Society, aerobic exercise for people with MS can improve:
- Cognition (thinking)
- Bone density
- Bladder and bowel dysfunction
- Cardiovascular fitness and endurance
Another review found that exercise training is safe for people with MS and is not associated with relapse.
A physical therapist can help develop an exercise program personalized to you. Meaningful activities—like gardening, doing laundry, cooking, or walking the dog—are also forms of exercise. An occupational therapist can help you modify these to be more accessible to you.
Exercise Your Brain
MS can affect cognitive thinking abilities in up to 65% of people with the condition. Cognitive impairment most commonly affects memory and slows information processing. Difficulties in executive functioning, attention, verbal fluency, visual perception, and more can also be affected.
It’s important for your healthcare provider to perform an annual cognitive screening to monitor changes. If they or you notice cognitive decline, they can refer you to the appropriate professionals and even organized “brain training” programs.
On your own, you can keep your mind active by challenging yourself and learning new skills to promote neuroplasticity (the growth of new neurons). Some activities include:
- Word searches
- Card games
- Word games
- Playing music or learning a new instrument
- Reading and writing
- Artwork or crafts
- Learning dance routines
- Learning a language
- Leading workshops or presentations
Get Quality Sleep
Getting a good night’s sleep is important if you have MS, because sleep deprivation can worsen fatigue and other MS symptoms.
Unfortunately, sleep issues are common among people with MS. This can be due to factors like daytime napping, certain MS medications or their side effects, vitamin D deficiency, pain, and increased stress due to MS.
Some tips for improving sleep quality with MS include:
- Reducing caffeine and alcohol
- Practicing sleep hygiene, such as going to bed at the same time every night, keeping electronics out of your room, and not eating or watching TV in your bedroom
- Practicing meditation or other techniques to empty your mind before bed
- Exercising regularly and earlier in the day (not close to bedtime)
- Not drinking fluids after dinner or close to bedtime, and urinate soon before going to bed to limit times up during the night
- Talking to your healthcare provider if you notice a change in your sleep, fatigue levels, concentration or thinking, and emotions
Consider Vitamin D
Consider having your vitamin D levels checked if you have MS. Vitamin D deficiency is a risk factor for MS, and having sufficient vitamin D is a protective factor for MS. Scientists believe this is because vitamin D can modulate (change) the immune system, as well as protect neurons in the central nervous system.
Vitamin D could reduce MS relapses by up to 50%–70%. Supplementing vitamin D can also reduce the severity of MS symptoms, slow progression, and overall improve quality of life.
However, high doses of vitamin D can also lead to a dangerous buildup of calcium. Therefore, it’s important to consult your healthcare provider before starting vitamin D supplementation. Your provider can advise you on any recommended brands or dosages.
People with MS are more likely than the general population to have depression. This is due to symptoms like fatigue, pain, and cognitive changes, as well as the physiological changes in the brain due to MS itself.
If you have MS and are feeling depressed, you’re not alone. Depression can occur in up to half of people with MS. Speak to your healthcare provider about treatment options, including medication, therapy, or lifestyle changes.
Smoking is both a risk factor for developing MS, and it can also make existing MS progress faster. It can also increase the level of disability. If you’ve been diagnosed with MS, quitting smoking is one of the best things you can do for your longevity and quality of life.
To quit smoking, talk to your healthcare provider, who may refer you to a clinical pharmacist or cognitive behavioral therapist. There are also medications that can help you quit smoking. The Department of Health and Human Services’s site Smokefree.gov is a good resource to get started.
Reducing your stress with MS is easier said than done.
MS can change your physical, emotional, and cognitive abilities and create stress in your daily life. You may be worried about the unpredictability of a relapse, medical appointments and bills, participating in work and hobbies, or what people may think of you. The physiological changes of MS can produce bodily stress, as well. There are a lot of valid reasons you may be stressed if you have MS.
Managing stress can reduce your MS symptoms, reduce exacerbations (times of new or increased symptoms), improve your immunity, and help you feel better overall. Some stress reduction tactics include:
- Relaxation techniques
- Planning ahead
- Pacing activities throughout the day or week
- Leaning on your social support network
- Participating in meaningful hobbies
- Cognitive behavioral therapy
Avoid Too Much Heat
For about 60%–80% of people with MS, exposure to warm temperatures can trigger fatigue and other MS symptoms. This is referred to as heat sensitivity. This happens because when the core body temperature increases, the already damaged nerves have even more difficulty conducting electrical signals.
It’s recommended that people with MS be aware that heat can trigger symptoms and to avoid exposure to too much heat. Some tips from the National MS Society include:
- Wear breathable, lightweight clothes.
- Take cold baths or showers.
- Stay in air-conditioned spaces or by a fan.
- Stay hydrated and eat cold or frozen foods like Popsicles.
- Choose cooler times of day to go outside.
- Swim in pools only less than 85 degrees Fahrenheit.
If your healthcare provider prescribes air-conditioning due to your MS, then the cost may be tax-deductible.
Reduce Alcohol Consumption
Alcohol consumption has not been explicitly linked to MS as a risk factor. However, the side effects of alcohol, combined with MS symptoms such as mobility limitations, difficulty sleeping, lack of coordination, vision problems, and poor bladder control can put a person at risk.
Additionally, alcohol can interact with some MS medications.
MS is a chronic autoimmune disease that can cause fatigue, pain, cognitive changes, muscle weakness, and more. There are many medical treatments available for MS. You can also manage your MS symptoms with lifestyle changes, such as keeping a balanced diet, avoiding heat, reducing alcohol intake, making sure you have sufficient levels of vitamin D, reducing stress, quitting smoking, improving sleep quality, treating depression, and exercising your brain and body.
A Word From Verywell
The unpredictability of MS symptoms, relapses, and how it affects your abilities can be stressful. Adopting some, or all, of these lifestyle changes may give you back a semblance of control while managing your MS symptoms. Talk to your healthcare provider about incorporating some of these measures into your MS treatment plan.
Frequently Asked Questions
What foods should you avoid if you have MS?
There is no single specific MS diet. It’s recommended to eat a balance of fruit, vegetables, whole grains, and legumes. One study on a very low fat, plant-based diet found this could reduce MS-related fatigue.
What kinds of exercises are best for people with MS?
It is safe for people with MS to exercise. Exercise has not been associated with MS relapses. The best kinds of exercise will differ from person to person and depend on the symptoms present. Aerobic exercise, flexibility, strength training, and water aerobics are all good exercises. Consult with a physical or occupational therapist for therapeutic exercises specific to you.
What can trigger an MS flare-up?
Some triggers for an MS flare-up include heat, stress, infection, lack of sleep, and hormonal changes such as during menopause or menstruation.