MS Map

Evidence-based techniques and approaches specifically curated for Multiple Sclerosis. Filter by symptom, category, or search for specific techniques.

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Evidence Level:

47 techniques found

meditation
SUPPORTED

Mindfulness-Based Interventions for Pain

Mindfulness meditation techniques that change how the brain perceives and processes pain. Multiple RCTs show improvements in pain interference, perceived stress, mood, and quality of life.

PainMoodStress
10-30 minutesbeginnerDawn Ehde, PhD
cognitive
SUPPORTED

Cognitive Behavioral Therapy for Pain

Evidence-based psychological approach that teaches stress management, coping strategies, and helps change negative thought patterns that contribute to pain experience.

PainMoodStress
45-60 minutes per sessionintermediateDawn Ehde, PhD
hypnotherapy
SUPPORTED

Self-Hypnosis for Pain Management

Self-hypnosis training that helps change how the brain processes pain. Controlled trials demonstrate reductions in daily pain intensity and pain catastrophizing.

Pain
15-30 minutesintermediateDawn Ehde, PhD
grounding
EXPERT-SUPPORTED

Pacing and Energy Conservation

Taking short, dedicated rest breaks throughout the day to conserve energy. Research shows energy lasts longer with regular rest breaks, reducing the need for recovery days.

Fatigue
1-15 minutes per breakbeginnerMeghan Beier, PhD
bodywork
EXPERT-SUPPORTED

Exercise Snacks

Short exercise sessions spaced throughout the day instead of one longer session. Can have same positive effects as longer sessions without excessive fatigue.

FatigueMobility
10 minutes per sessionbeginnerMandy Rohrig, DPT
cooling
EXPERT-SUPPORTED

Cooling Techniques for Heat Sensitivity

Using cooling vests, neck towels, or cold-water foot baths to manage heat sensitivity. Around 60-80% of individuals living with MS experience heat intolerance. When the body's temperature elevates, nerve conduction is slowed or blocked, causing a temporary worsening of symptoms.

Fatigue
As neededbeginnerBeth Bullard, Occupational Therapist
cognitive
PARTIALLY

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Gold standard treatment for insomnia addressing behaviors and thoughts that negatively impact sleep. More effective than pharmacological intervention long-term.

Sleep
45-60 minutes per sessionintermediateAlexa Kane, PhD
grounding
EXPERT-SUPPORTED

Sleep Hygiene Practices

Consistent sleep-wake schedule and sleep environment optimization. Research shows sleep quality can influence MS clinical evolution.

Sleep
OngoingbeginnerAlexa Kane, PhD
grounding
EXPERT-SUPPORTED

Strategic Napping

Limited napping to prevent excessive daytime sleepiness without disrupting night sleep.

SleepFatigue
5-30 minutesbeginnerAlexa Kane, PhD
grounding
EXPERT-SUPPORTED

Rest vs. Sleep Distinction

Understanding the difference between sleepiness and fatigue, and resting appropriately. If sleepy, use bed for sleep. If fatigued but not sleepy, rest elsewhere.

SleepFatigue
As neededbeginnerAlexa Kane, PhD
bodywork
STRONGLY

Aerobic Exercise

Walking, swimming, or cycling at moderate level. Cochrane reviews and network meta-analyses consistently show improvements in fatigue, muscular fitness, mood, and quality of life.

FatigueMoodMobility
20-30 minutes per sessionbeginnerMandy Rohrig, DPT
bodywork
STRONGLY

Strength Training

Resistance training using bands, light weights, or bodyweight exercises. Systematic reviews show improvements in fatigue, muscular fitness, and quality of life.

FatigueMobilityPain
20-30 minutes per sessionintermediateMandy Rohrig, DPT
bodywork
SUPPORTED

Stretching and Flexibility Exercises

Daily stretching, yoga, or Pilates to improve mobility, address spasticity, and increase range of motion. RCTs show benefits for flexibility, strength, posture, balance, and spasticity management.

MobilityPainSpasticity
10-15 minutes dailybeginner
yoga
STRONGLY

Yoga

Yoga practice modified as needed. Network meta-analyses show improvements in fatigue, muscular fitness, mood, and quality of life. Improves flexibility, balance, eases fatigue, benefits mental health.

FatigueMoodMobility+2
20-60 minutesbeginnerMandy Rohrig, DPT
bodywork
STRONGLY

Aquatic Exercise

Water-based exercises that improve flexibility, strength, balance, and aerobic endurance while minimizing fatigue. Multiple RCTs show benefits for pain, spasm, fatigue, disability, depression, functional capacity, and balance. Buoyancy offers greater freedom of movement, cooler water helps with heat sensitivity.

FatigueMobilityPain
20-45 minutesbeginnerMandy Rohrig, DPT
yoga
EXPERT-SUPPORTED

Tai Chi

Slow, flowing movements with deep breathing and meditation. Improves balance, ability to perform daily living activities, and reduces depression.

MobilityMoodBalance
20-60 minutesbeginnerMultiple Sclerosis News Today
bodywork
EXPERT-SUPPORTED

Seated Exercise

Exercises performed while sitting. Effective alternative to standing exercises, safer for fall prevention. Examples include arm bikes, rowing machines, seated weight lifting.

MobilityFatigue
20-30 minutesbeginnerMandy Rohrig, DPT
bodywork
EXPERT-SUPPORTED

Functional Exercises

Exercises that break down daily tasks into single exercises. Particularly helpful for people with MS. Example: If challenged with getting on/off toilet, exercises targeting gluteal and quadriceps strength and calf flexibility.

Mobility
20-30 minutesintermediateMandy Rohrig, DPT
bodywork
EXPERT-SUPPORTED

Rating of Perceived Exertion (RPE) Scale

0-10 scale to quantify exertion before, during, and after exercise. Guides when to slow down or stop to avoid 'exercise hangover'.

Fatigue
Ongoing during exercisebeginnerMandy Rohrig, DPT
bodywork
EXPERT-SUPPORTED

Two-Hour Rule

If you don't feel as good two hours after exercise as at baseline, you may have done too much. Recovery from exercise should ideally occur within about two hours.

Fatigue
Assessment toolbeginnerMandy Rohrig, DPT
bodywork
SUPPORTED

High-Intensity Interval Training (HIIT)

Alternating periods of high-intensity exercise with recovery. Research shows benefits for fatigue and fitness in MS.

FatigueMobility
20-30 minutesadvanced
meditation
SUPPORTED

Mindfulness Meditation for Stress

Mindfulness meditation and breathing exercises. Multiple RCTs show improvements in perceived stress, mood (anxiety/depression), and quality of life in people with MS.

StressMoodAnxiety
10-20 minutesbeginner
breathing
EXPERT-SUPPORTED

Deep Breathing Exercises

Deep breathing or belly breathing to help feel more at peace. Incorporated within mindfulness programs and yoga.

StressPainAnxiety
5-10 minutesbeginnerMultiple Sclerosis News Today
yoga
STRONGLY

Yoga for Stress Relief

Gentle yoga practice. Network meta-analyses show improvements in fatigue, mood, and quality of life. Linked to less fatigue, increases mood-boosting endorphins, lowers stress hormones.

StressMoodFatigue
20-60 minutesbeginner
grounding
EXPERT-SUPPORTED

Social Support

Connecting with friends, family, or MS support groups. Helps improve mental health and provides emotional support.

MoodStress
OngoingbeginnerMultiple Sclerosis News Today
cognitive
SUPPORTED

Acceptance and Commitment Therapy (ACT)

ACT for symptoms and emotional competencies. RCTs show benefits for emotional regulation, stress, psychological symptoms, and reductions in insomnia symptoms in MS.

MoodStressSleep
45-60 minutes per sessionintermediate
bodywork
SUPPORTED

Physical and Occupational Therapy

Movement, mobility, and posture improvement focused on balance, mobility, and core stability. Systematic reviews, meta-analyses, and RCTs show benefits for balance, mobility, pain relief, and functional capacity. Helps with pain relief, improves movement, teaches strategies to reduce strain.

PainMobility
30-60 minutes per sessionintermediate
bodywork
SUPPORTED

Massage

Body massage therapy. RCTs and pilot studies show benefits for fatigue, pain, mood, leg function, quality of life, stress, anxiety, depression, spasticity, and sleep. Relaxes muscles, improves circulation, promotes healing.

PainStress
30-60 minutesbeginner
bodywork
SUPPORTED

Hydrotherapy

Water-based therapy (Ai-Chi aquatic exercise) focused on therapeutic benefits. RCT demonstrates benefits for pain, spasm, fatigue, disability, depression, and autonomy in MS. Similar to aquatic exercise but with specific therapeutic focus.

PainMobility
20-45 minutesbeginner
cooling
EXPERT-SUPPORTED

Cooling Vests and Garments

Wearing cooling vests, neck wraps, wrist bands, or cooling accessories to manage heat sensitivity. Many people with multiple sclerosis are heat sensitive. MS research has proven that heat and humidity often aggravate common MS symptoms. MS research has also proven that cooling the body can help lessen the negative effects of heat and humidity on a person with MS.

Fatigue
As neededbeginnerMSAA
cooling
EXPERT-SUPPORTED

Evaporative Cooling Techniques

Using evaporative cooling towels, bandanas, or scarves to provide cooling relief. Moistened and refrigerated wrist bands, scarves, t-shirts, shorts or swimsuits might be a nice addition to your summer wardrobe.

Fatigue
As neededbeginnerBeth Bullard, Occupational Therapist
cooling
EXPERT-SUPPORTED

Cold Drinks and Ice

Sipping frozen drinks or sucking on ice chips to cool core body temperature. Stay hydrated with plenty of decaffeinated cool drinks.

Fatigue
As neededbeginnerMayo Clinic
cooling
EXPERT-SUPPORTED

Environmental Cooling Strategies

Managing home and outdoor environments to stay cool. Prevents heat-related symptom worsening before it starts. Important for heat-sensitive individuals. Use air conditioning and fans, plan activities during cooler times, avoid direct sunlight, and take cool showers or baths.

Fatigue
OngoingbeginnerMayo Clinic
cooling
EXPERT-SUPPORTED

Cooling Before, During, and After Activity

Using cooling strategies proactively around physical activity. The use of wearable cooling products before, during, or after activity can extend your ability to engage in your chosen task and lessen the effects of the heat.

FatigueMobility
Before, during, and after activitybeginnerBeth Bullard, Occupational Therapist
nutrition
PARTIALLY

Mediterranean Diet

Following a Mediterranean-style diet pattern. Research suggests that following the Mediterranean diet may be linked to a lower risk of worsening disability in MS. The Mediterranean diet includes fruits and vegetables, whole grains, legumes, nuts, and olive oil. It also means not eating large amounts of red meats, butter, sugar and other unhealthy foods.

Mood
Ongoingintermediate
nutrition
EXPERT-SUPPORTED

Low-Fat, High-Fiber Diet

Following general healthy eating guidelines recommended by MS specialists for overall health. MS specialists often recommend a low-fat, high-fiber diet, such as that recommended by the American Heart Association. Healthcare professionals agree that eating a healthy diet to promote general wellness and prevent certain other medical conditions could potentially have a positive impact on MS and its symptoms.

Fatigue
OngoingintermediateMSAA
nutrition
EXPERT-SUPPORTED

Adequate Calcium and Vitamin D

Ensuring sufficient calcium and vitamin D intake. Important for bone health in MS. Low vitamin D levels associated with increased MS risk and more severe disease. Vitamin D3 promotes the absorption of calcium, which is necessary for bone health, and supports immune function. Daily intake of vitamin D3 of 2,000 to 5,000 international units daily is recommended in people with MS.

Mobility
OngoingbeginnerMayo Clinic
grounding
EXPERT-SUPPORTED

Energy Conservation Techniques

Getting plenty of rest to help relieve the symptoms of MS. Look at your sleep habits to make sure you're getting the best possible sleep.

Fatigue
OngoingbeginnerMayo Clinic
home-modifications
EXPERT-SUPPORTED

Home Environment Modifications

A physical or occupational therapist can teach you stretching and strengthening exercises. The therapist also can show you how to use devices to make it easier to perform daily tasks.

Mobility
OngoingintermediateMayo Clinic
bodywork
EXPERT-SUPPORTED

Functional Exercise Integration

Incorporating exercise into daily household activities. Functional exercises particularly beneficial for MS. Break down daily tasks (like making bed, climbing stairs) into exercise components. Practice movements that translate to daily activities. Improves functional capacity, makes daily tasks easier, and maintains strength.

Mobility
Throughout daily activitiesintermediateCan Do MS
bodywork
EXPERT-SUPPORTED

Accumulated Daily Activity

Building physical activity throughout the day in short bouts. Can be accumulated in multiple short sessions throughout the day. All daily activities count (stairs, household tasks, walking).

FatigueMobility
Throughout the daybeginnerNational MS Society
grounding
EXPERT-SUPPORTED

Activity Planning and Pacing

Planning daily activities to prevent heat-related fatigue. When planning your daily activities, think about the weather forecast and plan to engage in indoor tasks during the heat of the day. Schedule rest or cool-down breaks into your routine.

Fatigue
OngoingbeginnerMSAA
meditation
EXPERT-SUPPORTED

Guided Imagery

Using guided imagery for relaxation and symptom management. Requiring a state of deep relaxation, guided imagery brings about benefits that range from improved mood and lowered anxiety, to reductions in blood pressure and blood sugar, improved immune functions, and less pain.

StressMoodAnxiety+1
10-20 minutesbeginnerMSAA
meditation
EXPERT-SUPPORTED

Progressive Muscle Relaxation

Relaxation techniques to help relieve stress. Stress may trigger or worsen your symptoms. Yoga, tai chi, massage, meditation or deep breathing may help.

StressPain
15-30 minutesbeginnerMayo Clinic
bodywork
STRONGLY

Home-Based Aquatic Exercise

Water-based exercises at home or in accessible pools. Swimming or other water exercises are good options if heat makes your symptoms worse.

FatigueMobilityPain
20-45 minutesbeginner
bodywork
EXPERT-SUPPORTED

Household Mobility Exercises

Functional exercises that improve ability to perform daily household tasks. Functional exercises particularly beneficial for MS. Examples include exercises for making bed, kitchen mobility, stair climbing, and sit-to-stand. Improves functional independence, makes daily tasks easier, and maintains strength.

Mobility
20-30 minutesintermediateCan Do MS
home-modifications
EXPERT-SUPPORTED

Home Exercise Equipment Adaptations

Using adapted or accessible exercise equipment at home. Allows exercise regardless of mobility level. Enables exercise at home, accommodates various ability levels, and maintains fitness.

MobilityFatigue
20-30 minutesbeginnerCan Do MS