Spastic equinovarus foot deformity from MS

[WACVet]

Well, now I know what it is, but my questions now consist of

1) Is there a "progression" rate? My foot isn't as bad as some of the pictures I've seen, so hopefully I'm "catching it" early?
2) When did you notice it happening, what made you notice it?
3) What treatments have others had, and how is it working for you?
4) Can spasticity cause other deformities?

[WACVet]

Wow, no replies. I'm the only one here with this? I had hoped I would have someone to discuss this with, as I'm waiting for my Neuro to see if they can get me in earlier. My baclofen has been upped to 20 mg, my daughter has massaged my legs, and works my ankle. We've noticed that as she works my ankle, the spasticity gets worse and fights her moving it. So very, very strange.

I use to be a weight lifter, and was always taught to work out the stiffness, but seems with spasticity, walking/working it out just makes it worse. Guess I'll find out soon what I can do for this....

[nappy]

Sorry you haven't had any replies.

I don't even know if mine counts either.

I wear braces on both legs to counter foot drop. I can walk without them just not too much. As I get tired the foot drop gets worse so I keep the AFOs on for most of the time.

I see the specialist who made my orthodics and braces to keep them adjusted. My left foot began to give me pain about two years ago. (Numbness and pain- really do I get to have both?) I was twisting my foot and walking more and more to the outside. We tried building up and adjusting the braces, but it didn't help. I developed a spur that ran across top of my foot.

It was the first joint after the ankle. Xrays and scans showed that I was developing arthritis in the joints.

After many rounds of injections with steroids my ortho said something needed done. The usual course was to fuse the joints so they could not flex and allow my foot to twist over to the side.

That surgery would require two months of non weight bearing recuperation. And I was very hesitant to be immobile for that period of time.

My surgeon came up with an alternative and I now have ball bearings in my joints. I just had the surgery after Christmas, but I was back to work in two weeks. I had a knee scooter which my second graders found exciting.

After two weeks I was permitted to put my heel down and from there to progress as I felt I could tolerate. I had my "regular shoes" on a month after surgery.

Although it is still healing I am happy to be using it.

My surgeon said that the fusion might still need to be addressed later but he understands my thinking about the present. If this buys me some time I am happy.

Additionally- your comments about massage sometimes making your spasticity worse. I also understand that. Sometimes it helps, sometimes it makes things worse. I just had a deep tissue release massage yesterday and while the clinician was working out my shoulder muscles my one leg decided to cramp up and scream for attention.

Sometimes rest helps, some times not, sometimes activity helps- some times not. Temperature fluctuations- you name it. I could make a list of things that causes my spasticity to ramp up. It is a guessing game most times.

Perhaps your baclofen could be adjusted. 20 isn't all that much. I was up over 120 before I had ITB.

Good Luck I hope you hear from the dr. soon.

[WACVet]

Nappy, thank you for posting! I am having a problem with foot drop, if I'm on my feet too much (ugh, what is NOW too much). Actually, it's not too bad, as I don't have to "high step" (did in the past), and can just slide the foot along.

I've learned I can't "walk it out", as it just makes my spasticity worse, and when it comes to the foot, massage (moving of the foot/ankle) also makes it worse. This makes NO sense to me, and goes against everything I learned, in respect to exercising the muscles!

I'm on 20mg baclofen 3x's a day, and can't imagine 120mgs! Thankfully, my Neuro changed my appointment from the 28th of April, to the 1st!! That is just amazing for the VA system, and even set me for an afternoon appointment. I have to travel 2 hours, one way to the VA, and they usually make appointments 8-9:30 in the morning.

I should know more on Friday (I can't wait!!), and will post after I rest up. This MS really keeps us on our toes!

[WACVet]

Just got back from my Neuro appointment... He put me on Amantadine to try and combat some of the fatigue. He's setting up an appointment with PM&R (pain management and rehabilitation) to get botox injections to try and combat the contracture, that's causing my foot to turn in.

I questioned about how my legs get worse the more I use them, instead of the stiffness being walked out, he said that's MS! I kind of hoped this was all, just my imagination, but he confirmed that it wasn't. He didn't tell me what I WANTED to hear, but what I needed to hear, and I'm really appreciative that I have him as my Neuro.