Medicine plays a key role in treating your multiple sclerosis (MS), but it takes more than pills to manage the effects of the disease on your daily life. If you want to help your mind and body work better, whether it's for work or play, rehab therapy may be the answer.
Different forms of rehab therapy, also called restorative rehabilitation, target the way MS changes your life. It helps you stay independent and handle many of the physical, mental, and emotional challenges you face.
Physical Therapy (PT)
MS affects everyone differently, but you'll probably find that it limits movement in at least one part of your body. You may find you have pain in a certain area, balance problems, trouble walking, dizziness, fatigue, or bladder issues. For all these problems, physical therapy can help by building up your strength.
Ask your doctor for a referral, and check with other people who have MS for suggestions on where to go in your area. You may have one to three sessions to learn exercises to do at home, and then follow-ups as needed. Some therapists may be able to come to your home to work with you.
Your physical therapist will help you set up a fitness program that's good for your strength and goals. Regular exercise helps with all types of MS, but it can be hard when you're tired or you overheat easily. You'll learn how to work around these issues to get the most from your workouts.
You may also learn:
- Stretches to prevent or ease muscle spasms
- Exercises to keep muscles strong and improve coordination and balance
- Range-of-motion exercises, like straightening and bending your arms and legs
- Tips to prevent falls
- How to use canes, crutches, scooters, wheelchairs, or other aids, if necessary
If your MS symptoms make it hard to do your job, your therapist can take you through some tests and document the kind of trouble you're having. This is called a functional capacity evaluation. It measures whether you can work an 8-hour day and may help if you need to apply for Social Security disability benefits.
Occupational Therapy (OT)
Occupational therapy tries to change and simplify the way you do everyday tasks at home. The goal is to let you work safely without having to rely on help from other folks, and make your daily life easier and more enjoyable.
In general, an occupational therapist can help you find easier ways to:
- Cook and do chores
- Have fun and enjoy your hobbies
- Bathe and use the toilet
- Get dressed and groom yourself
An occupational therapist also can give you information on how to adjust your surroundings to suit your needs. They might suggest ways to alter your home, your car, or your computer to make them easier to use. They can also look at your workplace and suggest changes to help you do your job safely and comfortably
MS may alter the way you think, concentrate, or remember. If those are problems for you, cognitive rehab fights back by helping you work that big muscle called your brain.
Cognitive rehabilitation can make a big difference in your life. A neuropsychologist, someone who specializes in brain changes caused by disease or trauma, can show you activities to sharpen your skills.
They'll also give you strategies for organization and time management. You'll learn little tricks like leaving yourself reminder notes, making checklists, or using word association to trigger a memory.
MS can sometimes affect your mood in unpredictable ways. You may get worried about your future or feel isolated from your family and friends.
Just as other forms of rehab therapy focus on ways to help you handle your everyday tasks, your feelings may benefit from some training as well. Let a counselor or psychologist support you through the emotional issues that can come along with MS.
This might include something called “resilience training,” which focuses on how to respond in a healthy way to hard times. MS can cause plenty of stress, but resilience training offers strategies to help get back on your feet. These include:
- Stay social: Keep up with family and old friends or make new ones if necessary.
- Stay flexible: This can mean changing the way you think of normal. A good sense of humor and a positive outlook can help a lot when you’re dealing with some of the serious issues that MS can throw your way.
- Plan ahead: There are serious practical challenges that can arise with MS. You can help lessen the challenges and the anxiety that goes along with them if you plan for them. For example, as you start to become less mobile, you can slowly work toward making your home easier to navigate by wheelchair.
- Take care of yourself: This could mean walking outside, or doing your PT exercises, or resting. It could simply be meditation. It depends in large part on your MS symptoms and how far along you are in your MS journey.
- Seek meaning: This can mean involvement in your community through outreach, hobbies, or religious organizations. Or, it may be time together with friends and family. Art, music, and literature can be great ways to connect with what is meaningful in your life.
Speech and Swallow Therapy
If MS causes problems with your voice or the way you speak, speech therapy works on your communication skills. A speech-language pathologist (SLP) tests your mouth, voice, and breath and shows you exercises that can strengthen weak areas.
Speech therapy is also useful if you're having trouble swallowing, called dysphagia.
Your doctor might use a special imaging procedure called a modified barium swallow, where you ingest a small amount of radioactive substance that shows up clearly on an x-ray machine. This tells your doctor and SLP useful information about how you swallow.
Your SLP will also test everything from your lips and throat to the larynx -- an organ in your neck that holds your vocal cords. They'll point out ways to change your diet or hold your head while swallowing.
Sexual Dysfunction Therapy
To start with, it’s a good idea to talk to your medical team about sexual issues. They may be able to adjust or change your medications in ways that improve your sex life. But nonmedical therapies also play a part. For example, physical therapy exercises can help lessen muscle stiffness and spasm and allow both men and women to better adjust their bodies for satisfying sexual activity.
A sexual therapist or other members of your team might also be able to help with strategies like conserving energy for sex by taking it easy and planning out bathroom habits and liquid intake so as not to interfere with sex.
You may be able to counter the weaker genital sensation that sometimes accompany MS with slightly harder stimulation by hand or vibrators.
Finally, there may be difficult emotional issues that come along with changing sexual function that sometimes happens with MS. Couples therapy can help you and your partner get on the same page. Cognitive Behavior Therapy, or CBT, can help you overcome certain unhelpful thought patterns that might interfere with a healthy body image and satisfying sex life.
When you look at your job and workplace, you may see the challenges MS presents. But a therapist looks at it through different eyes and sees the changes you can make to keep working.
If you want to move into a new career or brush up on your interviewing skills, a vocational rehab therapist can give you advice.
A vocational rehab specialist can also talk to you about your legal rights on the job. They can explain how the Americans with Disabilities Act may allow you to make tweaks to your workplace that take into account your MS symptoms.
This form of rehab is work disguised as fun. Taking part in activities that you enjoy has physical and social benefits.
A recreational therapist will help you make a plan to take advantage of your own interests. You'll find out how your MS symptoms don't have to stand in the way of doing things like yoga, swimming, golf, and horseback riding.