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Your muscles play a role in every movement you make. They increase or decrease in tension or resistance to make a movement or stay still (such as to help you maintain your balance).

Spasticity is a common symptom of MS that causes sudden stiffness or involuntary muscle twitching in the body.

With the right information, support and management strategies, you can manage this symptom to live more comfortably.

Spasticity – what it is and how it differs from spasms

Spasticity is characterised by stiff, heavy or difficult-to-move muscles. Muscles usually have an internal springiness. In a muscle with spasticity, it’s as if that spring is wound too tightly, causing overactivity in the muscles. This contraction of the muscle can cause stiffness, difficulty moving or unwanted movement.

Spasticity can affect any muscle but usually affects the:

  • back lower leg (calf)
  • back of thigh (hamstrings)
  • front of thigh (quadriceps)
  • inner thigh (adductors)
  • muscles that bend the elbow (biceps)
  • muscles that pull the arm against the body
  • muscles that bend the wrist and fingers.

Spasticity tends to become worse over time.

A spasm is the sudden, involuntary tightening or contraction of a muscle. Both spasticity and spasms can be mild, moderate or severe and usually vary over time. The symptoms can be annoying, uncomfortable and unpredictable.

For some people, spasticity or spasms can be painful and affect their ability to walk, sleep and do personal care activities, which may cause a fall or an injury.

How can MS cause muscle spasticity?

The muscles in your body help you move your limbs or hold them still. To make a muscle move, the brain sends a message to either tighten or relax a muscle. For example, to bend your arm, you’ll need to tighten the biceps muscle (at the front of the arm), while relaxing the triceps muscle (at the back of the arm).

MS can affect these signals between the brain and muscles in a few different ways:

  • The muscle can stay in its tightened (or shortened) state, making that body part feel stiff, tight or difficult to move.
  • The muscle can become fixed in one position (also known as a contracture).

The disrupted nerve messages can cause a muscle to make involuntary movements or lose coordination, which can lead to spasms.

How can spasticity affect you?

Some of the most common signs of spasticity are:

  • difficulty making movements
  • difficulty straightening or relaxing the muscles
  • muscle tightness or pain
  • uncontrollable spasms (usually in the legs)
  • exaggerated jerk responses.

Spasticity makes your body use a lot of energy, which can lead to fatigue and potential pain or tightness in and around the joints and lower back.

Types of muscle spasticity and spasms

The two types of MS-related spasms are flexor spasticity and extensor spasticity.

  • Involuntary bending of the hips and knees (towards the chest).
  • Mainly involves the hamstring muscles on the back of the upper leg.
  • Involuntary leg straightening.
  • Usually involves the upper-leg muscles (quadriceps) and the inner thigh muscles (adductors).
  • The hips and knees will stay straight with the legs close together or crossed over at the ankles.

It’s possible to experience spasticity in the arms, but it’s less common in people with MS.

Ways to treat and manage MS spasticity

If you’re experiencing spasticity or spasms for the first time or symptoms are getting worse, speak to your MS nurse, GP or neurologist as soon as possible. This is particularly important if you’re:

  • in pain
  • having issues sitting, standing or lying down comfortably
  • having difficulty walking or moving from one spot to another
  • experiencing emotional distress or difficulty sleeping
  • having difficulty with day-to-day activities or personal care.

The sooner you seek help, the better placed you will be to manage your symptoms and reduce the chance of them getting any worse.

Movement and stretching

Regular movement and stretching can keep your muscles, ligaments and joints as flexible as possible. You can do this through stretching, yoga, Pilates or other physical activity, or passive movements assisted by a physical therapist.

A physiotherapist can teach you how to stretch, maintain flexibility and move and position your body to prevent muscle tightening or stiffness.

It’s also important to have good posture when standing, sitting and lying down.

Manage triggers

There are certain triggers that may set off spasticity symptoms. While they can be different for everyone, they may include:

  • health conditions, such as infections
  • other MS symptoms, such as bowel or bladder problems and pain
  • tight-fitting clothes
  • being too hot or cold
  • anxiety and stress
  • fatigue
  • moving too quickly
  • medication
  • overexerting yourself.

Seek support

Allied health professionals, such as an exercise physiologist or a physiotherapist, can help with a range of positioning, stretching and relaxing techniques.

You can also discuss medication and other treatment options with your MS nurse, GP or neurologist.

Emotional support can also go a long way. With our Peer Support program, you can connect with other people living with MS and their families through a range of face-to-face groups and online forums.

This page has been reviewed and approved by Executive Manager Client Engagement and Wellbeing Jodi Haartsen. Jodi is a registered MS Nurse who has helped thousands of patients over her 20 years’ experience at Eastern Health MS service in Australia, in several roles including nurse educator, research nurse and nurse practitioner. Jodi is the 2022 winner of the global MS Brain Health Leader Award in the Independent Healthcare Professionals category.

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