Neurological Fatigue & Associated Conditions

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What conditions cause neurological fatigue?

Fatigue is a very common problem, causing approximately 1.5 million Australians to see their doctor each year. There are numerous reasons why you might experience fatigue, such as lack of sleep, poor diet and lack of physical activity. Neurological fatigue is a more severe form of fatigue and is a common symptom of many neurological conditions.

Conditions that cause neurological fatigue include:

  • Multiple sclerosis
  • Parkinson’s disease
  • Myasthenia gravis
  • Traumatic brain injury
  • Post-polio syndrome
  • Chronic fatigue syndrome
  • Functional neurological disorder
  • Transverse myelitis
  • Stroke

Research has indicated that the prevalence of neurological fatigue in many conditions is higher than that which would be expected based purely on age and disability.

Neurological fatigue is one of the most common symptoms that we see in neurology. The medical field’s understanding of the pathophysiology of neurological fatigue is quite limited, so the term ‘fatigue’ lacks standardised definition or measurements.

Generally the main symptoms of fatigue include being overwhelmed when completing tasks requiring only low effort and feeling limited with respect to engaging in any task requiring physical or mental endurance.



What is fatigue?

When the term is used by health professionals, fatigue describes an overwhelming feeling of tiredness, weakness or lack of energy. It is more than just feeling tired or sleepy, although these symptoms may also occur.

Fatigue is a symptom, rather than a condition, and can be mental, physical or a combination of both. For people with neurological conditions, chronic fatigue can lead to greater disability and lower quality of life.

What causes neurological fatigue?

The exact cause of neurological fatigue in many conditions isn’t fully understood. Research has shown several factors may contribute to neurological fatigue:

Disorders that disrupt how signals cross the join between nerves and muscles (called the neuromuscular junction) and metabolic diseases (those affecting the body’s energy systems) can affect the ability of your muscles to sustain the effort of contracting.

Diseases affecting the central, peripheral, and autonomic nervous systems can cause what is known as central fatigue. This can impact your perception of effort and limit how long you can sustain mental and physical activities.

This includes diseases that cause nervous system lesions, such as MS, and those involving disturbances in chemical signalling between brain areas.

Nervous system and systemic inflammation and over-activation of the immune system seem to play a part in causing neurological fatigue in some conditions.

Neurological fatigue and exercise

Fortunately, regardless of the cause of your fatigue, there’s a simple thing you can do to help – exercise! Although at first it may seem counterintuitive, rather than making you feel more tired, exercise has been shown to boost physical and mental energy levels.

It may seem counterintuitive to exercise to manage fatigue, but it makes sense when you think about it. Imagine, for example, you’ve had a hard day at work, school or home and feel tired by the afternoon. You could go and lie down, or you could go for a short walk. Often, the short walk will refresh you and restore your energy, so you can keep going into the evening.

Research evidence also shows that physical activity is one of the best ways to combat fatigue. For example, a paper published in 2006 analysed results from 70 studies exploring the effects of exercise training on fatigue in 6,807 people. They found that exercise training (which they called ‘chronic exercise’) increased feelings of energy and reduced feelings of fatigue compared with control conditions.

Furthermore, the effect of exercise training was larger than that of cognitive-behavioural therapy or drug treatments for improving feelings of energy and lessening feelings of fatigue.

In another study, researchers looked at six weeks of exercise training for 36 healthy young adults who reported persistent feelings of fatigue. They found beneficial effects on energy in groups performing both low- and moderate-intensity aerobic exercise.

Scientists are still discovering exactly how regular exercise fights fatigue and boosts energy. It seems that exercise positively influences your body’s energy systems and metabolism, while supporting the health of every organ system.

Exercise for fatigue in MS

Neurological fatigue is very common in people with MS. Exercise for managing fatigue has been widely studied in this group, with positive results. A 2020 systematic review published in journal BMC Neurology, for example, analysed results from 31 studies exploring exercise for managing fatigue in 714 people with MS.

The authors explain their results “reveal and confirm that physical exercise significantly reduces neurological fatigue in patients with MS.” They conclude by strongly recommending that a regular exercise program should be part of rehabilitation programs for MS patients.

Active Ability - What neurological conditions cause fatigue

Exercise supports the health of every organ and system in your body

Chronic fatigue syndrome and exercise

While it’s not strictly a neurological condition, the nervous system is implicated in the development and symptoms of chronic fatigue syndrome (CFS).

For people with CFS, the idea of going for a jog or lifting weights can seem overwhelming. And too much exercise, or the wrong type, can definitely aggravate CFS symptoms.

However, research has shown that people with CFS can benefit from exercise when it is carefully prescribed and monitored. A 2017 systematic review analysed results from eight randomised controlled studies (involving 1518 participants) examining exercise therapy for CFS. Seven of them consistently showed a reduction in fatigue at the end of treatment with exercise therapy.

The study authors concluded that “patients with CFS may generally benefit and feel less fatigued following exercise therapy, and no evidence suggests that exercise therapy may worsen outcomes.” They also observed that exercise therapy had positive effects on sleep, physical function and self-perceived general health.

Exercise for fatigue in other neurological conditions

The impact of exercise for neurological fatigue has not been as well studied in other neurological conditions. However, early trials suggest it can be an effective neurological fatigue treatment. In this trial of exercise for Parkinson’s disease, for example, researchers found that aerobic walking in a community setting improved fatigue. It was also found to improve mood, motor function and quality of life, while being safe and well tolerated.

Regardless of your neurological condition, exercise can beat neurological fatigue and boost your energy

Regardless of your neurological condition, exercise can beat neurological fatigue and boost your energy


Neurological fatigue treatment – what type of exercise is best?

Almost any type of exercise can reduce fatigue and boost energy, including aerobic activities such as walking, swimming, cycling, dancing, boxing and rowing. Resistance (strength) training helps build muscle so you can cope more easily with the daily demands on your body.

The most important thing is finding an activity you enjoy, starting out slowly and building up gradually. This will ensure you experience more energy rather than wearing yourself out and reduce your risk of getting injured from doing too much too soon.

Most people should aim to build up to 45 minutes of physical activity on most days of the week. Your exercise tolerance can vary from day to day, so be sensible and never exercise to exhaustion. But doing what you can, even if it’s a small amount, will help towards building your capacity.

It’s also vital to make sure you’re getting adequate sleep and good nutrition to support your exercise efforts.

How much exercise should I do to increase my energy?

If you have neurological fatigue and would like to exercise to gain energy, it’s important you go about it the right way. If you overdo things, especially in the beginning, exercise can have the reverse effect and leave you feeling overtired. This experience can cause people with neurological conditions to abandon exercise before it’s had a chance to improve your energy levels.

Conversely, if you don’t do enough exercise, or do it too infrequently, you won’t achieve the optimum benefit.

It’s crucial to find the right type and volume of exercise for you. This will depend on several factors, including:

  • your current level of fitness
  • what neurological condition you have
  • whether you have other health conditions
  • your needs and preferences



For people with neurological conditions and/or neurological fatigue, prescribing exercise involves a fine balance between doing enough to get the fatigue-busting benefits without overdoing it and making you more tired.

This is where the experienced team from Active Ability can help. Our exercise physiologists are experts in designing exercise programs for people with neurological conditions. Our programs are all based on a personalised assessment to ensure they are suited to your needs, goals and health concerns.

Along with boosting energy, regular exercise has many other benefits, such as:

  • reducing the risk of chronic diseases, such as diabetes and heart disease
  • improving your metabolic health, such as your blood pressure and cholesterol levels
  • improving your mobility, balance and coordination
  • reducing symptoms of anxiety and depression
  • managing your weight
  • improving your mood.

If you have a neurological condition, Active Ability’s dedicated team of exercise physiologists can visit you at home, or your workplace, gym, pool or other preferred location.

Visit this page to learn more about how we can help you manage your neurological condition.

Or get in touch with us on (02) 8678 7874, or via our contact form