Multiple Sclerosis: A Physiotherapist’s Complete Guide!

Are physiotherapy and physical activity really useful in multiple sclerosis (MS)? And what can you expect from them?

My answers as a physiotherapist who likes to read up on international scientific literature!

♻️ Last update: August 14, 2025
👩‍⚖️ Declaration of financial interests: none directly related to the subject. My complete declaration of financial interests is in the legal notice section.
Written by Nelly Darbois, physiotherapist and scientific editor

A fact: people with MS are living better today

1 in 1000 people in Europe have multiple sclerosis, and the disease has been known and studied for centuries.

Medical treatments have really improved, and although there’s no cure for MS, some sufferers can look forward to a good quality of life.

Here are the factors that predict a rather favorable evolution with less negative impact on quality of life:

• being a woman;
• evolution by flare-ups ;
• mild flare-ups ;
• good recovery between bursts;
• especially sensory disorders;
• a long time between 2 attacks;
• few lesions on MRI;
• optic neuritis.

Source : Tafti 2022

There are studies evaluating the effectiveness of physiotherapy sessions

Physiotherapy sessions are often offered to people with multiple sclerosis. The aim is to :

• improve functional abilities: get things done in your professional and personal life;
• improve quality of life, by being able to do more things.

Research teams have compared the evolution of people with VS without physio sessions and other types of rehabilitation. Here are their findings [Amatya 2019]:

Structured, multidisciplinary rehabilitation and physiotherapy programs (exercises or physical activities) can improve functions such as mobility, muscular strength and aerobic capacity, as well as quality of life.

Overall, the evidence for many rehabilitation interventions needs to be interpreted with caution, as the data analyzed in the majority of included reviews were not derived from recent studies.

To put it more simply: the evidence we have today suggests that rehabilitation, especially physical activity and exercise, does indeed improve the quality of life of people with multiple sclerosis, compared with doing nothing.

Private physiotherapy sessions may be prescribed for you.

It is possible to have physiotherapy sessions on your own. Your GP or neurologist can prescribe them, and you can then make an appointment with a physiotherapist.

All physiotherapists are trained in the treatment of multiple sclerosis. In larger towns, there are also physiotherapists who specialize in neurology.

A diagnosis of MS entitles you to long-term treatment in France. Your physiotherapy sessions will therefore be reimbursed at 100% by the French health insurance system, with no advance payment. There is no limit to the number of private physiotherapy sessions you can have in this context.

You can also stay in a rehabilitation center

There are rehabilitation centers that offer day hospitalization (full or half day) or full hospitalization (you sleep there) for more “intensive” stays (but adapted to your level of fatigue).

Some people do one a year on a regular basis. Others do it only during or after a flare-up phase, to recover as much as possible.

Once again, your neurologist or attending physician can request such a stay. This is done centrally via the ViaTrajectoire website for your region in France. For example, for my region of Auvergne Rhônalpes (I’m in Savoie), it’s: https: //trajectoire.sante-ra.fr/Trajectoire/

All stays are reimbursed at 100%, except in certain private centers. In this case, your mutual insurance company may be able to top up the cost, but you should check beforehand by sending them the cost estimate for your stay.

The advantage of staying at a center is that you have access to different professionals in the same place: physiotherapists, occupational therapists, adapted physical activity teachers, speech therapists, neuro-psychologists, social assistants, PRM doctors, and so on.

There is no such thing as a “special MS” exercise, as it depends on your limitations and objectives.

Many people search on the internet for special multiple sclerosis PDF worksheets. Of course, I understand this wish.

However, there is no special exercise for multiple sclerosis.

It depends a great deal on your current abilities: some people are bedridden or in a wheelchair and are looking for exercises to do lying down. Others are trail runners and are looking for muscle-strengthening and balance exercises, standing up…

On the other hand, your physiotherapist can suggest an exercise sheet adapted to you, your current limitations and your objectives, after carrying out an assessment.

Otherwise, the easiest thing to do is to search Youtube for exercise videos and find a general one suited to what you want to do and your abilities.

In studies evaluating the effectiveness of rehabilitation, there’s no recommended standard exercise: it’s the fact of being in motion, challenging your muscles, joints and cardiovascular system that counts, no matter what you do with it, as long as it’s adapted to your current abilities!

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That’s all I wanted to say on the subject! Any questions or comments? See you in comments!