Spasticity triggers
What to do if you have a worsening of your muscle stiffness and/or spasm
Muscle stiffness and/or spasm are common symptoms experienced by people with multiple sclerosis. These symptoms can worsen significantly as a result of other influences such as an infection or other changes to your routine. These are called trigger factors (also known as aggravating factors). Identifying what is triggering these symptoms is usually straightforward, though sometimes it can be difficult to pinpoint what is responsible. This booklet has been developed to help identify potential trigger factors and to provide a guide to manage these situations effectively.
Stiffness and spasm can be dramatically worsened by trigger factors. If the trigger factor is managed appropriately then your symptoms of stiffness and spasm will ease without needing any medication. If the trigger factor is not managed appropriately then this can lead to worsening of your symptoms, unnecessary medication changes or secondary problems such as muscles becoming tighter and shortened. This can be very distressing and can result in worsening of your mobility.
Trigger factor list
We have included a list of trigger factors. Where you identify a change in your normal function or routine, tick the relevant box. There is space at the bottom of each section where you can record anything you think might be relevant, either for your own information or to discuss with the healthcare professional who provided you the link to this webpage.
Complete the trigger factor list
Stiffness and spasm diary
Using a stiffness/spasms diary for a week can help you indentify what causes your symptoms to worsen
How do I fill in the diary?
The day is divided into 6 sections - on awakening, morning, lunchtime, afternoon, evening and bedtime. Use this scale to note how troubled you are by yourm stiffness/spasm - there is a box in each section for you to write down your score.
1 = not at all troubled
2 = a little troubled
3 = moderately troubled
4 = extremely troubled
If you are troubled by stiffness and spasm, write down in the space provided what you were doing at the time, how you were feeling or anything you think might be relevant - this will help you identify what triggered your stiffness or spasm. As much information as possible will help.
At the end of the week review the diary to see if youcan identify a pattern.
What do I do once I've completed my diary?
Read the list of trigger factors and take appropriate action or take the actions suggested in the booklet. If you are still unable to identify what is aggravating your symptoms, contact your MS nurse or physiotherapist for further advice.
Need a diary?
Download a diary - (PDF 178Kb)
Order a diary online for free
Authors
Jane Lough
MS specialist physiotherapist
Paula Cowan
MS specialist physiotherapist
Thank you to
Dr Rachel Thomas, Consultant Neurologist, Southern General Hospital, Glasgow
