I sleep on my side. When I wake up in the morning and I try to rollover and get out of bed, my right leg seems frozen in the bent mode of my side sleep. I have to press on my upper thigh multiple times to try to get the nerves to “remember” to relax and let me straighten my leg. I assume this is my spasticity, hence my spastic leg.
Spasticity refers to the episodes of muscle stiffness and involuntary contractions in those of us with damaged central nervous systems. According to the MS Society, “Spasticity occurs as a result of an imbalance between the excitatory and inhibitory signals from the brain and/or spinal cord.” It’s presentation and severity varies widely across individuals and even in the same person over time. It is estimated that 85% of MSers will experience it over the course of this disease.
Strictly speaking, it can be hard to distinguish spasticity from other symptoms in MS. A sensation of stiffness in the legs may be spasticity, but also might be from abnormal sensations or from the weakness associated with MS. For the most part, it is identified based on self-reported symptoms, so for our purposes, it kind of doesn’t matter why.
How it may begin
In RRMS (relasing-remitting MS) it tends to be fairly mild in the early years. But spasticity is generally defined as being “velocity dependent”, which means that when a quick stretch is applied to a muscle, the resistance is increased. So even if you don’t yet feel it, it is there.
A few years after I was diagnosed I started to notice that I had way overresponsive jerking reactions to stubbing my toe or being tickled, for example. I chalked it up to my MS and laughed it off as proof that I was “sensitive.” And even when I learned that this “hyperreflexia” was often a precursor to full-blown spasticity, I just thought it was a manageable inconvenience.
But what I’ve learned for this post is that if ignored, spasticity can lead to limbs frozen in place, for example, or even just negatively affect our quality of life with increasingly annoying symptoms.
Physical therapists know that the tighter a muscle is, the more spastic it becomes. Experts will tell you that one of the first things to try to reduce muscle tightness and soreness is with stretching. You could try yoga and/or other range-of-motion exercises (see MS manual on stretching below for examples).
Besides exercise, there are medications that can be prescribed like baclofen or diazepam, herbal remedies for muscle spasm or relaxation, and even medical marijuana.
And while both MSers and medical professionals may be reluctant to try more invasive treatments such as local injections of Botox®️ or intrathecal baclofen therapy (ITB), they can be effective and well tolerated. A referral to a spasticity clinic with experience in the use of these therapies may broaden your options.
For my spastic leg, I now sleep on my back and have started doing bed exercises before I go to sleep and again before getting up. Baby steps!
- Spasticity section | National MS Society
- PDF Stretching for People with MS
- Build your own exercise routine | Multiple Sclerosis Trust (UK)
- Horseback Riding Helps People w/Movement Disabilities, Review of 16 Studies Concludes | The Consortium of Multiple Sclerosis Centers
- Bed Exercises | Sit and Be Fit
Links last checked Sept. 2022