Muscle spasticity is one of the most challenging symptoms of Multiple Sclerosis (MS). Patients with MS often experience a tightening or stiffening of the lower body muscles in the legs, groin, buttocks, and back.
Muscle spasticity can affect the ability to stand, walk, and balance and is one of the biggest detriments to a patient’s quality of life. Muscle spasticity can worsen during quick stretches or movements. However, when done correctly, gentle stretches can help patients manage spasticity effectively.
While lying on your back, bend your knees at a 45-degree angle, draw them together, and gently let both knees lower to one side, holding for 30 seconds. Then pull the knees back to the center and slowly lower them to the other side.
In this hip stretch, your goal is to decrease tightness, not get your knees to the floor, so only lower them as far as it feels okay. Keep your arms out to the side in a “T,” palms down. Move slowly.
Hip Flexor Stretches
Lying on your back, rest on the lower half of your bed with your knees and lower legs hanging off the edge. You should feel a stretch in your hip flexors located at the front of your hip. Aim to build up to a 30-second, then 60-second hold.
Placing a rolled-up towel on the floor, step on the towel with the ball of your foot, keeping your weight on the back of the foot. Then, step the opposite foot slightly forward, still maintaining the weight on the back of the foot, stretching the calf.
When seated, place a rubber ball on the floor and roll your foot over the ball, paying particular attention to places on your foot that lack feeling or feel disengaged.
While seated, hold a rolled towel at both ends, wrapping the towel under one foot. Lift the foot and towel with both hands and try to keep the leg extended for up to 30 seconds.
Tips for Exercising with Muscle Spasticity
Muscle spasticity affects everyone differently. If you experience muscle spasticity when extending your legs, avoid stretches that straighten the knee and hip to that point. Also, patients who incorporate stretches regularly see the most benefits and better movement.
Four out of five people with multiple sclerosis experience muscle spasticity. Muscle spasticity causes increased muscle tone, uncontrollable muscle contractions, and spasms. Like severe muscle cramps, muscle spasticity can be quite painful and is one of the most troubling symptoms of multiple sclerosis. Despite being so common and so troublesome, multiple sclerosis patients with muscle spasticity have few effective treatments options. In many cases, the muscle spasticity continues even after treatment with drugs such as baclofen or tizanidine. Not only are these drugs largely ineffective, in many cases they cause substantial side effects.
Marijuana has long been known to exert a muscle relaxing (anti-spasmodic) effect. As medical marijuana is becoming legal in more jurisdictions, researchers are now carefully studying the effects of the substances within marijuana. One important example is a study conducted by Spanish researchers. In 2010, Spanish drug authorities approved the use of an oral spray that contains a combination of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), two active substances found in marijuana (Cannabis sativa). Spanish authorities approved the use of this drug for multiple sclerosis patients with moderate to severe muscle spasticity who did not benefit from other antispasmodic drugs.
Dr. Lorente Fernández and other Spanish researchers were interested in learning whether this combination of THC and CBD was able to help multiple sclerosis patients with severe muscle spasticity. The scientists found that the combination of substances found in medical marijuana was effective in 80% of patients they examined. What is striking about this finding is that every patient included in this study had failed to find relief from other medical treatments of spasticity. In other words, they had difficulty in treating muscle spasticity. When viewed in those terms, an 80% effectiveness rate is extremely impressive.
Some patients withdrew from treatment because they felt that THC/CBD did not help them within the first 30 days of starting treatment or some experienced dizziness or weakness.
Muscle spasticity is one of the most common, most troubling, and most difficult to treat symptoms of multiple sclerosis. While traditional medical treatments often fail, the substances in medical marijuana may offer hope. This study illustrates that 4 out of 5 multiple sclerosis patients with difficult to treat muscle spasticity achieved relief from a combination of THC and CBD, substances found in medical marijuana.
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Reference: Lorente Fernández et al. (2014). Clinical experiences with cannabinoids in spasticity management in multiple sclerosis. Neurologia. 2014 Jun;29(5):257-60.
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