How to recognize spasticity?

[MarkLavelle]

Until very recently my sx were pretty much the same as at dx (24/7 paresthesia in all limbs), but I've lately felt like some of the muscles in my ankles/feet are causing a kind of pain that does not match up with cramps or other explanations.

Is there any way to know if this is an MS thing?

[mjan]

To be safe and sure, I don't think everything is MS. In fact I usually go to my orthopedic doc to rule in/out my symptoms/pain. They are very aware of my MS diagnosis. My MS neuro tends to blame it on other things (which could be a good sign), but sometimes will not accept it IS MS.

Let us know what you learn, ok?
Jan

[ldwestmo]

I have the same question

I am following this post because I have the same question.
I have had tightness/stiffness in my neck for 3 years or more. I finally broke down and went to an orthopedic several months ago. He sent me to therapy and it helped tremendously after 4-6 weeks. Between therapy sessions some stiffness would return but they were able to work it out with massage and heat. They said my “trap” muscles in my neck and shoulders were very tight. They attributed it to poor posture when working on computer or cell phone use. I have corrected those posture issues .
I have not been to therapy since November but I still do neck stretches daily to try and keep my neck as loose as possible. Week by week my neck is getting stiffer and stiffer. Especially when I am tired after working a long day (or not necessarily working – just holding my head up all day long). I do take balfocen from time to time and take 2 at night fairly often to help my neck relax.
I would really like to know how I can determine is MS spasicity. If it is spacisity would massage and physical therapy help?

[mjan]

I am following this post because I have the same question.
I have had tightness/stiffness in my neck for 3 years or more. I finally broke down and went to an orthopedic several months ago. He sent me to therapy and it helped tremendously after 4-6 weeks. Between therapy sessions some stiffness would return but they were able to work it out with massage and heat. They said my “trap” muscles in my neck and shoulders were very tight. They attributed it to poor posture when working on computer or cell phone use. I have corrected those posture issues .
I have not been to therapy since November but I still do neck stretches daily to try and keep my neck as loose as possible. Week by week my neck is getting stiffer and stiffer. Especially when I am tired after working a long day (or not necessarily working – just holding my head up all day long). I do take balfocen from time to time and take 2 at night fairly often to help my neck relax.
I would really like to know how I can determine is MS spasicity. If it is spacisity would massage and physical therapy help?

Yes! They usually give you exercises to do at home. Yes it returns, but with MEDS, like Baclofen and exercise/stretching, you can learn to live with it.

[MarkLavelle]

Jan,

I appreciate the "not everything is MS" reminder, even if it is sort of my motto. The physiatrist I see for my back (and other) problems is the one who sent me to a neuro and my eventual MS dx, and at 59 I have a typical assortment of declining body parts & functions, so I rarely forget it.

Around the time of my dx I started having much more frequent cramps and especially in small muscles in my feet. I now know that those were not spasticity, which is really the reason I posted: Whatever is happening does not feel at all like those cramps, even though it's mostly in the same areas.

Also, I forgot to mention that I've had a similar (but more painful) thing happening with the right side of my ribs a few times in the last week. Hug?

Let us know what you learn, ok?

I certainly will*, but in the mean time I'd love to see more discussion about how to recognize real spasticity.

*: MS is low man on my totem pole this year, as next week I am having a needle biopsy of a 2cm nodule in my right lung that looks cancerous on the PET scan (I suppose it's even possible that my tumor [in the bottom lobe] is causing the rib pain...). This is actually better (apparently no metastasis) than 20 years ago, when I had stage IIIa lung cancer and a metastasis to the brain 2 years later.

Gotta keep those medical professionals employed, after all...

-- Mark

[Marco]

Spasticity frequently appears as muscle stiffness, muscle fatigue, muscle spasms (cramping, pulling), lack of coordination, gait problems, and even pain. A number of factors can increase spasticity like: fatigue, stress, heat/cold, illness, position, humidity, etc.

I tend to compare spasticity like a rope that can be loosened or tightened. Normally, a rope is flexible and you can even tie it into knots, but pulled tight it loses it becomes rigid. If the rope is too loose you don't have enough muscle tone (wet noodle). Some people use spasticity to their advantage to overcome weakness (people may use rigidity to help walk).





Spasticity should not be considered "permanent" as many treatment options exist. Reducing your overall stress load can help spasticity, as can breathing exercises, meditation, prayer, etc. Other patients may prefer using heat/cold, massage, TENS units, acupuncture, etc. Physical and occupational therapy can often help develop an exercise program and help with activities of daily living. If spasticity is impacting your speech or swallowing a speech therapist can be a wonderful help. Many neurologists will freely prescribe spasticity medications like oral Baclofen or Tizanidine. Benzodiazepines, Gabapentin and even anxiety drugs may also be used. Several of the oral medications have unwanted side effects, especially in higher doses so keep before and after notes. For chronic spasticity in specific muscles Botox may be used. For more widespread spasticity a mechanical implant or surgery may be considered.


The key point is that if spasticity is impacting your quality of life then you should consider treating it. I would suggest you start with the easier things like stretching before moving to medications. See if your doctor can have a physical therapist evaluate you and create an exercise/stretching program for your needs. As time goes on you may have to use more than one therapy, but spasticity is largely manageable.

Here's the NMSS link to spasticity.
http://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Spasticity

[mjan]

Jan,

I appreciate the "not everything is MS" reminder, even if it is sort of my motto. The physiatrist I see for my back (and other) problems is the one who sent me to a neuro and my eventual MS dx, and at 59 I have a typical assortment of declining body parts & functions, so I rarely forget it.

Around the time of my dx I started having much more frequent cramps and especially in small muscles in my feet. I now know that those were not spasticity, which is really the reason I posted: Whatever is happening does not feel at all like those cramps, even though it's mostly in the same areas.

Also, I forgot to mention that I've had a similar (but more painful) thing happening with the right side of my ribs a few times in the last week. Hug?



I certainly will*, but in the mean time I'd love to see more discussion about how to recognize real spasticity.

*: MS is low man on my totem pole this year, as next week I am having a needle biopsy of a 2cm nodule in my right lung that looks cancerous on the PET scan (I suppose it's even possible that my tumor [in the bottom lobe] is causing the rib pain...). This is actually better (apparently no metastasis) than 20 years ago, when I had stage IIIa lung cancer and a metastasis to the brain 2 years later.

Gotta keep those medical professionals employed, after all...

-- Mark

I am sorry for what you are going through. Enuff I say!
Are you on any medical forums for support? I am on CSN=cancer survivors network as I had kidney cancer 2 years ago. However, the Cancerous tumor went with my left kidney. Just being monitored these days.

I would strongly suggest them: www.csn.cancer.org or www.smartpatients.com.

I am available to share with too. You can find my email address on my profile here.

I have had the most horrible MS hug history. Just yesterday as I read your post here, I was having this horrible pain from my upper right back, then to my rib cage. I wanted to scream. I did stretching and took my meds. It lasted all evening and through the night. Its better now.

Geezlouize, eh Mark?

Are you a NFL fan? Isn't the superbowl in your area of the country?

Gentle hugs, Jan

[mjan]

Hey Mark, do you take an anti cholesterol med by any chance?

One of the side effects is terrible spasms plus other crappy things.

Just curious. It has bothered me so that they are changing my med AGAIN.

Jan

[MarkLavelle]

Spasticity frequently appears as muscle stiffness, muscle fatigue, muscle spasms (cramping, pulling), lack of coordination, gait problems, and even pain. A number of factors can increase spasticity like: fatigue, stress, heat/cold, illness, position, humidity, etc.

Marco,

Thanks for all the info.

I'm a 95% sensory (paresthesia) MSer having some new sx, and my main Q is basically "how can I tell the difference betweeen cramps and spasticity?" I get that they can be similar, but I'm hoping to learn how to tell the difference.

On the causes side, I've got plenty of stress these days...

[MarkLavelle]

Hey Mark, do you take an anti cholesterol med by any chance?

One of the side effects is terrible spasms plus other crappy things.

Jan,

Yikes! I've been taking simvastatin for a few years now. I'll ask my cardio about that when I see him (which happens to be tomorrow!).

I'm inclined to think that all the recent stress is triggering the (apparent?) hug action and probably more (like the arrhythmia), but it's only happened 2-3 times so far (once during lunch, when the pain totally beat out the eating or talking to my co-workers). I'm a hard core stoic, but the last time it happened I really couldn't think about anything else...

On the cancer front, I'm a bit surprised to find myself relatively calm. I'm nervous about the needle biosy next week, and the surgery (if it's malignant), but it's also "old hat" in a way, and clearly a much earlier stage and not as life-threatening as what I went through 20 years ago. Cancer may not be vanquished yet, but the treatments have advanced considerably.

"Geezlouize" is almost exactly how I'm feeling, but I'm also thinking that if I can get through this I can quit the rat race once and for all (can you say "burnout"?). I just want 5 good years for doing whatever I want...

-- Mark

[Echo2099]

For me...

To ME, meaning my experience, is spasms and spasticity are two different things. When I have spasms...they happen suddenly, are quite strong and my leg stiffens either drawing up toward my trunk or stiffening straight out. These spasms don't last long, maybe 20-30 secs. They are a bit painful, but come and go quickly.

Spasticity however stays with me a long time, it doesn't come and go. The muscles in my left leg are always tight and that makes it hard to bend my leg or follow thru the swing phase of my gait. Stretching helps the spasticity but can sometimes cause a spasm if I stretch too far too fast.

I get Botox injections in the muscles that are spastic. Also, Baclofen doesn't agree with me, so I also take Dantrolene for spasticity. It works differently than Baclofen.

As I said, this is MY experience, it may be different for you or others.

Echo