Your Rehab Team for Secondary Progressive MS

If you have stiff muscles, fatigue, and other symptoms from secondary progressive multiple sclerosis (SPMS), rehab therapy can help you stay more active.

Rehab comes in a few different forms. It helps with the physical and mental effects of SPMS on your life and keeps you independent and safe. You might need to see more than one kind of therapist.

Physical Therapist

SPMS affects everyone differently. Some people feel extremely tired. Others have trouble with walking, balance, and coordination. Stiff muscles, weakness, and numbness are also common, and the symptoms may gradually get worse over time.

Your physical therapist will check you to see which activities give you the most trouble. Then he'll design a program to improve your strength, walking ability, and any other physical challenges you face.

The typical physical therapy program includes things like:

  • Exercises to improve muscle strength and endurance
  • Stretches to relax tight muscles
  • Tai chi and yoga to increase strength and flexibility
  • Advice on how to use a cane, crutches, scooter, or other devices to help you get around
  • Exercises to strengthen your pelvic floor muscles and prevent bladder problems

Occupational Therapist

An occupational therapist helps you do your everyday tasks more easily. The therapist teaches you how to make changes to your home, office, and daily routine to get more done and use less energy.

Your occupational therapist will figure out what your needs are and suggest things like:

  • Strategies to save energy
  • Safety equipment like grab bars and a shower bench
  • Tools like buttonhooks, weighted forks, and grabbers to make up for weakness in your hands
  • Changes to your computer and desk to keep you comfortable while you work
  • Exercises to improve your balance and coordination

Cognitive Rehabilitation

Problems with thinking, memory, and attention can crop up when you have SPMS. A cognitive rehabilitation therapist teaches you ways to adapt to these changes.

You'll see a brain specialist called a neuropsychologist for cognitive rehab to help you manage any trouble you have with thinking.

Your therapist will find out what areas trouble you most. Then he'll come up with a plan to improve your thinking skills.

If you start a cognitive rehab program, it might include things like:

  • Organization tools like to-do lists, calendars, notes, and appointment reminders
  • Methods to block distractions and improve your focus
  • Memory tricks like word association to help you recall names, words, and facts


Vocational Therapist

If work starts to get more challenging with SPMS, a vocational therapist can show you how to:

  • Tweak tasks to make you safer and let you get more done
  • Change your workspace to fit your comfort and abilities
  • Organize your day to prevent fatigue

If the job you have now doesn't go well with your SPMS, the therapist can help you find and apply for a position that's a better fit.

Speech-Language Pathologist

Every time you chew food, swallow, or speak, you use muscles in your lips, tongue, and other parts of your mouth. MS can damage the nerves that control these muscles.

Nerve damage can slur or slow your speech, making it hard for your friends and family to understand you. When you eat, it may be hard to swallow. You might feel like food is always stuck in your throat.

A speech-language pathologist will check your lips, throat, and tongue to find the source of the problem. Then he'll teach you ways to gain more control over speech and swallowing. This might include:

  • Techniques like slowing down or pausing when you talk so other people can understand you
  • Devices to amplify your voice or talk for you
  • Methods to chew and swallow your food more completely

How to Build Your Team

Your neurologist or primary care doctor can help you set up a rehab team. Depending on the type of insurance you have, you may need a referral to see these specialists.

To make sure rehab works for you, it's important for your therapists to work together. They also should work with the doctor who treats your SPMS.

WebMD Medical Reference Reviewed by Neha Pathak, MD on August 26, 2019



Can Do MS: "Cognitive Rehabilitation in MS: Research Update."

Cedars-Sinai: "Secondary-Progressive MS."

Cleveland Clinic: "Occupational Therapy & Multiple Sclerosis," "Vocational Rehabilitation Services."

Multiple Sclerosis International Federation: "Rehabilitation."

National MS Society: "Managing Cognitive Problems in MS," "Physical Therapy in Multiple Sclerosis Rehabilitation," "Rehabilitation," "Speech & Swallowing: The Basic Facts,"  "Treating SPMS."

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