Muscle twitching and spasms are common in people with multiple sclerosis (MS) and may feel worse at night, during sleep. A small twitch may be a brief, involuntary movement in one muscle. Muscle spasms and stiffness affect between 40 percent and 80 percent of people with MS at some point.

Spasms can be painful and make parts of the body jerk uncontrollably, which can make it hard to get a good night’s rest. “I couldn’t sleep because of spasms,” one MyMSTeam member shared.

Read on to learn why muscle twitching and spasms may feel worse at night with MS. You’ll also find tips to help manage them and sleep more comfortably.

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Why Do MS Muscle Spasms Happen at Night?

You may be wondering: Does MS cause muscle twitching? It can.

When muscles affected by spasticity stretch, they may twitch or jerk in an uncontrolled way. In fact, spasticity is one of the most common symptoms of MS.

Spasticity means there’s increased muscle tone or tension in the muscle. MS-related nerve damage can affect the messages between the brain, spinal cord, and muscles, which may lead to increased muscle tone, muscle spasms, and sometimes pain.

Muscle spasms can be worse at night because spasticity is worse when you move less and your muscles stay in the same position for hours, such as when you’re sleeping. Your body positioning in your bed also matters — unsupported joints can cause extra tension and tightness in your muscles.

Spasms can also worsen because of triggers. Common triggers include infections, such as urinary tract infection (UTI), constipation, skin irritation like that caused by tight clothing, pain, fatigue, and stress.

How Do Muscle Spasms at Night Affect People With MS?

Muscle spasms at night may cause you to lose sleep and feel more fatigued the next day. Not getting good sleep can make life with MS harder and may make other symptoms, such as fatigue and weakness, feel worse.

MS leg pain at night can also be part of the problem. Muscle spasms and stiffness can be painful.

Sometimes, just knowing you’re not alone can help. Many MyMSTeam members express the pain and frustration of dealing with muscle spasms at night:

• “I get them every day. Sometimes, even in the middle of the night. I was just drifting off to sleep last night when the arch of my left foot decided to do something.”
• “Had a horrible foot spasm last night, and my hip was hurting for days too.”
• “Bad night with left and right shoulder and arm spasm.”
• “Last night kinda sucked … not much sleep due to left leg spasms.”

Tips for Managing MS Muscle Twitching and Spasms at Night

MS muscle spasms are common, but they can be managed. Managing spasticity, in general, can help reduce spasms at night. There are several treatment options for muscle spasms and stiffness, such as:

• Physical therapy to improve movement, strength, balance, and reduce pain
• Occupational therapy to improve skills needed for daily activities
• Medication options to help reduce spasticity and related symptoms
• Equipment like braces or splints for stretching stiff muscles
• Electrical stimulation therapy
• Look for a trigger, such as a UTI, constipation, skin discoloration, or pressure points
• Keep the room at an optimal temperature to avoid overheating

Exercise for MS Muscle Spasms and Twitching

Exercise may help with spasms by improving flexibility and reducing stiffness. A physical therapist can recommend exercises and movements that may increase flexibility and decrease spasticity.

“I get them every day. Sometimes, even in the middle of the night. I was just drifting off to sleep last night when the arch of my left foot decided to do something.”

— A MyMSTeam member

Gentle activities like yoga, gardening, and range-of-motion exercises can be good places to start. Check with your healthcare provider or a physical therapist before beginning any new exercise routine.

You can also try steps at home:

• Make sure your mattress feels supportive.
• Use pillows or foam wedges to help keep your body in a comfortable position.
• Support your neck, back, knees, or ankles so your joints aren’t strained.
• Avoid tight pajamas or other tight garments.
• Keep your sleep area at a comfortable temperature.

If you wake up with spasms, gentle stretching may help some people. You might try slowly bringing your knees toward your chest, letting one knee fall to the opposite side, and then repeating on the other side. You can also try flexing your feet.

MyMSTeam Members Share Tips

Members of MyMSTeam often share what has helped them cope with nighttime spasms. These are personal experiences, not medical advice.

Instead of adding unsafe weight or pressure to your legs, consider safer support, such as pillows or foam wedges. Positioning supports may help put your body where muscles are less likely to stiffen or spasm.

Each person with MS is different, but here are a few tips from members of MyMSTeam:

• “The only thing that seemed to help was putting on multiple layers of socks to create counterpressure in my foot. It made the twitching less disruptive to my sleep.”
• “I have to make myself get up and walk it off when I have leg spasms at night.”

If your spasms suddenly get worse, look for possible triggers instead of assuming a food or supplement change will fix the problem. Keeping a diary may help you identify trigger factors.

Tips for Getting Better Sleep

Getting enough sleep is important, but MS can make it hard. Nighttime spasms, pain, bladder symptoms, stress, and medication side effects can all interfere with sleep.

Managing spasms is an important step toward better rest. Reviewing triggers, improving your sleeping position, and asking your care team about medication timing may help.

If you take medication for muscle stiffness or spasms, ask your doctor whether timing it before bed could help. Some guidance suggests taking these medications around 30 minutes before sleep so they’re working when needed.

If you’re losing sleep because of MS, talk with your healthcare professional or neurologist. They can review your symptoms, medications, pain, bladder or bowel concerns, and positioning needs.