When I was diagnosed with MS in 1989, the only drug treatments were steroids. I was given high-dose steroids to treat relapses and low doses to try to prevent them. Nothing worked.
When the first disease-modifying drugs were approved by the FDA in the 1990s, prices were extremely high and the reported benefits were minor. My neurologist recommended other helpful things, and I have benefited from nondrug therapies like physical therapy and occupational therapy.
What Does Physical Therapy Do?
Physical therapy (PT) focuses on increasing strength, stamina, and flexibility. MS patients typically get PT after a relapse or noticeable progression, but the National MS Society recommends we see one every 2 years or so.
I had a bad fall last December and fractured my pelvis. The injury triggered progression of my MS. I couldn’t transfer from a bed to a chair, or even sit up unsupported. My provider prescribed 4 weeks of physical therapy and 4 weeks of occupational therapy. Therapy changed my life; I wound up better than before the fracture.
The therapists showed me stretches I could do myself and others that my wife helped me with. Some were done in bed, some in a chair, and some standing with support. The therapists (I had a total of four) would move my body the way I was supposed to move it, so it was easy to learn. They also did passive stretches in which they did all the work.
After 8 weeks of home therapy, I was well enough to go to the therapy gym and work on their mats and machines. The office looked like a gymnastics team practice space with parallel bars, ladders, large mats, treadmills, and pulleys. They gave me light weights and elastic resistance bands to do upper body strengthening. It was hard work, but fun.
With all those therapists, I learned more exercises than I could do every day, but I do some each day, and I feel more energized than I have in years. I definitely sleep better after exercising.
What Happens in Occupational Therapy?
Along with the PT appointments, I was getting occupational therapy (OT) twice a week. OT focuses on teaching patients how to do things more easily and how to modify our environments to accommodate our needs. They have equipment for almost anything, like cooking tools with built-up handles so I won’t drop them. When I was really weak, they told me to get a shower bench for transferring into the tub and taught me safer ways to transfer to and from the toilet and my scooter.
OTs can recommend easier ways to do chores, write, eat, bathe, get dressed, and other daily tasks. Mine helped me redo my writing desk to make it an easier place to sit and type. He also rearranged my bedroom to help me get to things, like bringing clothes down from a high rail to bedroom wall hooks 3 feet off the ground.
How Are They Different?
In practice, OT and PT are similar in many ways. Each will teach you stretches, strengthening, and range-of-motion exercises, such as straightening or bending arms and legs. Each will give tips to prevent falls and coach you on the use of equipment, such as canes or crutches. Mine taught me easier ways to get in and out of bed and to get dressed.
In my experience, PT stays focused on getting the body to do more, while OT figures out better ways to do things. I found both extremely valuable.
PTs and OTs can also help patients qualify for disability benefits. When I applied for disability in 2002, a therapist put me through tests (called a functional capacity evaluation) and documented what I could and couldn’t do. I got the benefits, which made a huge difference for me.
I strongly encourage everyone with MS to see a PT or OT every couple of years. Learn more about physical therapy from the National MS Society.
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