Muscle spasms, also called muscle cramps, are a common symptom of multiple sclerosis (MS). Spasticity, which causes muscle stiffness and tightness, affects between 60 percent to 90 percent of people with MS. Spasms are painful contractions or tightening of one or more muscles. They may cause a body part to jerk in an uncontrolled way.

Just like MS can affect people in many different ways, spasticity can affect different muscles, cause different sensations, and make daily activities harder in different ways. No matter how you experience MS spasticity, you’re not alone. “I experience terrible muscle cramps at night at rest — it’s maddening!” one MyMSTeam member wrote.

Read on to learn about different types of muscle spasms and how they affect MyMSTeam members.

What Causes Muscle Spasms in MS?

In normal movement, some muscles relax while others contract. With MS, damage to nerves in the brain or spinal cord can disrupt this action. This change to your nervous system can cause many muscles to contract at once, yet resist being stretched. This change in the motor system causes a tug of war between your muscles.

Some muscle contractions can feel like a charley horse or menstrual cramp. Others are jerky movements, similar to the way your leg jumps during a reflex test. One MyMSTeam member likened her excruciating charley horses to “late labor pains.”

Types of MS Muscle Twitching

There are three different types of muscle spasms in MS:

• Flexor spasm — The limb bends up toward the body.
• Extensor spasm — The limb shoots out, away from the body.
• Adductor spasm, commonly in the legs and thighs — The limbs come in toward each other.

Muscle spasms can occur in different muscles at different times. They last between a few seconds to 15 minutes or longer. Sometimes, they repeat many times. If muscles jerk repeatedly — such as a rhythmic tapping of the foot on the floor — it’s called clonus.

Muscle spasms may be triggered by various situations:

• Sudden position changes or movements
• Extreme temperatures
• Infections
• Wearing tight clothing
• Constipation
• A full bladder
• Stress

Some people experience more muscle spasms during MS relapses. Some triggers for spasticity are also common relapse triggers. Learning to identify and address what triggers your muscle spasms can help to prevent and treat these difficult symptoms.

Fasciculations: How Are They Different From Muscle Spasms?

Unlike the larger contractions that happen during muscle spasms, fasciculations are tiny, fluttering twitches that only contract a small portion of a muscle. Fasciculations are very common. You may notice them after exercise, in times of high stress, or if you haven’t had enough sleep. They can also be a side effect of some medications, including corticosteroids (steroids).

However, muscle fasciculations can also be caused by some autoimmune conditions, nerve damage, or having too little of certain nutrients in your diet. If you keep experiencing muscle fasciculations, talk to your neurologist. They can help you determine whether the twitches are connected with MS or another condition. In most cases, fasciculations go away on their own without any treatment.

How Do Muscle Spasms Affect People With MS?

Muscle spasms can affect any muscle in the body, but the most common muscle spasms in MS are in the arms, legs, or trunk and back. Severe, ongoing muscle spasms can disrupt mobility and have a significant impact on quality of life.

For 1 in 5 people with MS, spasms regularly affect their daily activities such as bathing, dressing, or walking. It can be debilitating when your arms or legs don’t work properly or when your body acts in painful, unpredictable ways.

Members of MyMSTeam describe their muscle spasms in various parts of the body:

• “One big tense-up that won’t release.”
• “Really, really tight muscles that no amount of stretching helps.”
• “Burning, cramping, and spasms that are so severe, it feels like my muscles are ripping away from my bones.”
• “My legs feel like there are electrical bolts going through them.”
• “I walk like a robot.”
• “My legs, arms, and back muscles are so sore, it’s like I worked out hard!”

Walking and Standing

Muscle spasms in the lower extremities can make it difficult to walk, maintain balance, or climb stairs. Some people with MS experience their toes cramping and separating, which can be very uncomfortable. “During the day, my toes curl uptight with my big toes going in the opposite direction,” said one MyMSTeam member.

Another shared, “Feels like I’m walking in quicksand.”

“My left leg feels like I’m wearing a concrete shoe,” described someone else.

“My right leg kicks out without warning,” wrote another member.

Some people with MS may experience foot drop. This may occur when the signals from your brain to your legs are disrupted, causing difficulty lifting the front of your foot well enough to walk.

Sitting

For people with MS who have limited mobility, lack of movement can also cause muscle spasms in the lower body. Some members describe this as “butt muscle twitching.” “I start to get butt spasms, especially after sitting all day,” wrote one member.

“My legs twitch sometimes when I get up or stretch,” said another.

Some members have found it helpful to place pillows or cushions on chairs. Having good posture and support for the body when sitting can help you avoid aches and pains.

MS Twitching at Night

Many members report spasticity that’s worse at night and disrupts sleep. Arm and leg jerking can cause you or your partner to wake up several times during the night, leading to daytime fatigue. “Every evening for about 30 minutes, my legs and torso get very twitchy,” explained one member. “It’s annoying and tiring.”

Another member wrote, “I feel like I have something moving deep under my skin. It travels from one place to another.”

Other Aspects of Daily Life

Upper body spasms can lead to dysfunction that interferes with eating, writing, dressing, and even driving. One member shared, “Feels like you got punched in the arm.”

Another said, “I have had this pain in my arm for a good month now and it aches a lot.”

For others, symptoms of spasticity occur in their hands and fingers. “My hands will spasm into claws, so badly that I refrain from driving any farther than the store,” explained one MyMSTeam member.

Hand spasticity can create a deformity that another member called “the claw.” Prolonged muscle cramping can lead to contractures, where joints become frozen and immobile and range of motion is lost.

Managing Muscle Spasms

Luckily, there are many ways to treat spasticity for people with MS. Talk to your neurologist or another health care provider if muscle spasms are affecting your quality of life. They may refer you to an occupational therapist or physical therapist.

Medications for Muscle Spasms

As far as medications, treatment options may include muscle relaxants such as baclofen (Lioresal). If you have severe spasticity, your doctor may suggest an implanted pump to infuse baclofen. Botox treatments (where botulinum toxin is injected into muscles) can help reduce muscle tone and help with spasms. Your doctor may also recommend tizanidine (Zanaflex) or clonazepam (Klonopin).

Other Ways To Manage Muscle Spasms

It can help to regularly stretch your muscles. Physical or occupational therapists can teach you customized stretches and other exercises to preserve your range of motion and help build muscle tone. Researchers have studied whether alternative treatments like transcranial magnetic stimulation or transcutaneous electrical nerve stimulation could help with muscle spasms. They have not yet been proven effective.

Talk to your doctor about whether it might help to add one of these options to your MS treatment plan.

Talk With Others Who Understand

MyMSTeam is the social network for people with MS. On MyMSTeam, more than 215,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

What do your muscle spasms feel like? How do muscle spasms affect your daily life? Share your experience in the comments below, or start a conversation by posting on your Activities page.