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Person Sitting Doing MS PT Physical Therapy for Spasticity

How Physical Therapy is Treating My Spasticity and Pain

I suffer from leg spasticity. The quads (front of my thighs) can get rock hard and hurt like the dickens, and the hamstrings (back of my thighs) are usually drawn tight as catgut on a fingerboard, making it inevitable that I’ll get a cramp from climbing steep stairs or stepping over the side of the tub to take a shower. This happens despite taking 120 mg of baclofen every day. But a muscle relaxer is not enough.

Using heat and massage to manage the pain

I used to apply a heating pad to release the muscles and relieve the pain, but heat has become an even worse enemy this year, making me swell, redden, and sweat in a 70 degree room. Twice a month, my boyfriend works my upper legs with his big, strong hands, kneading the muscles until they soften and the pain disappears. Spasticity hits me in the rib cage, too, in my arms all the way down to the tips of my fingers, and around my waist. I have empathy for women who were so tightly corseted during Victorian times that some of them broke ribs getting laced up. Torso spasticity can feel bone-splitting at its worst.

Adding in other types of pain

Even though heat and massage temporarily help all of these things, that isn’t the only kind of trouble that follows me through each day. Add the pain of lumbar stenosis and sciatica.

Lumbar stenosis and sciatica

The pain of lumbar stenosis appears after I’ve been on my feet for three minutes or more and can only be relieved by sitting. Arthritic facet joints narrow the spinal canal and press on the nerve. This can also irritate the sciatic nerve, sending waves of pain from the glute all the way down the leg. It often wakes me at night when I’m sleeping on my side. Changing position and bending my knees more quickly eases the pain. But more is needed to manage these types of lower back pain.

Trying physical therapy

I asked my neurologist for a physical therapy order several months ago before embarking on a three-week course of prednisone for worsening MS symptoms, meaning to delay PT until after I was done with the steroid. After tapering down prednisone, which had given me complete relief from all my symptoms in its higher doses, the back pain, spasticity and fatigue returned and I was soon back to square one. I didn’t hold out much hope for improvement with physical therapy, but I committed myself to a three-day-a-week, four-week long program anyway. I’m so glad I did!

Techniques used in physical therapy

Now finishing my second week, the therapist is using a number of effective techniques. First, electrodes are glued to my back and a stim unit sends waves of electrical current to my mid-back down to the top of my glute on the left side. It feels creepy good now that I’m getting accustomed to it. After that, my left side gets massaged. My therapist sometimes uses his elbow on the worst places until I yelp: Hey, ease up! I wish it could be a full-body massage, but this is great, too. I can feel it loosening my tight muscles.

Exercises at home

After massage, the therapist stretches my hamstrings and piriformis muscles. I have homework to do, too: three exercises done on my bed that bring the knee up to my chest, tightens my core muscles, and pulls one bent leg across the opposite thigh to stretch the piriformis. And there is no end to the tips my PT has given me and the exercise tools I can use.

Comparison shopping to save money

I buy everything on Amazon and have so far purchased a Lacrosse ball, a peanut (two Lacrosse balls stuck together), and a pool noodle with a 3.5-inch diameter. My PT has taught me how to use these for self-massage and I am eager to try them when they arrive next week. The pool noodle is 55 inches long and will have to be cut into a 12-inch section. It was cheaper to buy a long pool noodle than a foam roller, which comes in shorter lengths but is not as small in diameter. This kind of comparison shopping is time-consuming but will save money in the long run.

Working towards symptom relief

Although my stenosis pain isn’t much better, my PT and neurologist said it can take a while to see real improvement. I feel stronger for having started the home exercises and want them to work. The alternative is cortisone injections and surgery, but the literature says this kind of surgery doesn’t have a high success rate. As for the stretches for spasticity, I know these have to be done every day, twice a day for the rest of my life. I’m up for it.

I highly recommend PT if you are thinking about adding it to your wheelhouse in that never-ending search for symptom relief. Good luck to us all.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The MultipleSclerosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • asapcynthia
    7 months ago

    Your symptoms, except for the arm spasticity, mirror mine. With the stenosis and all the other stuff too. Pt has helped me more than anything, but’s getting hard now. I can’t do anything that requires being on the floor because it’s too hard to get up off the floor. I am looking into chair yoga, but looking is as far as I’ve gotten. If it applies, see my article on pelvic floor spasticity. Good luck

  • lfitch1
    7 months ago

    I just can’t understand the hype and conclusion that PT or exercise is a help for pain and fatigue.
    Not to minimize success stories here, but I recently had to go to PT for extreme pain in my shoulder, the Dr. gave me a cortisone shot and sent me to PT. It not only aggravated my already inflamed shoulder but robbed me of most of my energy for the whole day and the day after!
    What am I missing?

  • Kim Dolce moderator author
    7 months ago

    lfitch1, I’m so sorry that you’re still hurting after the shot and PT. I’m sure you’ve already followed up with your doctor about those issues. I don’t know your history or why your shoulder is hurting, I can only suggest you follow up with your doctor.

    I can relate to the worsened fatigue on exercise days and the next day, that is so typical of MS. I just give in to it and nap on those days–but over time the trouble area ought to improve. It can take time for PT to work. If it didn’t for you then your doc should reassess your treatment plan. You shouldn’t have to live with the pain.

    Some people don’t respond well to cortisone shots. Again, this is something to discuss with your doctor.

    I’ve also found that massage can do a world of good where other treatments have failed. I hope you can find some relief. Please don’t give up.

    –Kim

  • Alina Ahsan moderator
    7 months ago

    Hi @x468ah, I’m sorry for the trouble with printing! We’re aware of this issue on the site. If you could email us at contact@multiplesclerosis.net, I would be happy to email you a PDF printable version of this article, and any others that you would like!
    -Alina, MultipleSclerosis.net Team Member

  • Hel46ene
    7 months ago

    Shelly Comito:
    I don’t see an option for print this page. I just did control P.

  • kleiney
    7 months ago

    “The alternative is cortisone injections and surgery, but the literature says this kind of surgery doesn’t have a high success rate. ”

    What surgery are you referring to?

  • stumblingbumbling
    7 months ago

    I’ve gone to pt twice and have had great results. bottom line is stretching and stretching some more. It was nice to read of remedies for the pain and crippling effect spasticity can have. Pt works but, it can be a long time until you can get in to see a therapist.

  • Hel46ene
    7 months ago

    I would like to print these articles. But they do not let you print them correctly. Help

  • Shelby Comito moderator
    7 months ago

    Hi @x468ah, thanks for reaching out! I’d love to see if I can help you get these printed. When you go to print this page, do you see the option to save as a pdf file instead? I find that sometimes when I save something from the internet as a pdf to my desktop first and then print the pdf file, it comes out better that way.

    Let me know if that works. If not, we can move to email correspondence and try some different options. Keep me posted! Best, Shelby, MultipleSclerosis.net Team Member

  • Kim Dolce moderator author
    7 months ago

    Hel46ene, I’ve asked my site leads for assistance with your printing problem. Will get back with you as soon as possible. Sorry you’re having trouble! –Kim

  • Irina
    7 months ago

    Electrodes and stomach should not be used if you have spinal lesions.

  • drwithms
    7 months ago

    I’m an MD w MS and have very relevant comments! I too have terrible spasticity but usually during the night. Baclofen controls things during the day but nights are terrible even on 40 mg. I have taken an occasional Valium when things got bad in the evening and then my doctor put me on nightly Valium for the spasticity which put me into a terrible funk. I came out of it after three days of stopping the Valium. I added full spectrum CBD oil before bed and have not had a single twinge of spasticity during the night for the past few nights. What a relief…Jumping up during the night and walking on my spastic cramped leg to stop it is not easy!I’m taking about 6 mg 2-3 times a day.

    Regarding Lumbar spinal stenosis… Mine continued to progress over the past 10 years and was managed with physical therapy and epidurals quite well. Until my MS got bad and I became very inactive…Worst mistake ever! My sciatica was so bad I could not stand for more than a minute without debilitating pain and had to use a scooter To walkIget around. I went to 8 spine surgeons (I am a surgeon so this is not surprising!) No one was enthusiastic about operating on me because of my MS (And probably because I am a surgeon LOL). I tried for months with PT and more epidurals to avoid surgery but had to proceed because the pain was so bad. Eight surgeons gave me four different options. Minimally invasive, posterior only, anterior only, anterior and posterior open. When I met the surgeon that I ultimately chose, he did an open anterior/posterior approach in about 2 1/2 hours total operative time (this is why you choose somebody who does this all the time, has a vascular surgeon who also does this all the time do the anterior spine exposure, and has been for more than 10 years). Because of my MS I went to an inpatient rehab facility for two weeks after surgery. Surgery went extremely well but the rehab after discharge has gone extremely slow because I am so out of shape and have lost most of my muscle tone. :-(. I am almost one year postop and have not had a twinge of sciatica! I begin using a cane all the time which really helped me avoid falls. I feel great and I am continuing with PT three times a week. I am getting stronger every day!

  • Kim Dolce moderator author
    7 months ago

    Wow, doc, thank you so much for sharing all the details of your treatments! I’m so glad you’re getting stronger and the sciatica seems to have gone away. You make me rethink some options. Hope you continue to improve. –Kim

  • drwithms
    7 months ago

    Oops wanted to add on that lumbar fusion has excellent results in the right hands

  • Kim Dolce moderator author
    7 months ago

    Okay, good info, I’ll discuss with my neuro next week. –Kim

  • marigoldg
    7 months ago

    I have Secondary Progressive MS and have substantial problems with spasticity in my right leg (especially my quads), my torso and back. I’ve tried the route of muscle relaxers, PT and other treatment options. They worked for a while, but after a time, they became less and less effective.

    Finally, I gave in to have Botox injections in my right leg and have been amazed at how much relief it provides. I get injections every three months and I can feel immediate relief. The injections allow me to continue driving, walk up stairs and walk instead of using a wheel chair.

  • Irina
    7 months ago

    My neuro said that Botox only helps with local spasticity but would not help me since I have general spasticity.

  • Kim Dolce moderator author
    7 months ago

    marigoldg, so glad Botox is working for you. I asked my neuro about it but she only does Botox for migraine treatments, she doesn’t know how to do it for limb spasticity. She has only encouraged me to get the intrathecal Baclofen pump but I don’t want that. Maybe I’ll look into Botox from another doc. Thank you for sharing your experience. I hope you continue to find relief with Botox. –Kim

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