Spasticity related to multiple sclerosis can range from mild stiffness to painful muscle spasms. Stretching is one of the best ways to manage it.
By Brian P. Dunleavy /// Medically Reviewed by Jason Paul Chua, MD, PhD
Updated on April 4, 2023
Regular stretching is one of the most helpful remedies for muscle spasticity caused by MS.
Mary Ellen Ciganovich became very familiar with muscle spasticity in her more than 30 years of living with multiple sclerosis (MS).
The holistic health and spirituality teacher has tried to engage in physical exercise — mostly yoga and light weight training at the gym — every day to help manage her symptoms.
Still, she says, “You never know how your day is going to be. Some days, I wake up and feel great and can’t wait to get to the gym. Then there are other days I fall as soon as I get out of bed, either because of the pain or because I just don’t have the strength in my legs.”
The symptoms of muscle weakness and pain that Ciganovich describes can be traced to one of the common symptoms of multiple sclerosis: spasticity.
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The definition of spasticity reads like a description from a medical school textbook, but the National Multiple Sclerosis Society (NMSS) calls it a “feeling of stiffness” as well as “involuntary muscle spasms” or “sustained muscle contractions or sudden movements.”
These symptoms may be as mild as simple muscle tightness, but they may become severe enough to produce painful muscle spasms as well as pain and stiffness in and around the joints.
Spasticity has been estimated to affect anywhere from 60 to 84 percent of people with MS, according to a review published in 2019 in Current Neurology and Neuroscience Reports. It most often impacts the legs.
In addition to causing pain and spasms, spasticity can lead to disability by causing gait disorders, falls, fatigue, and sleep disturbances. It may also lead a person with MS to depend on a wheelchair sooner than they otherwise would, per the review.
Still, the degree of spasticity, the muscles involved, and the resulting impairments vary from person to person, according to Alexius Enrique G. Sandoval, MD, medical director of the Multiple Sclerosis Rehabilitation Program at Johns Hopkins Medicine in Baltimore.
Effects and Types of Spasticity
Spasticity typically worsens as MS progresses, so it’s not necessarily an early sign of the condition. Those who have an MS diagnosis, Dr. Sandoval says, should notify their care team when they start to experience the symptoms of spasticity — such as muscle tightness and pain — before it begins to interfere with their activities.
“There often is an associated jerking of the limb as well,” Sandoval adds. “People often say they feel as ‘stiff as a board,’ and this interferes with their activities of daily living, affecting their ability to sit, stand, or walk.”
The two most common types of spasticity in MS are flexor spasticity and extensor spasticity, according to the NMSS.
Flexor Spasticity This mostly involves the hamstrings, which are the muscles on the backs of your upper legs, notes the NMSS. People experiencing flexor spasticity may notice that their hips and knees seem stuck in a bent position and are difficult to straighten.
Extensor Spasticity This kind, on the other hand, can affect the muscles on the fronts (quadriceps) and insides (adductors) of your upper legs, effectively forcing the hips and knees to remain straight, with “the legs very close together or crossed over at the ankles,” the NMSS says.