What can I do to manage spasticity and limit its impact?

Factors that can precipitate spasticity include changes in position, elevated body temperature, painful stimuli, bladder or bowel distension, and infections. Spasticity can either be localised to the muscles of one extremity, or be more generalised in nature.

Maintenance of range of motion is the key to preserving functional ability and should be initiated as early as possible for those joints at risk for restriction from full movement. Daily stretching can be very helpful.

Each joint should be slowly moved to its full range of motion. Proper positioning techniques in the bed and chair are also important. If a person is able to walk or stand, this is helpful. Any home exercise program that focuses on the muscle groups of the hip, knee, and foot can be beneficial.

Cooling therapies can be helpful in warmer climates, including cooling garments and locally applied cool packs/towels. Orthotics such as splints and braces can help by maintaining good positioning. Monitor things like ingrown toenails, tight-fitting orthotics, and bladder/bowel functioning.

Consult with a physiotherpist or occupational therapist to determine what regimen would work best in your situation. If a muscle spasm does occur, the activity should be stopped until the spasm passes before proceeding. Encourage your loved one to move slowly and smoothly. Quick jerks and sudden moving can often set off a spasm.

Are there complementary medicines that can help spasticity?

There is some evidence to suggest oral cannabinoids may be effective in relieving spasticity in people with MS. Sativex, a cannabinoid-based treatment, received  a license in Ireland in 2014 but is not currently available as the HSE do not reimburse it. Some people with MS purchase CBD oil, which does not contain THC (the psychoactive component of cannabis) and as such is not illegal in Ireland. It should be noted, however, that such products are not properly standardised or regulated. Always consult with a medical professional before considering embarking on such a treatment.

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