Symptom Management 16 msfocusmagazine.org It is estimated that 80 percent of persons withmultiplesclerosisexperiencethesymptom called spasticity. A recent study indicates that about one million people in the United States have MS; therefore, about 800,000 thousand people with MS live with some degree of spasticity. Spasticity is a hallmark of neurologic diseases that affect the central nervous system. Spasticity involves stiffness and/or muscle spasms, which are sustained muscle contractions or sudden jerky movements. It can range from a mild feeling of tightness in your muscles to severe, painful, uncontrolled spasms or muscles cramps. It may cause feelings of pain and tightness around your joints and back. And it can be aggravated by external stimuli, such as sudden movements, temperature changes, position changes, tight clothing, or infections. Without treatment, spasticity can cause: • Pressure sores – open wounds that form because of friction • Pain and fatigue – your spastic muscle is working continuously without any rest • Sleep disturbance – restless leg syndrome may be a disturbing feature • Joint contracture – causing joint deformities and difficulties with positioning and pain • Ambulation difficulties – if the muscles in back of the legs [hamstrings] and the muscles of the upper thighs are affected, then the knees and hips are bent and may not be able to straighten). If the quadriceps and the muscles in front and inside the upper legs are in spasms, the hips and knees stay straight with the legs closed or crossed over. • Additional difficulties with positioning, mobilizing a wheelchair, and transferring to and from beds, toilets, and cars. Cause of Spasticity Gamma-aminobutyric acid (GABC) is a neurotransmitter in your nervous system. Impulses to and fromyour nervous system are chemically transmitted by GABA. An absence ordeficiencyofitallowscontractionsorspasms, because your nervous system isn’t able to send out a message for your muscles to relax. Treatment After evaluation, a physician will typically recommend physical and occupational therapy to attempt to relax and stretch the muscles. These can frequently help to relieve spasms and reduce pain. However, you must be careful not to overwork the muscles and cause fatigue. Occasionally splinting and bracing may be beneficial. Oral medication may be recommended as well. The most common are baclofen, tizanidine, diazepam, and dantrolene. These can have various side effects, ranging from Treatment and Management of Spasticity in MS by Claude Oster, D.O., P.L.