Balance and Coordination

Muscle issues, including weakness and spasticity, are central features of multiple sclerosis (MS), affecting up to 80–86% of people with the condition and significantly impacting mobility and daily activities. Proper understanding and management of these symptoms can improve function, reduce discomfort, and enhance quality of life.

What are Muscle Issues?

Muscle issues in MS primarily manifest as:

  • Weakness: Reduced strength or energy in one or more muscle groups, often affecting the legs asymmetrically and leading to difficulty with walking, balance, and posture.
  • Spasticity: Increased muscle tone causing stiffness, involuntary spasms, and resistance to passive movement; severity ranges from mild tightness to severe rigidity that impairs function.

Damage to the myelin sheath in the brain and spinal cord disrupts nerve signal transmission, leading to:

  • Weakness: Slowed or blocked signals reduce voluntary muscle activation; deconditioning from inactivity further exacerbates muscle atrophy.
  • Spasticity: Loss of inhibitory signals and abnormal reflex arcs cause persistent muscle contractions; factors such as heat, infections, and sudden movements can trigger or worsen spasticity.
  • Seek assessment: Consult your neurologist, MS nurse, or GP to identify underlying causes and rule out other conditions.
  • Track symptoms: Keep a diary of weakness or spasm patterns, triggers, and severity to aid tailored interventions.
  • Communicate clearly: Describe sensations (e.g., “tightness,” “jerks”) to your healthcare team to optimise treatment plans.
  • Exercise and stretching: Engage in regular, gentle strength and range-of-motion exercises guided by a physiotherapist to maintain muscle function and prevent contractures.
  • Temperature control: Use cooling strategies (fans, air conditioning) to reduce heat-induced spasticity flares.
  • Relaxation techniques: Practice deep breathing, mindfulness, or yoga to ease muscle tension and stress-related exacerbations.
  • Assistive devices: Utilise braces, splints, or orthoses to support weakened or stiff limbs during activities.
  • Positioning: Maintain balanced and symmetrical postures when sitting, standing, or lying to prevent spasticity-induced distortions.

     

  • Physiotherapy & Occupational Therapy: Tailored exercise programmes, manual therapies, and adaptive equipment to improve mobility and daily function.
  • Medications:
      • Spasticity: Baclofen, tizanidine, gabapentin, or botulinum toxin injections to reduce muscle tone and spasms.
      • Muscle weakness: No direct pharmacological cure; focus is on management of contributing factors and maintenance of activity. 
  • Advanced interventions: Intrathecal baclofen pumps or surgical tendon release in severe, refractory cases.

General Information

Living with MS-related pain can be challenging, but support and resources are available:

  • Multiple Sclerosis Society of New Zealand – National support and advocacy.
  • Regional MS Societies (Auckland, Wellington, Canterbury, etc.) – Local services, peer support, and resources.
  • Healthline – 0800 611 116 – Free 24/7 nursing advice.
  • Disability Connect – 09 636 0351 – Information and advocacy for people with disabilities.
  • Work and Income New Zealand – 0800 559 009 – Financial assistance and services.

Symptoms

Understanding MS