In How to Manage MS-Related Spasticity, we discussed different therapeutic strategies to combat spasticity. Conservative approaches can be quite effective in combatting mild spasticity, including stretching and strengthening exercises. Oral medications such as BACLOFEN are often effective, especially in the early stages of the disease.
* Stretching and range of motion exercises can treat connective tissue tightness. Stretches should focus on a single muscle group. Hold for 30 seconds, rest, and repeat 3-5 times. NO BOUNCING ALLOWED.
* Yoga, Tai Chi and biofeedback may be appropriate relaxation interventions. Swimming and aquatic exercises may also be helpful.
* Problems with co-contractions can be treated with timing exercises and by focusing on motor control.
* Strength training can assist with the timing of movements, depending on the strength or weakness of the agonist/antagonist muscles.
* Strengthening can be achieved in a variety of ways, using free weights, machines, theraband, Swiss Balls, or aquatic exercises.
* General conditioning can help to strengthen weak and deconditioned muscle groups and increase endurance and cardiovascular conditioning.
* Pain may be alleviated or reduced by stretching, transcutaneous electrical nerve stimulation (TENS), or thermal modalities such as cooling.
Early in my MS career, I told the neurologist that I was experiencing unusual tightness in my calves. His recommendations were yoga, swimming, plenty of fluids and potassium-rich foods. These strategies helped somewhat, but not completely, and I certainly didn’t know how to properly stretch my muscles.
At home, I would talk about how knotted my calves were and the response I received was something like this: “Good grief, Lisa!! What did you do?” My response: “Absolutely nothing, and this is not as bad as it usually gets.”
So it wasn’t until the enormous, never-ending (seemingly) relapse I experienced last winter/spring that the neurologist and I discussed spasticity. Basically, the back of my legs were pulled so tight that I couldn’t extend them to stand straight. It was excruciating.
Also, I couldn’t stand from a chair or the sofa without pulling on a table. On Day 3 of a 5-day course of IV Solumedrol, I actually could stand up from a seated position. The moment was thrilling!!
A month later the spasticity was returning and my neurologist prescribed Oral baclofen (Linosenil®). Following the titration schedule described below, I found a therapeutic level. At first I did experience increased fatigue as a side effect, but that dissipated after 3-5 days. I was so nice when my legs could be completely straightened and I could walk more easily. The increased mobility was most welcome.