What is Spasticity?
Spasticity is the feeling of tightness, usually in the legs (as my case) among Multiple Sclerosis, but it can effect any part of the body. It is considered an increase in muscle tone (muscle tightness) and there are two types of spasticity that are common among Multiple Sclerosis.
Flexor – Involves hamstrings in upper legs and the hip flexors (muscles at top of upper thigh).
Extensor – Involves Quads and adductors (muscle on front and inside of upper leg).
Spasticity effects about 20-34% of MS patients in some way shape or form. It is a very common symptom.
How to Treat Spasticity:
Baclofen (Oral Pill) - the most common treatment, a muscle relaxer that targets nerves in the spinal cord.
Baclofen Pump – A pump that is surgically implanted under the skin and releases a set dose of Baclofen into the spinal cord via a tube. This is for more extreme cases of spasticity.
Tizanadine (Zanaflex) - another option, Zanaflex is a skeletal muscle relaxer which slows down action in the brain and nervous system. This works great for spasms but can cause really bad cotton mouth!
Diazepam (Valium) – This drug has a strong sedation effect, many people use it to sleep which is why it's typically prescribed to help when spasticity is interfering with sleep. Also used for anxiety and to help prevent seizures. Can be addictive.
Dantrolene (Dantrium) – Typically only used when other drugs have not worked. Can cause some tough side effects.
Botox – Also for extreme cases of spasticity, Botox injections can help relieve spasticity for around 3 months, as always, this varies from person to person. It is typically administered in a medical facility.
Exercise and stretching! Even massage, acupuncture, supplements such as Magnesium, or Cannabis are said to help. For me (and most others) stretching works best!
My Experience With Spasticity
Spasticity was never an issue for me until my major relapse at the beginning of 2012 that effected my spinal cord but now I live with a bit of it everyday. When it first hit, my right leg was fully extended and so tight that I could not even bend it, in fact, I remember a nurse leaning into my extended leg as I sat in a chair and still not being able to bend it at all. I had never been in that kind of pain in my life, it made a sciatica feel like a walk in the park. I remember them giving me a shot of Dilaudid and feeling almost no relief. I was asking for Norco as soon as it was available because my lower back was so tight from my leg being extended to the max that it was causing excruciating pain in my lower back. After a while (and much rehab) I was finally able to bend my legs on my own and after much stretching and exercise at home it is not so much of a problem anymore. When I get stressed however, I immediately feel my legs start to tighten up and cramp causing me to feel like if I don't start stretching and massaging them right away that they might (but probably not) lock up rendering me unable to walk. This is one of the many reasons I try to just avoid confrontation and other stressful events.
Luckily my spasticity is under control enough that I walk just fine without the aid of a cane and I am sure that as my balance improves I should be able to do a slight jog! I have tried several medications such as Baclofen and Tizanadine, but nothing gives me that instant feeling of relief we all want from popping a pill. I take Baclofen in the morning and at night just to see if I can get any help from it and at the least it stops my myoclonus jerks at night when I am trying to sleep.