A senior woman receiving physical therapy, sensory reeducation exercises for the hand

Physical Therapy for Multiple Sclerosis

A senior woman receiving physical therapy, sensory reeducation exercises for the hand

According to the National Multiple Sclerosis Society, multiple sclerosis (MS) is a central nervous system disease in which nerve damage disrupts signals traveling between the brain and the body. While there are certain predisposing factors, such as geographical location, there are no certain causes of MS. Fortunately, physical therapy for multiple sclerosis can help provide patients with some relief from MS symptoms.

Related: Multiple Sclerosis: The Basics

Forms of MS 

The disease can present in several different forms. The most common of which is relapsing-remitting MS (RRMS). Other forms include secondary progressive MS (SPMS), and the rarest, primary progressive MS (PPMS).   

Some common symptoms of MS include: 

  • Fatigue 
  • Muscle weakness 
  • Muscle spasticity 
  • Bladder/bowel problems  
  • Cognitive/behavioral changes  
  • Difficulty regulating temperature  

Most individuals will describe MS as having “peaks and valleys.” Some days can be symptom-free, but others can be debilitating. Depending on one’s form of MS, the timing and length of these peaks and valleys can vary. 

How can physical therapy help? 

Physical therapy is a safe and effective means of rehabilitation for individuals with MS. Current research has highlighted the benefits of aquatic therapy specifically for those with MS.  

Aquatic therapy is unique in that it provides buoyancy and weightlessness which can relieve some of the pain and pressure on fatigued muscles. Additionally, it provides a more stable temperature than outdoor exercise. This removes the need for these patients to self-regulate their temperature.  

The American Physical Therapy Association (APTA) also recommends other options, including moderate progressive resistance training and aerobic exercise. Studies have shown that regular aerobic and resistive exercise can reduce fatigue, improve mood, and increase the quality of life for patients with MS.  

Are there PTs who specialize in MS?  

Every licensed physical therapist will have the tools to treat patients with MS. However, there is a subset of board-certified specialists who are uniquely trained in neurological conditions. Licensed physical therapists can undergo further training and education to become board-certified neurologic clinical specialists. The abbreviation “NCS” after their name denotes their role.  

To become eligible by The American Board of Physical Therapy Specialties, therapists must report 2,000 hours of direct patient care in the specialty area before sitting for board examination. Specific physical therapists who have received an NCS certification, as well as those in all specialty areas, can be found online in the APTA directory 

Getting started 

When beginning physical therapy with a patient who has MS, the therapist should begin with an examination. They’ll assess various aspects including strength, flexibility, and mobility. The therapist and patient will then work together to create an individualized plan of care.  

Recent legislation allows physical therapists to provide treatment without a direct referral from a physician. However, many individuals  diagnosed with MS will already have a neurologist on their medical team who should be kept informed. The most recent clinical practice guidelines for treating patients with MS recommend a comprehensive review of care at least once per year. This should include medical and rehabilitation team members.