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How to manage fatigue with a neurological condition (Part 2)

Aisling van der Walt
Miss Aisling van der Walt
Occupational Therapist

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Part 2: General Principles of Fatigue Management in Occupational Therapy

Fatigue is an extremely common symptom for people living with neurological conditions. Neurological fatigue is an overwhelming feeling of tiredness which can be debilitating enough to stop people from doing everyday activities such as getting dressed, going to the shops, or preparing food. Unlike physical fatigue, neurological fatigue cannot be alleviated by taking a rest.

This 2 part blog aims to offer general advice to people living with fatigue and those supporting them. It is important to note that each person is different and how fatigue is experienced and managed is unique for each person. These general strategies are a good starting point; however you should discuss them with an occupational therapist to develop a bespoke fatigue management plan that is right for you. Click here to read Managing fatigue part 1: Understanding your fatigue, avoiding boom-bust and how occupational therapy can help.

Click here to book an appointment with a private neuro specialist occupational therapist at the National Hospital for Neurology and Neurosurgery.

General Principles of Fatigue Management

  • Take frequent rests
  • Prioritise activities
  • Plan ahead
  • Organise tools, material and work area
  • Adopt a good posture
  • Lead a healthy lifestyle and do exercise

Take frequent rests
Balance activities with rest and allow for time to rest when planning a day’s activities.

  • Rest means doing nothing at all. This could mean taking a nap or just relaxing. Watching television or reading complex material is often stimulating to the brain and not restful.
  • Take frequent short rests rather than one long rest. Rest before feeling tired to avoid a ‘boom-bust’ cycle. Read more about the ‘boom-bust’ cycle here.
  • Find a relaxation method that suits you. Try listening to music or using relaxation or mindfulness apps to help you relax.

Prioritise activities

  • List the activities you do during a typical day or week. What jobs could be done by other people?
  • Consider outside help, for example from agencies.
  • Consider jobs that could be cut out of your daily routine or done less often, for example ironing or food shopping.

Plan ahead / Time management

  • List your daily or weekly activities in order of priority so that you can give most energy to the essential activities before becoming fatigued.
  • Make a daily or weekly timetable of activities that need to be done.
  • Spread heavy and light tasks throughout the day
  • Set yourself realistic targets.  Targets differ for each person.  Speak to you occupational therapist to determine what is appropriate for you.
  • Break down large complex tasks into smaller segments that can be spread throughout the day.  For example, peel potatoes in the morning ready to cook in the evening or lay out clothes the evening before you need them.

Organise tools, materials and work area (Ergonomics)

  • Organise your work area, for example your kitchen, as closely as you can according to ergonomic principles.
  • Good ventilation is important as heat can exacerbate fatigue.
  • Have a specific area for each task, storing essential equipment there for immediate use. For example, designating a tea-making area with tea, cups and a kettle in place, or storing washing powder next to the washing machine.
  • Keep your work areas as uncluttered as possible.
  • The larger the grip, the easier the task will be.

Adopt a good posture

  • Activities should be carried out in a relaxed and efficient way, minimising stress on your body, which will in turn save you energy.
  • Try to maintain an upright and symmetrical posture during all tasks.
  • Rest on a perching stool if necessary while carrying out tasks.
  • Rest in order to reduce strain on your joints and soft tissue, i.e. sit in a high-back chair that supports you while carrying out a task, for example eating or using a computer.
  • Avoid excessive twisting and bending.

Lead a healthy lifestyle and take exercise

Try to keep generally fit. Exercise is essential, but remember to balance exercise with rests. Grading the intensity and type of exercise needs to be carefully considered. Maintaining involvement in some regular exercise may help to maintain your general fitness and efficiency of movement.

If you plan to resume exercise after a period of time, you should consider seeking advice from your GP. It is important to discuss this with your physiotherapist who advise on specific exercises that may be more relevant to you.

These general principles for fatigue management offer a good starting point to understand your fatigue and consider what strategies might help to better manage the impact of fatigue on your daily life. The impact and management of fatigue differs for each person and it is recommended that you speak with an occupational therapist to discuss what strategies are appropriate for you.

To book an appointment with a private neuro specialist occupational therapist at The National Hospital for Neurology and Neurosurgery click here. Referrals are only accepted for patients with an NHNN consultant. Alternatively, seek a referral to an NHS neuro occupational therapist via your GP.

The following are useful resources for people living with neurological fatigue and their families and carers:

The Brain Tumour Charity –

MacMillan –

Brain and Spine Foundation –

The Stroke Association –

MS Society –

MS Trust –


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Letter to Aisling van der Walt, Occupational Therapist

I can finally feel that I am fully recovered. I want to thank you all for your help in getting me here. When I left the hospital I didn’t even dare dream this would happen, and when I left London I had plans in place but was very uncertain that I would be able to accomplish them. You all gave me tools, support, and confidence.

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