Spasticity in ms: tips for management

Spasticity is when your muscles become tight, making them hard to move. Depending on the severity of your symptoms, treatment can involve medication, physical or occupational therapy, or

surgery. Spasticity affects about 60% to 84% of people with multiple sclerosis (MS). It occurs when muscles become stiff, making it hard to move. Spasticity can affect any part of the body,

but the condition most commonly affects the legs, reports the National Multiple Sclerosis Society. The stiffness can range from slight to total inability to stand or walk. A minor case of

spasticity might involve a feeling of tightness or tension, but severe spasticity can be painful and incapacitating. Sometimes spasticity involves muscle spasms. A spasm is a sudden,

involuntary jerk, muscle contraction, or muscle tightening. Are there different kinds of spasticity? These are the two most common types of spasticity in MS: * FLEXOR SPASTICITY: Your

muscles are extremely tight, leading to your limbs bending. The tightness may lead to you finding it difficult to straighten them. * EXTENSOR SPASTICITY: Your muscles are also extremely

tight with this type, but your limbs are intensely straight, making it hard to bend them. You can also experience spasticity in your arms, but it is not as common in people with MS.

Developing a treatment plan If you have MS, your doctor may recommend some prevention strategies for spasticity before it begins. This can include: * yoga * progressive muscle relaxation *

meditation and other relaxation techniques * massage The goal of treatment for spasticity is to relieve symptoms like muscle contractions and pain. Certain things can trigger symptoms or

make them worse. Part of your treatment plan should include identifying triggers to help you be better prepared to avoid them. Some common triggers are: * changing positions * making sudden

movements * humidity * infections * extreme temperatures * tight clothing Your doctor may refer you to other healthcare professionals such as physical or occupational therapists. Depending

on the severity of your symptoms, you may also consider: * MEDICATIONS to reduce muscle stiffness * ORTHOTIC DEVICES like braces and splints to help with positioning * SURGERY to sever (cut)

tendons or nerve roots Spasticity may gradually progress over time, even with relapsing-remitting forms of multiple sclerosis. It may also get worse during an MS flare. Medication for

spasticity Medications can be used to treat MS-related spasticity. The goal of medication is to lessen muscle stiffness without weakening muscles to the point where you can’t use them.

Whatever medication your doctor prescribes, they’ll probably initially start you off with a low dose. If needed, they can gradually increase the dose until you find the one that works well.

The FDA-approved antispasticity drugs used to treat MS are: * BACLOFEN (LIORESAL): Baclofen is available as an injection and orally. It relieves spasms, cramping, and muscle tightness. It

can also improve muscle movement and relieve spasticity pain. Side effects can include fatigue, nausea, vomiting, headaches, dry mouth, excessive sweating, and an increased need to pee. More

serious side effects can include sleep apnea and liver damage. * DANTROLENE (RYANODEX): Dantrolene is a skeletal muscle relaxant that can relieve cramping, spasms, and muscle tightness.

Side effects can include dizziness, weakness, and fatigue. Liver damage is a more serious side effect. * BOTULINUM TOXIN (BOTOX): This is administered via intramuscular injection. It can

relieve upper and lower limb spasticity in MS. Injections have effects that last for several months and typically do not have systemic side effects, such as fatigue or urinary urgency. Oral

medications are taken every day. However, oral medications for spasticity can cause systemic side effects, such as headaches, nausea, and urinary urgency. In a 2014 systematic review, the

American Academy of Neurology found evidence to support the use of cannabinoids to help reduce pain in people with MS-related spasticity. Researchers note that most of these studies were

defined as low quality, and the results were inconsistent, including some results suggesting diminished cognitive skills. More recent research indicates that cannabis can help reduce pain

and spasticity. Your doctor can help you decide which medication is right for you. You should always speak with your doctor before starting any medication, even if it is available over the

counter. Physical and occupational therapy for spasticity Regardless of whether you use medication, it’s important to include movement in your treatment plan. A physical therapist can assess

your strengths and weaknesses to help determine which exercises are most likely to help. Then they can show you how to do these exercises properly. Exercises can also help with: * walking

and mobility issues * strength * balance * posture * fatigue * pain If you have trouble performing routine tasks like dressing, consider working with an occupational therapist. They can

teach you how to use assistive devices and make home modifications to make doing tasks easier. Devices for spasticity Assistive devices, also called orthotic devices, can help keep your legs

in the proper position so it’s easier to move around. Talk with your doctor or physical therapist before purchasing an orthotic device. Some assistive devices that can help cope with

spasticity include: * poles * canes * crutches * scooters * wheelchairs These devices can help you maintain balance, support your weight, and minimize fatigue by making walking and other

everyday activities less taxing. Surgeries for spasticity Because surgery always carries some risk, it’s usually a last resort. Surgery for spasticity involves cutting tendons or nerve roots

to help relax stiff muscles. These procedures can be effective in treating spasticity. When to see your doctor If you’re experiencing spasticity or occasional muscle spasms, you should

mention it to your doctor or neurologist at your next visit. If spasticity is painful or interferes with certain movements, consult with your doctor now. Without treatment, severe spasticity

can lead to: * pain * frozen and disabled joints Early treatment can help you prevent these complications. Takeaway Spasticity can vary in degree and frequency. Treatment increases the

likelihood of relieving pain and stiffness and improving function. You can work with your doctor to create the right treatment plan and adjust it as your needs change.