Muscle cramps and  stiffness

As MND progresses the limbs gradually become weaker. Muscles can become stiff, also known as spasticity, resulting in joint aches and pains. These factors may increase the risk of falls.

Support you can give

Muscle cramps can be helped by physiotherapy and, in some cases, a medication called quinine. Cramps typically improve in the later stages of the condition.

For muscle stiffness physiotherapy can be helpful by recommending supporting exercises which:

  • Maintain mobility for as long as possible by preventing muscles from becoming stiff
  • help maintain maximum range of movement (ROM)
  • help maintain comfort and reduce problems associated with muscle weakness
  • strengthen muscle groups not yet affected by MND (which can help to
    compensate for those that have weakened or wasted)
  • help maintain circulation through active muscle movement.

In some cases, medication such as baclofen, tizanidine or small doses of benzodiazepines, eg clonazepam may be prescribed to help relax the muscles. Dosage of muscle relaxants should be carefully adjusted to avoid increased weakness and decreased mobility.

Pain relief

If the person experiences pain, it may be due to a number of factors including the muscle cramps and stiffness as above. Other causes may be immobility, poor posture or skin sensitivity. Occasionally there may be some neuropathic pain.

For the relief of skin sensitivity consider a pressure relieving mattress and ensure the person is appropriately supported to change position and maintain skin integrity.

If painkillers are necessary the type recommended will depend on how severe the pain is. Mild to moderate pain can often be controlled using non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.