Multiple sclerosis is a debilitating disease of the central nervous system that leads to disruption in the conduction of impulses due to demyelination of nerve fibers secondary to disorder of immune system.1 MS is a chronic and progressive disorder that affects nerve fibers at several levels of the nervous system causing sclerosis (due to scar tissue formation) at various locations; hence, the name multiple sclerosis. All the ensuing symptoms of multiple sclerosis are due to this damage to the nerve sheath. The symptoms may range from neuropathic pain, weakness, fatigue, paresthesias, visual disturbances, speech problems, coordination problems, along with spasticity.
What Do MS Muscle Spasms Feel Like?
Spasticity is a common symptom of multiple sclerosis affecting nearly 60-90% people with MS. It refers to a feeling of muscle stiffness and can lead to a wide variety of muscle spasms. Muscle spasms are sudden involuntary contractions or movement leading to jerking of the affected muscles. Spasticity and spasms can affect a person’s quality of life drastically and impact their daily activities.
The severity of spasticity can range from mild (just a feeling of stiffness) to severe (accompanied by painful uncontrollable spasms). Although, it can affect any part of the body, it is more common in arms, legs, back and trunk muscles. Spasticity can cause difficulty walking along with exacerbating the symptoms.
Spasm can be related to flexion. In which the spasm leads to joint bending making it difficult to extend is known as flexion spasm. The other type of spasm is related to extension. In which the muscles tighten and remain straight making it difficult to bend is known as extension spasm. Another form of spasm is adductor spasm, where it is difficult to separate thighs and they are pulled towards the body. Spasm can also affect the trunk in which the back arches off of a bed or back of a chair.
Cause Of Muscle Spasticity In MS
Spasticity and muscle spasms are caused due to increased muscle tone, which is a measure of resistance of a muscle to movement.2 The tension and relaxation in a muscle is maintained by normal nerve conduction in the muscles. However, the disturbance in the nerve stimulus conduction in a muscle can lead abnormal muscle tone. The coordination between the impulses and muscles is disrupted leading to prolonged contracture of a muscle causing spasms. Spasticity can affect any part of the body depending which part of the nervous system is affected by MS.
Spasticity and spasms are also associated with other symptoms of weakness, pain, and clonus. Spasticity can be helpful in some situations, especially if the muscles are weak. The stiffness provides strength in weak muscles and helps them to function, such as walking. Spasticity and spasms are often associated with cramping pain and on occasions they are unassociated with pain symptoms. Clonus or abnormal repetitive, upward and downward or tapping movement of foot can also be associated with spasticity and spasms.
Management Of Spasticity And Spasms In MS
Spasticity and spasms can be managed with the use of muscle relaxants. The first line treatment of drugs includes baclofen and gabapentin. When these do not help in relieving symptoms, other drugs including dantrolene, tizanidine, clonazepam, diazepam and pregabalin can also be used as a second line of treatment. Sativex, a cannabis-based mouth spray is also a licensed treatment for MS spasticity. Other options of management include botox, intrathecal baclofen, phenol and finally surgery; however, surgery is performed in very rare cases.
Movement and stretching along with physical therapy and occupational therapy are important part of keeping muscles active and reducing spasticity and spasms. If left without treatment then spasticity can cause serious complications, such as contractures of joints and pressure sores. If over treated, then that will result in weakness of muscles devoid of stiffness and rigidity that will result in inability to walk if leg muscles are involved.
Therefore, right amount of physical therapy is important maintaining right amount of spasticity.
- Massage Therapy for Multiple Sclerosis (MS): Benefits- Pain, Stress Reduction
- Special Diets For Multiple Sclerosis (MS)
- Alcohol and Risk of Multiple Sclerosis: Is there a Link?
- How is Transverse Myelitis Connected to Multiple Sclerosis?
- Can Medical Marijuana Treat Multiple Sclerosis or MS?
- Common Symptoms of Multiple Sclerosis in Women