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Need to Know: How to Manage MS Leg Spasticity

Need to Know: How to Manage MS Leg Spasticity

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Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum.

This week’s question is inspired by the forum topic “Leg spasticity: How do you manage it?“, from April 30, 2018. 

What is leg spasticity?

Muscle spasticity is a common MS symptom. It can occur anywhere, but generally, it occurs in the muscles that we use to stand and balance. That means the legs are a common, if not the most common, target.

Lesions in the brain and spinal cord that damage the nerves controlling muscle movement are the chief cause of this unpleasant, sometimes disabling symptom.

Types of leg spasms

Extensor spasticity refers to muscle spasms on the front of the leg (the quadriceps) and the inside leg (the adductor muscles).

Flexor spasticity refers to spasms in the muscles on the back of the leg (the hamstrings) and the muscles that connect the upper thighs to the hips (the hip flexors).

Clonus is a general term that means “rhythmic, repeating spasms.” That weird twitching and jerking in your legs? That’s clonus.

Stiffness is generally viewed as the same thing as mild spasticity. However, even when considered mild, stiffness can lead to problems with walking and gait, especially if your spasticity seems to favor one side over the other.

Join the MS forums: an online community especially for patients with MS.

Triggers for leg spasms

Several triggers can worse spasticity in the legs:

  • temperature extremes
  • humidity
  • a change in body position
  • clothing that is binding
  • constipation
  • posture problems
  • generalized pain (not necessarily related to MS)
  • broken skin or sores
  • fever
  • overheating from excessive exercise
  • anxiety
  • infection elsewhere in the body (which leads to inflammation)

What you can do about spasms in your legs

There are some approaches you can take to reduce or relieve leg spasticity. Some options work better than others, so if one doesn’t work for you, try another.

  • Treat separate conditions such as arthritis, a pulled muscle, or restless legs syndrome. Any kind of inflammation can lead to leg spasticity. Discuss your concerns with your doctor. Treating other causes of muscle pain and stiffness can greatly improve overall comfort.
  • Start an easily maintained stretching plan. You can work with a physical therapist to create a plan or consult other resources (books, websites, and videos) of MS-specific stretching exercises.
  • Aquatic therapy, tai chi, and gentle (Hatha) yoga are forgiving to the joints and help with strength and relaxation.
  • Try progressive muscle relaxation. It’s useful for releasing tension not only in the muscles but also in the mind, putting a cap on anxiety, which also can lead to muscle tension.
  • Massage from a practitioner is fantastic. Deep tissue is less comfortable but longer-lasting. A gentler massage, though more temporary, can be the pick me up you need during a rough day. Bedtime massage, either using a foam roller or other self-massaging products or from the fingers of a loved one, can be effective.
  • A warm bath, also and especially at bedtime, can help calm the muscles and inspire them to “let go.”
  • Transcutaneous electrical nerve stimulation (TENS) uses electrode-like patches applied to specific muscles to generate stimulation that brings relief to specific parts of the body (i.e., the calves, the bottom of the feet, and the thighs).
  • Medications for spasticity include muscle relaxants, certain benzodiazepines, dopamine agonists (like those used for restless legs syndrome) and even Botox. Consult your doctor.
  • Some people swear by oral applications of the cannabis product known as Sativex.
  • Certain kinds of braces for the feet and legs can help keep muscles and joints in proper alignment, preventing the development of contractures (see below).

If you don’t treat leg spasms

Obviously, if you can’t ignore the pain and stiffness in your legs, you’ll feel miserable. But even worse, you could develop something known as contractures, which are joints that are frozen or immobilized by perpetually stiff muscles. Unfortunately, contractures can also trigger more spasticity, so don’t be a hero. Find ways to release the unpleasant rigidity in your muscles; you don’t have to suffer needlessly.


Have you found the secret solution for managing your leg spasms? If so, others who are plagued by this problem would love to read about your success. If not, reaching out to other people with MS may be fruitful if you think you’ve exhausted your options. Post your replies in the comment section or at the original “Leg spasticity, How do you manage it? ” forum entry.


Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.

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  1. Simone says:

    Hello, I don’t have MS , I have SPS, but I have had horrible Muscle spasms. I have bought me a therapy planket for my bed, which is 12 kg heavy. It seems to be strange, but to be honest, it helps me so much. I need one month, before I can sleep under this planket the whole night with the whole body. I began only to put it over my legs, so the legs begin to cramps from day to day less. Now, the spasms are in a normal mode. I can live with it, because the pain is gone in the most of the time.

    • Tamara Sellman says:

      Hi Simone,
      Yes, weighted blankets can be useful for all kinds of things, including insomnia and RLS. FWIW, I have to have the lightest blankets possible because the weight of them actually causes cramps in my toes (weird, but true). But of course we are all different and whatever works for you is the best solution. Thanks for sharing!

  2. Cynthia King says:

    About ten years ago I started getting Botox in my feet and lower legs. I couldn’t stand flat on my feet because the spasticity wouldn’t allow it. It has been such a life changing thing. I didn’t need the spasticity meds during the day. I could fit into a normal pair of shoes. I could walk unaided. Over time my balance went so I have to use a walker. I still get the shots, maybe more for relief than mobility. If spastic legs are your problem go this route. You will get relief without side effects. I have often thought about ditching my husband and running (ha) off with him, he’s that good. But his wife probably wouldn’t like it so I have never brought it up.

  3. Julie Plave says:

    I was plagued by leg spasticity until I found “The MS Gym” (a free Facebook group led by guru Tervor Wicken). He has created many videos (you can find them on youtube or the Facebook group) showing how to release these spastic muscles. I’ve been doing his exercises for 8 months now, and they really work. I can now sleep most nights without being woken up by spasms. He’s an extremely gifted teacher and really shows you the safe way to release and stretch. I highly recommend checking out his videos; they have been a total game changer for me!

  4. Linda Karon says:

    I have a heavy wooden bed frame and when the cramps and spasms start, I roll onto my stomach and put the bottoms of my feet hard against the bed frame. It really helps.

    • Tamara Sellman says:

      That could work for people who don’t have back problems (unfortunately, I get hugs and neck spasms so stomach sleeping is out of the question).

  5. Lydia Hackett says:

    Hi! I second The MS Gym with Trevor!!! Just wonderful, and I learn so much why my body is doing different things due to MS . Then how to fix my issues. Love it.

  6. Bill says:

    I have PPMS and have had severe spasticity in my legs that drugs would barely help. I found a good physiatrist and have botox injected every three months. It works wonders and has helped me to continue to walk. Botox has a copay program that covers most out of pocket expenses depending on the type administered. Look into their site and medication if you have significant spasticity. I swear by it, but just wish it lasted longer than three months.

  7. Fred Haseley says:

    My right leg extensor spasticity is controlled by Baclofen and my restless (left) leg is controlled by Pramipexole. Both are very effective for me. If I forget to take either on schedule, then the spasms or restless leg will start. The only time my usual dosage does not work is when I am feeling stressed at work and/or I am not getting sufficient sleep.

    • Tamara Sellman says:

      This is very true about sleep. Without it, we cannot heal up from the daily insults that MS brings. I also find baclofen useful and go with the lowest dose (5mg) I can get away with, and add the other half as needed when pain flares up, which only happens occasionally, thank goodness. Stress is also problematic (as I’m sure we all know), and I’ve found that if I drink too much coffee and don’t hydrate with water, the muscle rigidity and pain are even worse, so I’ve had to moderate my caffeine intake in the morning. To stay alert, I’m now using a “happy light” at my desk and it really makes a difference, so I feel better about cutting back to one cup of joe with breakfast and calling it good. Thanks for your insights!

  8. Brad Schultz says:

    Try Tai Chi.This condition requires a complete and holistic approach to treat and mitigate its symptoms. Appropriate exercise is part of it. Tai Chi is known to be very helpful in reducing or eliminating various symptoms and complications, even the reduction or relieving neuropathy. I have found the Eastern Internal arts offers time-proven wisdom on how to improve our health and energy in naturally effective ways. This way we can be in charge of our own health, and without the negative side-effects. I think we can learn techniques and principles to start to take charge of our own health. I’ve found some good holistic tips and techniques from the eastern arts here

  9. Lynn F. says:

    Interesting reading all of your comments and suggestions, I will definitely check out the “MS Gym” on Face book. I do take Baclofen and was recommended to try “Ancient Minerals” from Amazon because of their high Magnesium content. The “Night time” one was helpful, but I have learned to just keep my legs and feet warm, I sleep with a heating pad on my feet, I keep my bed warm. I have a heated mattress pad and I use a fuzzy blanket between myself and the upper sheet. I do light yoga & stretches during the day and all of that has lessened the spasms. I don’t use the mineral creams anymore. In just over 2 years I have gone from not certain of a diagnosis to SPMS.

    • Tamara Sellman says:

      Thanks for sharing what has helped you, Lynn.

      Would like to add that people with issues with overheating may wish to keep this in mind when trying out some options. It sounds like the extra warm bed works well for you, and that’s great, but I know for others with MS that being overwarm can contribute to relapses.

      As a boarded sleep health educator (CCSH), I would recommend keeping the room cool if doing so, and stick to layers you can peel off or pull back as needed. Your circadian rhythms need a dip in temperature overnight in order to get a solid night of sleep, which we all need if we have MS! 😉

      Good luck!

  10. Tim Carter says:

    I have found that for my wife having adequate levels of magnesium, potassium, and proper hydration during the day help keep RLS at bay as well as muscle cramps. Be cautious about how much water is consumed before bedtime of course, as this can cause too much bladder activity at night which will interrupt sleep. Magnesium supplements have been helping lately for her and eating lots of leafy greens naturally give her those needed minerals as well!

  11. Erika says:

    Hi guys, I have MS and have lots of spasticity in my lower legs but more on my feet and under feet. It feels so stiff it’s horrible and to top it all off I have foot drop.need advice. Is this an MS relapse? Can steroids fix it? Is botox a better route? It’s horrible I can sleep of walk. Wondering if anyone has experienced this?

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