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Spasticity in MS

Multiple Sclerosis (MS) [+info]

Multiple Sclerosis (MS) is one of the most common diseases of the central nervous system (brain and spinal cord). MS is an inflammatory demyelinating condition. Myelin is a fatty material that insulates nerves, acting like the covering of an electrical wire. It allows the nerve to transmit its impulses rapidly, for smooth, co-ordinated movements. In MS, the loss of myelin interferes with messages between the brain and other parts of the body. This produces the various symptoms of MS.

The sites where myelin is lost (plaques or lesions) appear as hardened areas or scars. In MS, these scars appear at different times and in different areas of the brain and spinal cord. The term ‘multiple sclerosis' means, literally, ‘many scars'.

For most persons, the condition involves an unpredictable, life long progression of complex symptoms.

Facts about MS

  • In the European Union, over 400,000 people have Multiple Sclerosis (MS).
  • MS affects people in the prime of life, when families and careers are developing.
  • It is the most common cause of disability affecting young adults. People are usually diagnosed between the ages of 20 and 40.
  • MS is more common in women than men, with a ratio 3 to 2. 
  • MS is the result of damage to the brain and spinal cord. This interferes with messages between the brain and other parts of the body.
  • The most common form of MS is one where symptoms come and go. For some people, MS means gradually increasing disability.
  • Common MS symptoms include: blurred vision, extreme fatigue, pain, numbness in legs and hands, loss of movement and speech problems. 
  • Following diagnosis, many people with MS lose contact with health and social services for years.
  • Increasing disability, compounded by lack of expertise in MS among professionals can mean that basic health problems such as depression, cognitive impairments, continence issues and sexual health all go unnoticed.
  • Palliative care skills are not always available to people whose MS is advanced and have complex physical and psychological needs.
  • Despite all research efforts, MS is not curable so far. Therefore, much more research on the causes and potential cure of MS is vital.
  • People with MS typically are keen to remain in employment for as long as possible, but have a progressive, degenerative, or fluctuating condition which means that they need to reduce/ adapt their hours and/or adapt their working environment to accommodate changing needs.
  • It is vital, particularly if they are faced with increasing disability, that they can access co-ordinated care from all the professionals within a multi-disciplinary team, skilled and expert in MS.

There are very significant countrywide and regionwide discrepancies in the provision and quality of services and support for people affected by MS across the European Union. However, there is growing recognition that people affected by MS have a great deal to offer through their own experience and knowledge of their disease, to professionals working with them.

MS in Europe [+info]

Ms is more common than you think

MS affects more than 600,000 in Europe

  •   > 100,000
  •   50,000 - 100,000
  •   < 50,000

Acording to the Organitzation for Economic Co-operation and Development (www.oecd.org)

Symptoms of MS [+info]

  •  

    74%

    Visual problems
  •  

    68%

    Abnormal speech
  •  

    96%

    Fatigue
  •  

    82%

    Spasticity
  •  

    92%

    Balance and coordination problems
  •  

    81%

    Muscle pain
  •  

    88%

    Altered sensations such astingling and "pins and needles"
 

What is Spasticity? [+info]

The muscles of the body maintain what is called 'normal muscle tone', a level of muscle tension that allows us to hold ourselves up. When the tension in these muscles increases they become rigid and are said to be ‘spastic'. When muscles become spastic, their range of motion decreases and movement of these muscles can be painful.

Spasticity is one of the most common symptoms of MS. It is defined as muscle stiffness that is frequently generalised and more or less continuous. Often, there are periods of worsening, in the form of involuntary muscle spasms, while muscle function is progressively lost.

Spasticity is one of the main reasons for disability in MS. This is because it tends to be associated with pain (continuous or due to spasms), changes in bladder function and in sleep, the inability to walk and perform other movements, including those required for personal hygiene.

Spasms are involuntary muscular movements in the limbs and torso. There are three kinds of spasms:

  • Flexors: make the limbs bend at the joints.
  • Extensors: make the limbs extend themselves.
  • Adductors: make the limbs close tightly to the body's midline (arms pulled toward trunk, the legs close together, etc).

More Information on Spasticity

Games that help carers and families gain a better understanding.

Consequences of Spasticity for MS Patients [+info]

  •  

    66%

    Muscle pain
  •  

    70%

    Pass water several times in the night
  •  

    70%

    Difficculty walking
  •  

    40%

    Restricted movements
  •  

    51%

    Poor sleep
  •  

    17%

    Require further help with washing and dressing

People suffering from spasticity associated with MS may present with a variety of symptoms, including:

  • Hypertonicity (increased muscle tone), which can lead to muscle stiffness, rigid joints and bladder dysfunction.
  • Spontaneous muscle activity, in the form of uncontrollable muscle spasms either isolated or as a series of rapid muscle contractions (called 'clonus').
  • Exaggerated tendon reflexes.
 

These are associated with:

  • Pain that can range from slight (tense muscles) to severe (painful spasms in the limbs).
  • Nocturnal awakening, due to pain and/or bladder dysfunction.
  • Deterioration of muscle function that may affect walking and all other types of movement and speech.
 

These symptoms of spasticity can result in functional disabilities, including changes in posture caused by an increase in muscle tone (muscle tension or activity state). Muscles must normally sustain an adequate level of muscle tone in order to keep the body upright and allow for movement, while at the same time permitting flexibility and speed during movement. Spasticity is the result of increased muscle tone, which results in a loss of muscle response. These effects can notably increase fatigue and make performing daily activities challenging.

 

Fatigue [+ info]

 

Fatigue is a common symptom that seriously impacts the lives of people with MS. It can aggravate other MS symptoms, like visual disturbances, difficulty concentrating and memory loss, hindering the ability to carry out daily activities. Fatigue can also negatively affect activities that are important to the patient, as well as affect those of their family members, friends and social circle.

More Information on Fatigue.

 

Sexual Dysfunction [+ info]

 

Sexual dysfunction (sexual problems) is a disorder that is frequently associated with MS for a number of reasons. The emotional burden of MS can be so great that the patient may not feel any desire. The pain and fatigue can also make sexual activity a problem. Frequently, both factors are involved. Some patients worry that sexual activity will require too great of an effort, that their MS will worsen or that they will suffer a new disease episode. This concern is completely unfounded.

More Information on Sexual Dysfunction.

 

Pain [+ info]

 

Approximately 86% of MS patients are affected by pain at any given time, with varying intensities. It is correlated with age, duration of the disease, degree of disability, fatigue and depression. Neuropathic (or neurogenic) pain is the result of the progressive loss of the myelin sheath. Muscle pain is the result of musculoskeletal changes – including rigidity and spasms – that are caused by the disease. The cause of headaches in MS patients is not clearly understood, although an association does exist with changes in brain function circuits and damage caused by the disease. In addition, the risk of having headaches seems to increase in patients with more damage.

More Information on Pain.

 

If you need any support or guidance, you can turn to your MS centre or local patients association:

Other useful resources