Pain suffered from post-polio syndrome...

[Dave-McKouen]

       My wife is a 49 year old female caucasian who suffered from polio when she was 6 weeks old. Alhtough the polio came and went, she did retain muscular damage associated with it and has had mobility issues all of her life. Now, at 49 years old, she is experiencing the relatively new problem known as post-polio syndrome, a continuing degenerative neuro-muscular disorder which afflicts past polio survivors later in life as a result of overused muscles which have basically been burned out from this overuse in the past years of trying to live normally, a very disheartening (and painful) situation. She is currently taking "vicoprofen" on a regular basis for pain, usually 25mgs. twice a day. This is proving to be insufficient as time goes on, and what I am looking for is a suggestion for a possible replacement medication which would serve her particular purposes better. Obviously, she is a vivacious and active (as much as possible) person who resents the fact that she is now being robbed of her already limited   mobility at a time in life when she should be able to start enjoying things. We know this is not going to go away and are trying to accept it as best we can, but I would very much appreciate any comments or suggestions as to what may serve her better for the purpose of pain management. Feel free to respond to this entry, or e mail me directly. Your advice and help is greatly appreciated.
                                             Sincerely, Dave McKouen.
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Dear Dave:
The post-polio syndrome has numerous facets. Because of the loss of strength of supporting muscles, it is very common for degenerative or arthritic changes to develop in the spine and in the major joints. This can be a major cause of pain. Another aspect of the syndrome is a progressive further loss of strength of muscles that were mildly weak to begin with. This has been attributed to metabolic stress and age related changes of the nerve cells supplying muscles. This problem has also been termed progressive post-polio muscular atrophy (PPMA). Other problems include pinched nerves, sleepiness and fatigue from obstructive sleep apnea, and psychiatric issues.
The relative contribution of these possibilities to your wife's problem would be best determined by a neuromuscular expert with experience in the post-polio syndrome. It is possible that at least some of the pain that she has can be controlled by means other than the use of strong analgesics. In addition, if the neurologist thinks it is appropriate, he may be able to organize a consultation with a comprehensive pain management program for optimum symptomatic control after diagnostic issues are resolved.