Dr Mailis-Gagnon Answers your questions on Neuropathic Pain

To stretch the muscle, straighten your leg and pull your toes upward toward the leg. You might also get some relief from a warm bath or shower, or conversely, from applying ice and massaging the leg. In the past, quinine was used to treat leg cramps that happened often or were severely painful. Quinine medications are currently available by prescription only due to adverse side effects. Vitamin E supplements or muscle relaxants might also be suggested.

One of the readers offered his experience that TUMS which prevent night leg cramps. If this is true, I suspect it may be due to additional calcium that the tablets contain that may influence electrolyte imbalance.

Q-Can you discuss post-polio syndrome?

A-This information is retrieved from the NINDS post Polio Fact Sheet. Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus (usually in middle age). PPS is characterized by new weakening in muscles that were previously affected by the polio infection and in muscles that seemingly were unaffected. Symptoms include very slowly progressive muscle weakness, fatigue (both generalized and muscular), and, at times, muscle atrophy.

Pain from joint degeneration and increasing skeletal deformities such as scoliosis are common. Some patients experience only minor symptoms. While less common, others may develop visible muscle atrophy, or wasting. PPS is rarely life-threatening. However, untreated respiratory muscle weakness can result in some respiratory problems. According to estimates by the National Center for Health Statistics, more than 440,000 polio survivors in the USA may be at risk for PPS. A similar figure for Canada can be 4,500 people. Researchers estimate that the condition affects 25 -60% of these survivors.

PPS may be difficult to diagnose in some people because other medical conditions can complicate the evaluation. Polio survivors with PPS symptoms need to visit a physician trained in neuromuscular disorders to clearly establish causes for declining strength and to assess progression of weakness not explained by other health problems. It is important to remember that polio survivors may acquire other illnesses and should always have regular check-ups and preventive diagnostic tests, such as mammograms, pap smears, and colorectal exams.

There are currently no effective pharmaceutical or specific treatments for the syndrome itself. However, a number of controlled studies have demonstrated that nonfatiguing exercises can improve muscle strength. Different medications have been tried in research trials but have not been found to work. Preliminary studies indicate that intravenous immunoglobin may reduce pain, increase quality of life, and improve strength, but research into its use is ongoing. Although there is no cure, there are recommended management strategies such as: Seek medical advice from a physician experienced in treating neuromuscular disorders. Do not attribute all signs and symptoms to prior polio.

Use judicious exercise, preferably under the supervision of an experienced professional. Use recommended mobility aids, ventilatory equipment, and revised activities of daily living. Avoid activities that cause pain or fatigue that lasts more than 10 minutes. Pace daily activities to avoid rapid muscle tiring and total body exhaustion. Learning about PPS is important for polio survivors and their families. Management of PPS can involve lifestyle changes. Support groups that encourage self-help, group participation, and positive action can be helpful. For some, individual or family counseling may be needed to adjust to the late effects of poliomyelitis, because experiencing new symptoms and using assistive devices may bring back distressing memories of the original illness.