From the Guidelines
Movement, particularly regular physical activity, can help improve MS symptoms, and showers may also provide temporary relief from muscle stiffness and spasticity. According to the most recent guidelines on physical activity for individuals with chronic conditions, including multiple sclerosis (MS), adults with mild-to-moderate MS should aim for at least 30 minutes of moderate-intensity aerobic activity, 2 times a week, as well as strength training exercises for major muscle groups, 2 times a week 1. Regular physical activity, such as walking, swimming, yoga, and tai chi, can reduce fatigue, improve strength, enhance balance, and boost mood in people with MS. It is essential to start with gentle exercise, 10-30 minutes, 2-3 times a week, and gradually increase as tolerated. Warm (not hot) showers can temporarily reduce muscle stiffness and spasticity by improving blood circulation to tight muscles, while cool showers may help manage heat sensitivity, which often worsens MS symptoms. For shower safety, using grab bars, non-slip mats, and shower chairs if needed is recommended. These approaches work because exercise promotes neuroplasticity, reduces inflammation, and releases endorphins, while temperature therapy affects nerve conduction and muscle tone. Always start slowly with any new activity and stop if symptoms worsen. Consulting with healthcare providers before beginning new exercise routines is recommended, especially for those with significant mobility limitations. While the evidence from the EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis also supports the benefits of physical exercise for people with chronic conditions 1, the guidelines specific to MS provide more tailored advice for this patient population 1.
From the Research
Movement and MS Symptoms
- Regular physical activity is a recommended behavioral goal for persons with multiple sclerosis, as it can reduce fatigue severity and impact 2
- Engaging in physical activity for at least 150 min/wk or 2 sessions of 10 to 30 minutes of moderate-intensity aerobic training plus 2 sessions of resistance training per week can result in clinically significant reductions in fatigue severity and impact 2
- Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course suggest that healthcare providers should endorse and promote the benefits/safety of exercise and lifestyle physical activity for every person with MS 3
Showers and MS Symptoms
- There is no direct evidence to suggest that showers can improve MS symptoms
- However, physical activity, such as walking or exercising in a warm water pool, can be beneficial for people with MS, and showers may be a part of the overall physical activity routine 4, 5
Physical Activity and MS Symptoms
- Physical activity is effective in managing MS symptoms, and sedentary behavior is associated with poor health 4
- People with more severe symptoms and progressive disease may require focused exercise promotion from healthcare professionals 4
- Interventions aimed at increasing long-term physical activity adherence should focus on increasing autonomy and competence for physical activity in the individual and promoting potential increased quality of life outcomes from physical activity participation 5
- A combined physical therapy and pharmacological intervention may be effective in improving mobility limitations in people with MS, and physical therapy may be augmented by medications such as dalfampridine 6