Managing Multiple Sclerosis Spasticity
If you have multiple sclerosis (MS), one common symptom you may experience is stiffness. In fact, 80% of people with MS develop some stiffness, or what doctors call spasticity. This MS-related spasticity can range from mild to very severe. It can come and go, and fatigue may trigger it. However, there are various strategies to help you cope with and manage spasticity.
Symptoms of MS Spasticity
Spasticity symptoms can range from a mild feeling of tightness to uncontrollable and painful muscle spasms. MS spasticity occurs most often in the muscles you use to walk and maintain your posture. As a result, you're most likely to notice these symptoms in your legs or back.
Your symptoms may include:
Difficulty moving muscles
Difficulty relaxing muscles
Difficulty straightening or bending your legs
Involuntary and sudden muscle movements
Reduced range of motion
Sensations of tightness or pain
Coping With MS Spasticity
MS spasticity can cause a wide range of symptoms that can vary greatly from person to person. Your MS doctor will check you for signs of spasticity by checking your muscle strength, your range of motion, and your reflexes.
It's important that your doctor checks for spasticity and treats it. Left untreated, spasticity can cause your muscles and joints to freeze. This condition is called contracture. Your options for managing MS spasticity include physical therapy, medications, and avoiding spasticity triggers.
Common triggers include:
Physical Therapy for Spasticity
Physical therapy is often the first choice for treating spasticity. This includes both stretching and range-of-motion exercises. Your doctor may recommend some exercises for you, or you may work with a physical or occupational therapist.
Your regimen may include:
Daily stretching exercises done on your own
Exercise in a comfortably warm pool
Passive stretching and range-of-motion exercises done for you by a therapist
Use of mechanical devices to give support and prevent contracture
Medications for Spasticity
The National Multiple Sclerosis Society recommends starting treatment with one of the MS disease-modifying drugs at diagnosis. Work with your doctor to find the best disease-modifying treatment for you. This is the best way to reduce attacks of all your MS symptoms.
There are also some medications that are specific for treating spasticity. These drugs don't cure spasticity, but they help with the symptoms.
Common spasticity drugs include:
Baclofen (Lioresal). This is a muscle-relaxing drug. It is the most common drug for MS spasticity. Usually, you'll take this in pill form. In severe cases, doctors might inject it into the spinal cord. It's important never to alter your Baclofen dosage or discontinue the drug without first consulting with the prescribing doctor.
Tizanidine (Zanaflex). This drug relieves muscle spasms. Your doctor may tell you to take it at night because it can cause sleepiness.
Diazepam (Valium). This drug is a benzodiazepine, so it can be habit-forming. It also causes sleepiness, which is why it's best to take it at bedtime.
Dantrolene (Dantrium). This is a powerful muscle relaxant. It can cause liver damage and blood problems, so it's not a first-choice drug for spasticity.
Botulinum toxin (Botox). This drug is an injection and may relieve muscle spasms in specific areas for up to three months.
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