Falling is the commonest cause of accidental injury in the UK, with more than 2.7 million people affected each year. Falls can happen to anyone irrespective of age or medical condition, though having multiple sclerosis can increase the risk of falling.
In the majority of reported cases, falls cause no serious harm other than perhaps embarrassment and dented pride. However, the consequences of falls can be serious, ranging from distress and loss of confidence, through to injuries, pain and loss of independence.
Research shows, perhaps surprisingly, that in people with MS the majority of falls actually occur inside the home.
Many falls are caused by a combination of factors, both to do with objects in the environment - such as tripping over something - and health related issues. Some of the MS related factors that increase the risk of falling include:
- visual problems - double vision, blurred vision and nystagmus can make it difficult to focus or to see any hazards clearly. Optic neuritis can affect your balance if information from the eyes reach the brain at different speeds
- problems with mobility and/or balance - in particular foot drop, numbness, dizziness and fatigue may cause issues
- continence problems - rushing to the toilet if you need to empty your bladder or bowel more frequently or urgently can make you less careful than usual and lead to falls
- problems relating to concentration, attention span, poor memory or other cognitive symptoms - this might mean you find it more difficult to judge distances, you may trip over things that you'd forgotten were there, or if you're trying to do more than one thing at once you're not fully concentrating on walking
- side effects of medications - such as drowsiness or dizziness.
You are also more likely to fall if you've had previous falls or experience depression. Falls are also a concern for people with MS who use wheelchairs and scooters - especially if they're not used all the time. Risk factors include when transferring in or out of a chair, uneven pavements, or when someone inexperienced is pushing the chair.
If you have experienced a previous fall, you may be concerned about falling again and become less active than you used to be, or limit what you do in an attempt to avoid situations where you feel you might be more vulnerable.
Even if you haven't fallen before, the fear of falling can itself be a risk factor. Reduced activity may mean your stamina levels and fitness are reduced as your muscles become weaker if you don't use them and your joints can become stiffer. As a result, everyday activities will be more physically demanding as your body isn't as used to moving and maintaining your balance, so your risk of falling increases. There is also a risk that you might become less motivated and increasingly dependent on others.
If you do fall, try not to panic. Although you may feel a little shaken and shocked, try to stay calm, gather your thoughts and remember what you need to do.
If you have had a fall, or are concerned that you are liable to have a fall, there are a number of services that may be able to offer some help.
- GP - as well as assessing and treating any health issues, your GP can refer you to appropriate local services and can recommend a falls risk assessment, which will look at ways to improve safety in your home and reduce the risk of further falls.
- Physiotherapist - can suggest exercises to improve fitness, balance and posture and can also advise on walking equipment. Some services may provide training in transferring into and out of a wheelchair
- Occupational therapist - can help you to find easier ways of doing everyday tasks such as showering, cooking or to help make things easier at work. They can also advise on and provide some equipment and adaptations to the home.