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Muscle Spasms
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Muscle Spasms

I am not sure if this is related to anything that is going on with me or if it is just something off the wall.

Is it possible to have a muscle spasm that wont go away? I have this spasm in my shoulder that has been there since I woke up this morning. I am taking my muscle relaxers to no avail. When I touch the top of my shoulder by my neck it is hard as a rock and my back around my shoulder is burning like crazy.

It was spasing yesterday too but only off and on today it is never ending.

Not sure what is going on but this hurts real bad and was wondering if anyone had any input on what I am feeling.

Thanks,

Paula
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1216899_tn?1288573925
I was curious if it is a spasm, or spasticity? I pretty much live with spasticity on a daily basis, and it's pretty bad at times, but I also have has some pretty bad spasms as well. I have had a spasm linger in my rib cage and diaphragm area in the ups of about two weeks before.

I know your pain, and feel for you, as either spasm or spasticity can be quite debilitating, not to mention just plain painful. I take Diazepam for my spasticity, but it doesn't seem to help with spasms at all. Sorry for not being helpful, other than to say, yes, I know what you are going through, and am sorry that your are experiencing it.

Good luck on finding some relief
John
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1312898_tn?1314571733
Hi Paula,  

Yes, you can have a spasm that can last that long.  I know it's a horrible thing isn't it.  I have areas that will sort of 'lock-up' during a spasm and then it seems like it comes and goes.  It takes a while to get on top of the pain.

Do you have pain medicine that you can take along with the muscle relaxant?  The pain of the spasm makes it more difficult to alleviate.  

Perhaps it's time to call your doctor and let him/her know that you can't get any relief from your spasms.  I finally got the courage to call mine and she tripled my dose!  So, my suggestion is to call your doc.

I hope you feel better soon!

Red  
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338416_tn?1260996698
Yup!  Great minds think alike - I've had a muscle spasm in my shoulder for a couple of days.  It's finally let up a little today.

Hey, try a cold pack on it.  I did that this morning and it really helped.
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Thanks everyone,

I am glad I am not alone in this, it hurts so darn bad. I can barely lift my arm. Moving it in the slightest little bit hurts so bad.

I have another question, what is the difference between spasticity and spasms, lol I know I should know the difference but I kinda thought they were the same thing lol. Like I said before I am learning as I go. Makes me feel dumb to ask that question but I won't find the answer if I don't ask.

Thanks to all. I will take another muscle relaxer and no I don't have pain pills to take witht them, however that would be great right about now.

Paula
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338416_tn?1260996698
well, my neuro changes his tune from day to day.  But what I call spasticity is an unusual soreness of the muscle.  The muscle also feels weaker than normal.  A spasm is a tightening of the muscle - a cramp, basically.
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1207048_tn?1282177904
Paula, I get this in my shoulder blades, usually the right more than left, and shoulder. It almost always starts with a day or so of muscle twitches in that area and by the 3rd day the whole area is sore and tight feeling. This lasts a few days then fades away.

I haven't had that happen for a few weeks now, but just this evening I've been getting a cramping muscle twitch in my left ribs area. I have no medicine for any of these experiences, so I'm praying this just goes away on it's own without too much pain. I'll get over my dislike of medicine at some point I guess LOL

I hope you feel better soon!!
~Jess
p.s. I tend to agree with Jen's answer regarding spasticity vs spasm. Once I have the DMD in my grubby little hands I'm going to be asking for a referral to see an Orthopedic doctor (I think that is correct?) because the back of my right knee is very sore, and my left thigh/ hip is also very sore. My neuro doesn't seem to focus on those issues.
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1386048_tn?1281015933
yikes!  sorry to read about this ongoing spasm paula...great advice from all and i'm afraid i can't really chime in.

best of luck girly and do call your doc...perhaps an up in the meds will help?

fingers crossed,

michelle
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147426_tn?1317269232
There is actually more difference between spasticity and spasms.  Jen, your description is not quite correct, but it can certainly "feel" the way you describe.

A muscle spasm is a hard contraction of the muscle.  Outside of MS we would call it a "Charlie horse" or a cramp.  The muscle bunches up, is hard and often becomes horribly painful.  They can be caused by many things including neurologic damage, electrolyte imbalance, overuse...

Spasticity is a neurological problem that causes the muscles in question to maintain a higher tone and to resist being stretched.  There are "stretch receptors" in our muscles that normally respond to the lengthening of a muscle with a bit of contraction.  You can think of the normal fuction of the stretch receptor as part of a system of checks and balances to allow for smooth very controlled movement.  They keep the opposing muscles from overacting.  But, they are also regulated themselves also.

With damage to the white matter of the CNS the regulation of the stretch receptors disappears.  So the muscles involved are always acting to counteract any lengthening of the muscle.  Left completely alone, spasticity will cause the involved muscle to contract and stay contracted.  In the worst scenario the joint involved will become permanently contractured.

Spasticity alone is not necessarily painful, though commonly it is.  We perceive spasticity as a stiffness of the limb involved and we feel that it takes more effort than usual to bend against it.  Muscles with spasticity are often "jumpy".  The littlest stimulation can make them tighten up - especially painful or sudden stimuli.  Even pain in another part of the body can make a spastic muscle worse.

I do recommend that you read the Health Page that John cited.  I talk there about the different qualities of spasticity, like how it is worse if you try to use a spastic muscle for a fast movement.  It may move normally with a slow measure effort, but a fast attempt might result in no movement at all.

When we discuss sapsticity you should note that we often talk about joints, when it is the muscles that have the spastic action.  This is because the muscles work "across" a joint to make somehting move.  Almost all muscles move something across a joint.  They are of no use if they didn't.  The main exception is the facial muscles for expression.

Spasticity is often region-wide.  It rairly involves just a single muscle group, like a spasm or cramp can.  So, one might have an entire limb that is involved with spasticity.  AND the spasticity might be in the extensor group of muscles or the flexor group of muscles.

If the flexors are spastic the limb will bend and fold up at the joints.   For instance, in an arm you can see the hand move into a fist and/or the wrist flex down, and/or the elbow bend deeply.  One may not be able to raise the upper arm forward (the flexor movement of the shoulder).  Flexor spasticity is VERY disabling, but thank goodness is not as common for us as extensor spasticity.

In extensor spasticity all the joints want to extend straight.  In my case, I have exensor spasticity of the right leg from the lower back down.  So, what my leg and hip want to do is:

The hip wants to pull the thigh backward (the glutes and lower muscles beside the spine tighten up)

The knee wants to straighten out (the quads are spastic)

The ankle wants to pull the toes downward (like they are positioned to stand on tippy toes.  (this is the action of the calves, the gastrocnemius and the soleus)

The foot pulls the toes down into a point, like in ballet.

People with lower extremity extensor spasticity have trouble marching with their knees high or lifting the foot up onto a step.  They tend to drop their toes and stumble while they walk.

Your neuro should be focusing intently on any areas of spasticity.  It is easily checked by passively moving the involved joint first slowly, then faster and faster.  The faster you try to make a spastic muscles stretch, the more resistance you encounter.  Since I have extensor spasticity, my knee "wants" to stay straight.  If I try to "kick up my heels" backward, I find that I can slowly lift the heel up towards the bacck of my knee, but if I try to kick it up fast, it won't even leave the floor.

Spasticity is most often (but not always) associated with muscle weakness.  Extensor spasticity can actually be helpful in helping people stay upright and walking - albeit stiffly.

A muscle spasm can occur all by itself or be superimposed upon a baseline of spasticity.  In MS the two things often occur together.  The underlying spasticity maight be subtle.  Muscle spasms are not.

I'll do a blurb on the proper treatment of spasticity.  But, briefly the treatment begins with removing noxius stimuli - sources of pain or bodily discomfort such as sores, or ulcers, splinting or bracing painful joints, treting infections like UTIs.

The next step is an ongoing and intensive program of stretching several times daily.

Then comes exercise.  Rather paradoxically an exercise program can reduce spasticity even if it strengthens the muscles that are too contracted to begin with.

The next step is relaxant medications

The next step is injecting medications to the nerves or muscles involved, like Botox which is being used in more and more sites.

And finally there are surgical interventions which should be saved for last.

The neurologist should be the right doc for analyzing spasticity.  Orthopedists deal with the bones and only reluctantly with the muscles.  If your neuro is failing to help with your pain and stiffness then you need to see either a Rehabilitation doc who specializes in neuro disorders (rather than sports med) or a doc in a field called "Physical Medicine."

Ask for a referral to a Rehabilitation specialist who will work with specialized Physcial Therapists.  I don't recommend the Orthopedic route unless there is also some problem with the joint or a bone.

Quix
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1396846_tn?1332463110
Quix,

Wow thank you so much for your informative response. I will contact my neuro tomorrow if it doesn't ease up. This is crazy, it is one thing after another. I can't lift my arm straight well I can if I do it slowly and the same with moving my arm out to the side. When I do try to move it, it hurts real bad that is why I thought it was an ongoing spasm, but I will see if tomorrow brings some relief.

I have been taking my muscle relaxers but to no avail. They are not helping at all. My neuro has pain management and PT in the building where he is. It is Riverhills Health Care and they have everything, down to their own MRI machines and do all their own testing, aside from the LP that I went to the hospital for.

I have a stick shift in my car and it is impossible to drive like this, I am upgrading next month so hopefully this will ease up till then, well hopefully it will ease up for good.

Thank you so much,

Paula
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1216899_tn?1288573925
First off, sorry for thread-napping Paula, I have a couple of questions here that someone may be able to help with. I have extensor spast. in my legs, right being worse than the left. I have worked out a pretty vigorous stretching method that helps a lot for the legs, to take the cramps out of my feet. The effects usually only last an hour or so at a time, but it helps.

The question I have is; do you know of a good stretching routine for the arm. I have flexor in my right arm, and have tried to find ways to stretch it that helps, and I mean some pretty vigorous stretching, but nothing seems to help. Most of the time my joints feel as though they are being ripped apart and flexed beyond limitation. I use my arms and hands regularly, as my job is very physically demanding, in fact, I believe that my job is the only thing that is allowing me to keep any sort of mobility.

Also, is there any exercises for the jaw, as this is a new symptom and is very, very painful, and the meds are barely keeping the pain in check. I have been wondering if it is actually spasticity in the face or if it is TN, though I'm pretty sure it's spasticity, due to the type of pain (nothing sharp or stabbing). This spasticity is causing secondary problems as well, as it pulls at my inner ear, I can hear what sounds like things moving around in there, and have found myself having some of the worse loss of balance I have ever had.

Ok, sorry, hehe, I've kind of turned a question in to a list of symptoms lol. These meds have got my brain a little bit loopy lately, and I find myself wondering what the hell I just said, so if I've lost anyone, sorry.

Fortunately my insurance doesn't require that I need to have a doctor's reference for specialized help, so perhaps I'll be able to call a PT and get some help.

Thanks for letting me ramble

John
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147426_tn?1317269232
John, Atypical TN is pain that is ongoing -rather than stabbing or jolting - present for more than 50% of the waking hours.  It is often described as a deep, boring ache, or even a burning.  Most neuro's and neurosurgeons who deal with a lot of facial pain do acknowledge that TN includes the classic lighting bolts of pain along with the constant deep often severe pain.  Some people have both kinds the constant pain with the jabs of more severe pain on top.  When I had it a great deal of my pain seemed to come from the TMJ.  It all melted away with the tegretol.

You can read about the different kinds of facial pain and their causes at:

fpa-support.org

There is also a questionaire which will give you a diagnosis according to your answers.  they are now separating the Trigeminal pain suffered by MSers and calling it Symptomatic Trigeminal Neuralgia.

Quix
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Thanks Quix, now get some sleep dang it! :)
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Wow, this is amazing.  Off to read and absorb... hopefully!
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Avatar_f_tn
This is the best explanation thus far!  Including the HP, because the exact implications for a patient (you) make it very concrete.

Can you tack your post onto the HP you did?

ess
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338416_tn?1260996698
Okay, so this explains why my neuro keeps whacking on the inside of my elbow, then telling me it's not spasticity.  I'm not sure what else it could be - maybe it's very mild spasticity.
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338416_tn?1260996698
I'm bumping this thread up so LoveMyMonkeys can read it - good info in here.  The HP is also excellent - recommended reading.
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