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333672 tn?1273792789

Paresthesias vs. spasticity

Anybody know for sure how to tell the difference between paresthesias and stiffness from spasticity? I am definitely having more paresthesias (burning, etc.), but also some things (pressure, feeling like my skin is too tight and dry, banding feelings) that I'm not sure about. Plus when I walk my feet often feel like they're wearing wet socks made out of concrete. Very unpleasant feeling.

I feel like I'm tight, but I've seen two neuros and a physical therapist in the past several months who say I'm not that tight so maybe all these feelings are just paresthesias? According to the PT, my flexibility is fine.

Also having more numbness, especially in my feet, which is making it really stressful to drive. Plus when I try to brake my knee and lower thigh sort of lock up and I feel like I can't really move my leg. I'm thinking I am going to have to get those hand controls.

I'm trying to decide if it's worth trying to up the baclofen as I'm also tired a lot recently (which I'm hoping is just due to being short on sleep). Any thoughts?

sho
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572651 tn?1530999357
Sho,
I wish I had the answer for this one.  I figured it was a paresthesia that made a patch on my leg feel like it was crawling with worms for about 5 weeks.  I told my neuro about it and he said it was a symptom of spasms. Obviously I still don't understand the difference, or if the doctors even recognize a difference.

If you have to get hand controls, be sure and check your car mfg's website and see if they have any financial assistance.  I've seen several that do, but I'm not sure if that is only on a new car purchase or if it applies to older models too.

be well,
Lulu
Helpful - 0
987762 tn?1331027953
COMMUNITY LEADER
Hi Sho,

It is a tricky question to answer, I found these basic definitions and a good article:

Paraesthesia describes a number of abnormal sensations just about anywhere in the body. These include tingling, prickling, pins and needles, electrical-type buzzing, burning, skin crawling, itching, partial numbness (like feeling through tent-cloth) and a variety of neuropathic pains.

Spasticity is involuntary muscle contractions that are not coordinated with other muscles. Most muscles in the human body come in pairs that work in opposite ways to eachother. When one is contracted, the other is stretched. The biceps and triceps are two such muscle pairs. When you stretch your forearm out, the triceps is contracted and the biceps stretched - when you pull it in, the reverse happens. The regulation of the two muscles is a complex, finely controlled and delicate mechanism which involves sending information to the muscles and receiving sensory feedback from them. In spasticity, the system gets things wrong and contracts both at the same time.

What are spasticity and spasms?
Spasticity can be described as involuntary muscle stiffness and spasms as involuntary muscle contractions. Any muscle can be affected but spasticity and spasms tend to predominantly affect a person's limbs or trunk.

http://www.mstrust.org.uk/information/opendoor/articles/0808_06_08.jsp

***********

The article is written by the MS Trust, its not long and an easy read. My basic understanding is Paresthesia is sensory and Spasticity and Spasms are muscle involuntary reactionary movements. I have Paresthesia, Spasticity and leg spasms which are different to the arm tremors, the Paresthesia sensations are annoying and constant but dont bother/affect me as much as the spasticity and spasms, they both make walking difficult. Thankfully the spasticity is easing up a little but the spasms continue not really painful unless i dont rest and then the spasticity picks up, you can see my muscles bouncing, my leg muscles apear to shudder and quiver which is visable under my clothing.

When i walk, my legs jerk up and down for each step, when its bad i cant seem to get my legs to straighten properly, they stay bent up and tight (think vergil from thunderbirds) and i shudder and shake. Its not as bad when i can straighten them more but they are jelly like, the muscles are still bouncing, shuddering and quivering even when i've stopped walking and i stand still. If i continue to walk, i start to loose balance and my gait becomes a weave and thats when i look drunk, I havent even mentioned the foot drop but its in there too. After all that i suppose i have spasticity and spasms intertwined, overlapping and one could set off the other, if you understand what i mean.

I'm not sure i've really answered your question but i hope i've helped :)

Cheers......JJ  
Helpful - 0
333672 tn?1273792789
Belated thanks, Lulu and Supermum for the info.

Lulu: I think I was having periodic spasms for quite a while before I recognized them for what they were.

I think the hand controls are not all that expensive (relatively speaking) and won't require a new car now that we got one with automatic transmission, but I haven't made a whole lot of headway on that task. Which means that, unfortunately, my husband has to go grocery shopping with me for a while (for some reason he dislikes grocery shopping).

JJ: I can understand the different causes in theory, but I sometimes seem to have trouble telling apart the different effects in my body. I don't think I get things where my muscles actually move (that I can notice), but I was walking (staggering) really stiffly before I started on the baclofen and I still don't bend my knees much when I walk (thought it might be my imagination, but the physical therapist noticed it, too).

Thanks for the article. It does show that this can be very confusing and hard to correlate written descriptions with felt experiences. I think what I mostly get in terms of spasms in my legs is the one they illustrate as extensor spasms. I get them in my arms, too.

Your spasms and spasticity sound unpleasant. Are you taking anything for spasticity? The baclofen helped me a lot.

Oh well, just another thing to adapt to, I guess.

sho
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987762 tn?1331027953
COMMUNITY LEADER
Hi Sho,

I'm not on anything, my GP straight up told me not to come back until after i saw the neurologist, i am sure she feels its a waste of time, she was annoyed and tried to talk me out of getting a referal, told me it was going to cost me hundreds of dollars blah blah blah, it cost me nothing. She did spend most of the consult reading my blood work & telling me how healthy i was, she didn't even look at me sitting there jerking all over the place. Oh, she did ask when i walked in why I was limping, well my feet cant lift of the floor, my legs are in constant spasticity and spasms and the room is moving about, its the only way i can walk!

I was a little taken back by her level of 'care' or lack there of, i couldn't at the time get words out of my mouth, i was slurring and stuttering and my nouns were totally lost, I was a mess and my doctor was quite happy to tell me i was 'healthy' and for me to leave to deal with this on my own, the only ones who showed any concern was the receptionist and other people in the waiting room, my doctor looked annoyed and impatient for me to leave and i was at that stage happy to oblige because the floor was looking rather comfy. I wont be going back, when i get the dx i'll be finding someone who knows how to actually help.

Is this what your what your experiencing?

Extensor spasm definition: A form of spasticity in which the legs suddenly straighten into a stiff, extended position. These spasms usually last for several minutes.
This type of spasm is fairly common in multiple sclerosis (MS). Extensor spasms are usually not painful, but can be forceful enough to make people fall out of their wheelchairs or beds. They often occur in the morning as people are getting out of bed or right after getting up.

Cheers.......JJ
Helpful - 0
338416 tn?1420045702
My rule is that if it feels like a sore muscle, cramp, or tight muscle, then it's spasticity.

If it feels like a weird sensation - banding, tight, too sensitive, cold, hot, burning, lack of sensitivity, etc - then it's paresthesia.

The knee and thigh locking up could be spasticity, or some form of muscle weakness.  I had a similar situation recently - the inner thigh muscle of my right leg decided it was REALLY sore, and whenever I tried to move my leg from gas to brake, it would cramp up.  I had to move my leg with my right hand as I was driving, which of course is extremely unsafe.  
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333672 tn?1273792789
Supermum: I'm sorry your GP is so dense. Because your bloodwork is fine, you must be healthy??? As if everything that could go wrong shows up in the blood? And even if she doesn't know what's causing your problems, she should be trying to find out and have the compassion to try to help with your symptoms in the meantime.

Yeah, it is like my leg kicks out straight as you describe, but it's pretty brief. More like ten seconds or so, not minutes. And it isn't particular painful.

Jen: Thanks for the rule of thumb. I think my problem is that my spasticity doesn't seem to feel like much of anything. I do sometimes get a sore muscle feeling in my thighs and my muscles do cramp occasionally, which they never used to do, but mostly it's just the durn paresthesias. Even when I definitely was stiff from spasticity, when the neuro noticed it and said he thought I should try baclofen, I think its main manifestation was that I walked like a drunk Frankenstein. And the baclofen helped me walk better, but didn't really make my legs feel better.

sho
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