8 Ways to Prevent and Manage MS Spasticity
Up to 90% of people with multiple sclerosis (MS) will experience the symptom of spasticity at some point in their lives, according to the MS Trust. Spasticity is when muscles in the body become stiff and hard to move, sometimes tightening against your will. This can lead to difficulty walking and increase your risk of dangerous falls—plus it’s painful and could lead to severe complications like frozen joints if left untreated. It’s sporadic and duration varies from person to person. To bring you relief, we asked experts for top tips to help prevent and treat this frustrating MS symptom.
Why Spasticity Happens With MS
When you have MS, inflammation in the brain and spinal cord can wreak havoc on the body, interrupting signals between the muscles and the brain. When the inflammation affects areas of your brain and spinal cord that control muscle and stretch reflexes, spasticity can result, according to the American Association of Neurological Surgeons (AANS). The muscle tightness can manifest in two ways, per the National MS Society: 1) flexor spasticity, when it’s hard to straighten your limbs, and 2) extensor spasticity, when it’s hard to bend your limbs. Read on about how to address it.
Stretch, Stretch, and Stretch Some More
“Stretching is the most holistic way to approach spasticity, and it’s variably successful,” says Kathy Zackowski, Ph.D., an occupational therapist and scientist who serves as senior director of patient management, care, and rehabilitation research for the National MS Society. “The best way to stretch is to put the muscle in the opposite position that it was in for an extended time.” For example, if your back is tight, hugging your knees to your chest in the morning after a long night of being fully extended could be a helpful stretch.
Don’t Forget About Passive Stretching
Here’s a secret: You can stretch your muscles to combat spasticity even while you’re sleeping. This is a type of passive stretching, which means it can be done with the assistance of a device or other helper, such as a physical therapist. “You can wear a brace at night that holds a stretch passively for the eight hours you’re asleep,” says Zackowski. That way, you don’t have to worry about wearing a brace during the day.
Get Regular Exercise
Incorporating regular physical activity into your life is another way to help combat spasticity with MS, says Jacqueline F. Rosenthal, M.D., a neurologist at the Andrew C. Carlos Multiple Sclerosis Institute in Atlanta. Active movement helps keep your muscles, ligaments, and joints flexible, according to the MS Trust. Find a form of exercise you enjoy and can fit into your routine—even if it’s just a daily walk around the neighborhood. Stationary biking, another great option, can help restore blood supply to leg muscles that are often affected by spasticity, says the National MS Society.
Take Breaks for Movement
Spasticity thrives when you stay in one position for too long—so making a point to move periodically is a must. “During periods of relative inactivity, such as sitting at a desk, it is important to try to take breaks to stretch,” says Dr. Rosenthal. Try setting an alarm on your phone at regular intervals as a reminder or make it a habit to move to a new location every so often when you’re working from home.
Work With a Rehab Team
When you have spasticity, working with your MS healthcare team to manage this symptom is key. In addition to your neurologist, a physical therapist and/or occupational therapist can be helpful. “Occupational therapists are trained to help you adapt activities so you can maintain your quality of life,” explains Zackowski. For example, they may be able to suggest new ways to do activities that lessen muscle spasms. Physical therapists are similar but focus on strength, endurance, and exercise, she says. Together, your team can prescribe a stretching and exercise regimen to fight your spasticity.
Try Electric Stimulators and Other Devices
Using a functional electrical stimulation (FES) device, like a WalkAide, which stimulates the muscles with small electric pulses, may also relieve spasticity symptoms, according to the National MS Society. These may be especially helpful for things like foot drops, when you struggle to pick up the front part of your foot with each step, says Zackowski. Your rehabilitation team can also suggest other devices—such as assistive bands or braces—that can help you ward off involuntary muscle movements and decrease tightening, according to the AANS.
If your muscles need even more help relaxing, there are several medications your doctor may prescribe, says Dr. Rosenthal. “If [stretching and exercise] are ineffective, then it is best to talk with your MS specialist to determine if you would benefit from pharmacologic treatments,” she says. For example, one common medication, baclofen, helps relax muscles so you can move more easily, says the National MS Society. This particular drug can be given as a pill or even via a surgically placed pump, which has fewer side effects. Additionally, Botox injections may also help prevent muscles from contracting, per AANS.
Know Your Spasticity Triggers
Getting to know your personal spasticity trigger factors can help you avoid them more often and hopefully reduce your muscle woes. For example, some people find that other MS symptoms, like pain or bowel or bladder problems, worsen their spasticity. Other potential triggers include having an infection, wearing tight-fitting clothes, or getting overheated. Your occupational therapist can also work with you to identify triggers and make adaptations to avoid them. Unfortunately, there are no foods or dietary changes that have been proven to significantly reduce spasticity, says Dr. Rosenthal.
The Bottom Line on MS Spasticity
“Spasticity is a really complicated problem, and so frustrating,” says Zackowski. “While we don’t have great interventions yet, a combination of stretching and medication can help.” Working closely with your healthcare team to come up with strategies that work for your specific spasticity symptoms is crucial. And remember, it’s important to get treatment at the first sign of spasticity, as this can help prevent serious complications down the line, says the National MS Society.
Spasticity Statistics, Triggers, and Treatment: Multiple Sclerosis Trust. (2020.) “Spasticity and spasms.” mstrust.org.uk/a-z/spasticity-and-spasms
MS Stretching Guide: The National MS Society. (2016.) “Stretching for People With MS.” nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure-Stretching-for-People-with-MS.pdf
Spasticity Treatment Information: American Association of Neurological Surgeons. (2021.) “Spasticity.” aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spasticity
Spasticity Overview: The National MS Society. (2020.) “Spasticity.” nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Spasticity