Spasticity – Muscle Tone, Stiffness, Tightness,


What is Spacticity? Spasticity is the feeling of tight muscles, usually in the legs but it can affect 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 (MS). Flexor; involves the hamstrings in the upper legs and the hip flexors (muscles at the top of the upper thigh). Extensor; involves the quadriceps and adductors (muscle on the front and inside of upper leg).
 Spasticity can cause painful spasms, lower back pain and joint pain. It can also affect your gate (the form of how you walk) because if your legs are stiff and rigid then you probably will not be able to take a simple step the way you are supposed to be able to. When muscles are spastic, everything obviously can feel rigid or mechanical and some people may not be able to even bend their limbs at all! Imagine waking up and feeling like you could only move as much as a wooden sketch mannequin; that is kind of what spasticity feels like to me. Most people with MS who complain about spasticity (in their legs) say it feels like they are “walking on stilts” and I would have to agree.

 

Spasticity affects upwards of 80% of MS patients in some way shape or form. It is a very common symptom in MS but affects everyone differently in regards to severity. (National Multiple Sclerosis Society)

How to Treat Spasticity:
Baclofen (Oral) – Baclofen is probably the most common treatment, a sort of muscle relaxer that targets nerves in the spinal cord. This medication can make you pretty drowsy though and is taken 3 times a day so I would say (when first taking this) to try to pay attention to your fatigue levels because it might just be this little pill.

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 obviously for more extreme cases of spasticity.
Tizanadine (Zanaflex) – another prescription 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 dry mouth!
Diazepam (Valium) – This drug has a strong sedation effect; most people use it primarily to sleep which is why it’s typically prescribed to help when spasticity is interfering with your ability to fall or stay sleep. Valium is also used for anxiety and to help prevent seizures. This medication can be addictive/habit forming.
Dantrolene (Dantrium) – This is another muscle relaxer that is usually only used when other drugs have not worked.
Botox – Also for extreme cases of spasticity, Botox injections can help relieve spasticity for around 3 months; Botox is typically administered in a medical facility.
Other – Exercise and stretching, massage, acupuncture, supplements (such as Magnesium) or Cannabis are all said to help. (I have found that exercise/stretching works best)

My Experience With Spasticity
Spasticity was never an issue for me until my major relapse at the beginning of 2012 that affected my spinal cord but now I live with a bit of it every day. 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 in the hospital and still not being able to bend it at all. I had never been in that kind of pain in my life, it made 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. After a while (and some rehab) I was finally able to bend my leg 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 not really) lock up rendering me unable to walk. This is one of the many reasons I try to just avoid confrontation and other stressful events.

46 thoughts on “Spasticity – Muscle Tone, Stiffness, Tightness,

  • May 18, 2013 at 3:42 pm
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    Hi, I stumbled across your blog a few days ago, have been reading a little, but when I read this, I'm sorry to say, but I was glad to know that someone feels like I do. My neuro told me she didn't have any other patient like me,with such severe leg pain. I have been in a wheelchair on awful days, a cane on okay days, and with nothing on good days. I started Tysabri 2 months ago, and it has helped with the pain. I still have to take pain medication to be able to walk unassisted, but I can tell its better because I can go longer between each dose. I have been to so many doctors for help, on some days I would have okay'd it for them to be amputated. Anyway, I'm glad it's helping you also, I'm keeping my fingers crossed.

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  • May 18, 2013 at 6:13 pm
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    Hi! Haha I understand, its weird because its a common symptom with MS…. Maybe mot so bad with everyone but lots of people deal with it in some way shape or form. Glad Tysabri is working for you. Give it a couple more months, maybe it will kick in a bit more?

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  • June 7, 2013 at 4:57 pm
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    Matt – have you ever had this type of pain in your arm. I am not diagnosed yet, but, it's looking that way. My arm has been on this weird path over the last 2 weeks. It started with tingles and stabbing pain. It was the prickly stuff with slight ache pain. That left for a week and came back stronger. The pain felt like I had an electric current running through my arm. The current is now faint and my arm has been sore and week for a week straight. Any of this sound familiar. If I don't MS, I will be so lonely trying to figure out what is happening to me. I am so exhausted from analyzing my symptoms and trying to figure out if this stuff is in my head. I need prayer.

    Kobe

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  • June 24, 2013 at 8:00 pm
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    So good (yet sad) to hear others with similar problems. My doctor put me on Baclofen for my thighs a few years ago, looks at me weird when I describe my paresthesias and ms hug. He sent me to a neuro but he would not discuss ms with me. I also have seizure clusters, another not very common problem. Never know when I will collapse at Walmart, or drop to my knees when feet feel stung by 10,000 bees. I wish doctors were more open minded, are they upset we look on web for info? What are we supposed to do when they 'don't understand or believe us'?? Glad to see your blogs, I was beginning to think it was 'in my head'.

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  • June 25, 2013 at 11:43 pm
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    Yeah, I have come to the conclusion that the doctors who get all offended when you look stuff up online are just insecure with their education and simply feel they should be THE ONLY smart person in the room because they paid for school yet they still can't accept that no one has all the answers, including THEM…. It IS sad to see others with our problems but its nice to know we are not alone….

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    • September 6, 2014 at 5:45 pm
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      So true Matt, that's exactly why I go to a Naturopath, a great one! I'm on Micro dose therapy and don't bother with those ignorant bafoon conventional "drs".

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  • March 3, 2014 at 2:06 pm
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    Hi Matt.. I have spasticity to and I would like to say thank you for sharing your story with the world, really help to know how other people dialing with the same symptoms. Good luck.. ;))) Sonia

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  • April 8, 2014 at 3:12 am
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    Hi matt, great blog =).
    I am not yet dx'd yet with MS. But my neuro said she is def' leaning toward it, so I'm a possible MS. Have lesions on brain scan in all the right places and in numerous amounts etcetc.. am doing the waiting game at the moment as many have donebefore getting their dx. I did not have spasticity in my legs, but did and have in my arms which comes and goes with short exertion, was one of the main symptoms I went to the doc for. There are pages I have researched that explain MS patients spasticity is not limited to the legs.
    I do have pain in my legs though that is around the top back of my thigh near groin area that goes around to the hip and down the back of my knee, calf and ankle. Originally it was both hips and lower back, soo much so that i could only walk to the letterbox nback before having to just stop walking altogether..and stairs..pfft forget that,was excruciating. Now its just the leg, hip and back of knee pain sometimes in both but mainly left side. I do have problems mainly on left side of my body.
    just thought Id add about the arms
    like I said,great blog mate.
    be well
    Lee

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  • April 11, 2014 at 6:50 pm
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    Hi, yes, I thought I mentioned but maybe not, legs are common, arms second most common and technically** you can have spacticity in ANY muscle as it's just an increase in tone. Did they give you Baclofen?

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    • April 24, 2014 at 9:13 pm
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      Matt, hi, no they haven't given me anything as yet, My GB gave me a script for muscle relaxants (mild ones) but because we can't get through to my neuro atm he doesn't want me to get the meds because he wants her approval first, my arms seem to be more affected expecially at work, and even just typing this out, they tense up and then get pretty painful. I am still waiting on my neuro, kind of frustrating but being it's the easter break both my GP and I think she has gone on a break for the duration of easter. We can only get into contact with her secretary who keeps saying she'll send my neuro an email. I'm beginning to feel like I'm being a pain to her because I am often ringing her office for that illusive appointment, my partner says don't be silly, you need answers, but I'm not one to hassle anyone and feel like I am hassling her maybe. It's just with work and all, I need some kind of answers so I can inform them if I need any more time off for more tests etc, and I cannot give this to them *sigh* plus I would like some relief to the tightness in my arms. I guess I should just be patient.
      I just wish if she is too busy to see me that she could pass me onto a neuro who can see me, but I can't even contact her to get my MRI results off her to bring to another neuro. Is doing my head in.
      Lee

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      • April 19, 2017 at 12:23 am
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        I don’t have MS but did have a Stroke so I am dealing with spasticity in my left arm On Baclofen which is not helping at all by the way. Dr. suggests the Baclofen pump which after researching it I have decided I don’t want to do it. I do want to reply to Lee Lee by saying that you should never worry about being a pain in the neck when it comes to Drs. I have found it’s necessary to be my own advocate. And I will continue to call as many times as it takes until the Dr either calls me back or his/her staff helps me. You should remember that the Dr. works for you not the other way around. And if it is a continuing problem I would certainly take my business elsewhere and find a newPrimary Dr. or Neurologist.

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  • April 14, 2014 at 6:17 am
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    Thx for posting. I am frustrated bc my dr claims they don't typically see this symptom in ms patients. Yet it appears common when I research. My legs were the first- super rigid, tight, heavy, hard. Then my arms about a year ago. Tried diazepam, baclofen, tizanidine but developed tolerance for all. Now doing Botox but limited by every 3 mo rule. Severely impacting work/school responsibilities. I get massages but cannot afford too often. I do water aerobics (can't do land anymore due to spasticity). Any other thoughts or suggestions? Trying to go the natural route and eat foods whose properties are known to reduce cramping???

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    • August 18, 2014 at 5:44 pm
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      Are you still having same problems? I am myself and most of those meds I've built tolerance to. Magnesium helps with cramping and epsolm salt baths do as well. Ive been asking my doc abt botox as well but haven't gotten too far, does Tht work for you? Do you have any suggestions?

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    • August 24, 2014 at 1:32 pm
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      I would say I have a pretty good tolerance to Baclofen. Magnesium never helped me at all, epsom salt didn't either. I would fill the bath only enough to cover my legs and pour the entire box of salts in the water; NOTHING. I never had it bad enough to warrant Botox; it's really only meant for people who LITERALLY can not bend or straighten their legs otherwise you won't be able to stand on your hello like limbs haha.

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  • April 14, 2014 at 4:34 pm
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    … … … Is your doctor joking? Spasticity is one of the most common symptoms of MS. Most people don't present with it but develop it somewhere down the line…. Wow… Sucks that you have built a tolerance to most those meds, but since your already doing botox I have no idea what to recomend…. They say Marijuana really helps spasticity but not everyone is for that.

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  • April 25, 2014 at 1:30 am
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    Matt, Hi mate,
    no I am not taking anything at the moment, My GP has given me a script for a muscle relaxant, but doesn't wish me to get it yet untill we speak with my neuro just to be sure, problem is we still can't get into contact with her, only her staff who keep saying they'll send her an email. Is the Easter break so we figure she may be off over the duration, fingers crossed I'll hear something by next week. She may not wish me to take anything till she has all the facts I guess.
    Lee
    P.s sorry if I posted a reply twice, I keep forgetting the comment as bit and when I click publish I am not sure if it goes through. so oops if I have =)

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  • April 25, 2014 at 8:36 pm
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    Well, if it IS spasticity from any neurologic cause, muscle relaxers will not work, it has to be something that will work on your nerves. HOPEFULLY it is NOT MS related though haha!

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  • April 26, 2014 at 10:47 pm
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    My regular GP Matt, is not an MS specialist, I guess he is trying to treat the symptom and not the cause, he has told me not to collect the script unless my neuro agrees with it, but we just have not heard from her as yet.

    A Question: Do you have days that seem to be totally normal with no, or very mild symptoms? I suppose I should ask "did" you instead of do you, meaning before you were diagnosed?
    Today I am not feeling too bad, have a slight stiffness in my calf muscle and a little black dot in my vision (new) but otherwise I feel fine.
    It makes me wonder if everything is just going away.

    Lee

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  • April 26, 2014 at 11:09 pm
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    Oh that makes sense, and yes, that is how relapsing remitting MS is before you sustain more permnanet nerve damage which on the outside shows as symptoms that don't seem to go away, the lesion doesn't heal.

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  • May 25, 2014 at 9:11 pm
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    Question please. I have been having very tight legs. Started with curled toes from "Morton Neruroma" right leg but still tight now but mostly one leg. Have been on muscle relaxers for 2-3 day. Not helping does this mean neuro and MS? Thanks

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  • May 31, 2014 at 2:33 pm
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    Well have you been diagnosed with MS? If so it's neuro and muscle relaxers will not help, you would need something like Baclofen. If you have not been diagnosed with MS than you might just need a different or stronger medication?

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  • August 18, 2014 at 5:24 pm
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    How long did it take for ur tone to release or calm down? I've found that going to my chiropractor works pretty good to loosen the muscles but all is temporary. Its a new thing for me to deal with. Its horrible!

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    • August 24, 2014 at 1:28 pm
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      Probably about a year before I stopped "feeling" it. My last neurologist would say he could still feel it when he tested me but I am so used to it I really don't feel it. I don't feel like it effects my life at all. BUT, if I get stressed? My legs tighten up like wet leather on a hot summer day! Baclofen does pretty much NOTHING for me no matter how much I take. For me, it's all about calming down, relaxing, clearing my head; all of which is way easier said than done as I am not one for meditation haha. Stretching helps most days.

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      • September 25, 2016 at 8:10 am
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        Hi Matt, why do you think stress brings on the tension/tightness in your legs? I’m curious because I have the same issue. When I start to get really stressed out my legs get crazy tight. If I calm down then the legs calm down. Any ideas?
        Thanks,
        Sara

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        • September 30, 2016 at 6:39 pm
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          Stress is just one of the main triggers of symptoms in MS, like the heat. I think stress causes inflammation so that is really it; stress can make any symptom worse but for me it mostly affects my spasticity.

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  • November 5, 2015 at 1:51 pm
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    Hi Matt, I have been having horrible pain in both legs, spasticity worse after walking and I get tired easy, at first the doctors thought it was spinal stenosis or disc issues, lumbar spine was ok. I am worried they won't find a cause and that bothers me because I need to know so I can heal it. I am waiting to see a neurologist and a further MRI. I had EMG it was negative. I want to thank you for sharing your story. I am starting to practice yoga something I love to do, it's been hard because my legs were very tight. I Cannot work at the moment because I am a nurse who works 12 hour shifts on a busy children's cancer ward, I often wonder about repressed stress and MS connection. Any way I would like to stay in touch. Love to you June

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    • November 5, 2015 at 2:53 pm
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      Sounds to me like seeing a neurologist will bring you the answers you want, best of luck!

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  • November 5, 2015 at 2:00 pm
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    Hi Matt, I have Spasticity too! Not yet diagnosed. Mine is worse after walking, I also cannot bend my left knee and I have burning pain in right leg. I had. EMG it did not show nerve entrapment. They found my reflexes were strong. I am waiting to see a neurologist. They also requested a MRI. I am off work I have a stressful job a nurse in children's cancer and ran around doing 12 hour shifts with little breaks. Do you think there is a connection between stress and developing MS? Anyway I pray for answers. I am also a yoga teacher and cannot practice fully now, have to modify but it does help my mind. Take care and keep in touch.

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    • November 5, 2015 at 2:55 pm
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      stress will not cause MS, it will EXACERBATE it though, stress is a huge trigger for me,

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  • November 29, 2015 at 11:42 am
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    My girlfriend's MS has her unable to walk. She could stand, but her thing is that her legs cannot bend due to her spinal injury caused by MS. I'm trying all I can, but it does not feel like enough.

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    • November 29, 2015 at 3:59 pm
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      If it is that bad look into botox injections, it's used for severe cases of spasticity.

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  • May 24, 2016 at 11:10 pm
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    Hi Matt,
    Well, still not diagnosed..has been a very long rod for me, and now this new, well a few new symptoms have arisen, have been having problems with numb corner of the mouth and what my neuro describes as trigeminal nerve problem, and now for the last week (give or take) a tightness in my buttock down to my foot on the left side, both front and back of thigh and calf tightness like a band around them, and more often than not foot, calf and thigh cramping. Like thismorning, and a few other mornings and nights (including occasional times during my work hours) I would straighten my leg out in bed, or curl up into my normal sleeping position, and my calf or foot would go into a strong cramp. All stiff and kinda painful but not always painful. I am having another mri on my brain on the 1st of june (2016) base of skull and brain, but this was ordered when I had the trigeminal thingy. The cramping is new since I saw my neuro, and I prolly wont see her till the results of my mri is ready. It makes me wonder, do I haveto end up in hospital with a bad attack like others have had before finally getting a diagnosis sigh. All my symptoms fit M.S, they have ruled out other culprits, but think small veins in my brain are causing it (even though my neuro still thinks possible m.s) my symptoms do not fit vasculitis (namely I dont have the constant headaches) so I am at a loss. I also think the limbo doesn't help things. This leg cramping and stiffness is quite annoying indeed.
    LeeLee

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    • May 24, 2016 at 11:39 pm
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      Has your neuro prescribed anything for it? Even without a diagnosis you should still be able to get something to relieve the pain (cramping)….

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  • May 26, 2016 at 9:59 pm
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    Hi Matt,
    No not yet, I will be seeing my GP before my neuro, wont see my neuro till after my MRI on the 1st June (public health system is slow), so she sees me when she can, and usually it's after symptoms have settled down, which is frustrating. I don't wish for symptoms but wish sometimes they'd hang around long enough for her to notice. The cramping though has gone on for a week, has gotten a little better but still off n on during the day. Still only my left leg. And strangely on the side of my left flank under my ribs also off and on. My GP though, when I get new symptoms will usually refer me to my neuro, so I may see her sooner. I ride a scooter to work, and need my leg to hold me up, not sure if taking any muscle relaxant would be good for that. Riding does cause a little cramping but is so far not made it dangerous. Is just weird that it is only my left leg and not my right also. My partner says I'm a wreck, one thing after the other, have given up explaining everything to him, he is supportive, but you know what it is like when you feel people just can't understand, especially when you have no name for the reason your body is going haywire…sigh. at work I am sure they just think I am faking things grrr. Anyways, hoping to see my GP monday and get a referral for my neuro then.
    Lee

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  • October 18, 2016 at 11:59 am
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    Hi Matt,
    I have spasticity in both of my legs and it seems connected to my lower back. My lower back and legs are very stiff and I’m wondering if you had the same as in extensor spasticty, where in you’ll get super extended lower extremities with foot drop. If you had the same case as I do, what excersises can you recommend to make my situation corrected or aleast make it less difficult?
    Thanks!
    – Jeff

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    • October 20, 2016 at 5:55 pm
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      I can’t recommend much, I used an AFO for a while for the foot drop, was on Baclofen for a while too which I think helped for a while and then I just did a lot of stretching and other random exercises in physical therapy until it became manageable. Now I would say without a shadow of a doubt that stretching is what help, mainly hamstring stretching, like touching your toes, Baclofen does not help anymore. I hate stretching but it does feel better afterwords

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  • December 4, 2016 at 2:17 pm
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    Dear Matt,
    I have terrible spasticity in my right leg. The pain in my shin is excruciating. My hamstrings art tight as well as my leg gets stuck when the knees bends on its own. It is very hard to push straight and extremely painful. My Dr wants to try the Botox, but I can’t get it for months. I don’t understand why I have to wait so long. I cry every am when I wake up though I can only sleep 2-3 hrs at a time due to the pain. I’m desperate. Any suggestions would be most appreciated. Thanks

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    • December 14, 2016 at 7:06 pm
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      If your doctor wants to try Botox I imagine you have already tried things like Baclofen, Zanaflex and Valium? I imagine they would not do much (if anything) if you are at the point where you need Botox…

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  • February 16, 2017 at 10:34 am
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    My leg bends and I can’t get it straight.my leg is very painful all the time ,like broken bone . It is not siotica I have that in my other leg.
    What such pan in hip thigh calf ankle and the pain is unbearable

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    • November 2, 2017 at 7:39 am
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      Oh yes, I am sitting on the computer Matt but I know if I sit Oh Joyce sounds the same as me. I find that if it is locked the best thing to do is to start wiggling your toes up and down slowly. Then move on (if you are seated on side of bed) by pushing your heel down several times. Dont force it. I push the back of my legs into the bed. I then rub the outside part of my thigh called the ITB. It will be very painful at first. I then rub the top of my hip above the painful bit. Eventually….damn after several minutes I will be able to straighten it out. I stretch it and then get up. Good luck I am sure there are heaps of people that use different techniques. Also find Deep Heat takes the edge off a little.

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  • November 2, 2017 at 7:30 am
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    Oh yes, I am sitting on the computer Matt but I know if I sit down even for 20 mins it is going to be difficult. I have the bent knee one after a total hip replacement over a year and a half ago. Sucks! Feels like my leg will break if I get up to quickly. Cant tolerate the Baclofen so on Diazepam and will see about botox when I see the neuro next

    Reply

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