Your spinal cord is an intricate pathway that connects millions of nerves from all over your body. They bundle together to form a tubelike structure that extends from your brain stem to the tips of your fingers and toes. All messages between your body and brain are transmitted through the spinal cord, making it one of the most important structures in our bodies. However, trauma, injury, and disease can create disruptions in communication and therefore, affect mobility and other bodily functions. Spinal cord disorders are a classification of conditions that can cause various levels of damage and deterioration. For more information on one type of spinal cord disorder, we’ll cover everything you need to know about post-polio syndrome.
What is Post-Polio Syndrome?
Polio is a virus that affects the nervous system. It’s considered a spinal cord disorder and leads to progressive degeneration. While it was eradicated from the U.S. in 1979, there are still about 250,000 people living with the disease. Due to the degenerative nature of polio, as many as 40% of survivors eventually get post-polio syndrome (PPS). Post-polio syndrome is a disorder that affects the nerves and muscles, causing muscle degeneration alongside chronic fatigue and pain in the joints. PPS only affects individuals who have had polio and can occur anywhere between 15 to 40 years after a diagnosis. Eventually, those affected may begin having trouble breathing, which is why it’s important to monitor the progression of the disease.
Causes of Post-Polio Syndrome
Unfortunately, aside from previously having polio, the underlying cause of PPS is unclear. Experts aren’t sure why some people develop this disorder and others don’t, but it seems to be connected with how your nerves branch out in the body. Since polio damages many motor neurons, the body tries to compensate for the shortage by sprouting new fibers and enlarging surviving units. Over time, this added stress on the motor neurons can lead to shortages and eventually, deterioration of nerve terminals. Another theory involves the idea that a latent polio virus becomes reactivated, and signals get confused, causing the immune system to attack the body’s nerves. More research is currently being conducted to better understand these causes.
Risk Factors for PPS
While the cause is unclear, there are certain factors that may increase your risk of developing post-polio syndrome. One of the biggest risk factors is the severity of your polio. Severe infections are correlated with higher rates of PPS. Polio infections that occur during adulthood, as opposed to childhood, seem to increase your risk alongside excessive physical activity. Finally, individuals who had a stronger recovery after polio seem to be at a higher risk, as the process of overcoming the virus may put excessive strain on your motor neurons and lead to burn-out. If you’re a polio survivor and are worried about your risk factors, talk to your doctor.
Signs and Symptoms of Post-Polio Syndrome
The early signs and symptoms of post-polio syndrome tend to affect the same muscles that were originally affected by the polio virus. These muscles may slowly become weakened, but onset can also occur quickly. Muscle weakness is often accompanied by fatigue, muscle atrophy, joint pain, scoliosis, and a loss of total muscle function. Symptoms tend to be more severe in individuals who had acute infections or those who had a greater recovery. Eventually post-polio syndrome may create breathing problems, sleeping disorders, and greatly interfere with basic day-to-day activities.
Related Disorders
Other spinal cord disorders may possess similar symptoms to post-polio syndrome, which is why getting a proper diagnosis is important. Amyotrophic lateral sclerosis (ALS) also affects motor neurons and causes progressive degeneration of nerve cells. This eventually causes death of the nerve cells in the brain, brainstem, and spinal cord, causing communication between your brain and body to stop. Multiple sclerosis (MS) similarly affects nerve cells and can lead to a wide range of varying neurological symptoms.
Post-Polio Syndrome Diagnosis
The primary diagnostic tool for post-polio syndrome is the evaluation of your medical history, a physical exam, and certain tests to rule out other disorders. There is no specific test designed for PPS. Instead, physicians consider previous polio diagnoses, muscle atrophy, and recovery from polio. An electromyography (EMG) may be used to determine motor neuron loss alongside imaging tests of the spinal cord and muscle biopsies. To rule out other disorders, a spinal fluid analysis may be done in addition to further electrophysiological studies and blood tests. Your doctor will work with you to determine all possibilities and if nothing else is found to be causing your symptoms, you will likely be diagnosed with post-polio syndrome. The biggest indication of PPS is previous polio infections, as individuals who have not had polio cannot develop post-polio syndrome.
To prepare for your doctor’s appointment, discuss any tests or procedures that will be performed ahead of time. Some of the diagnostic testing requires you to fast, while others may provide results that are difficult to process.
Treatment for Post-Polio Syndrome
Once post-polio syndrome is diagnosed, it is a lifelong condition. While there are supportive treatment options that can help you manage your symptoms and associated pain, there is no cure for PPS. Instead, treatments are focused on improving your overall quality of life and trying to slow the degeneration process as much as possible. One of the best ways to do this is to try to save your strength and avoid overexerting your muscles. This can help avoid expediting further death of motor neurons. There are also low-intensity exercises that you should perform with a professional therapist to help improve muscle strength. These exercises are considered non-fatiguing and should only be performed in brief cycles—10 minutes at most. If you feel exerted any time during these exercises, stop to rest or discontinue therapy for the day. To improve muscle elasticity while exercising, a warm environment is best. Always discuss your treatment plan with a neuromuscular disorder specialist. If you have any questions or concerns, don’t hesitate to contact your doctor.
Some other treatment options for individuals with post-polio syndrome include using assistive devices for walking. Things such as canes, scooters, wheelchairs, braces, and walkers can help you reduce the amount of stress placed on your muscles, thus slowing down degeneration. Try a few options to see what works best for you. Those suffering from pain should also consult with their doctors about medication use. As mobility declines, your doctor will work with you to practice alternative ways of performing daily tasks. This will help you adapt to your condition as it progresses. If you have any trouble swallowing or breathing, your doctor may recommend speech-therapy or assisted breathing machines. Prioritize your sleeping schedule to give your muscles time to rest and recover and reach out to mental health professionals if you’re struggling. Counseling is a great way to help individuals diagnosed with PPS adjust to ongoing effects of this disease.
Long-Term Outlook of PPS
Your post-polio syndrome care team will include a variety of specialists and therapists to give you the best outcome for your condition. Unfortunately, symptoms may eventually require assistive breathing machines and lead to complete immobility. Bringing a loved one to your doctor’s appointments can help you best prepare for these life-altering changes.
Spinal cord disorders vary in severity, but if you’ve been diagnosed with post-polio syndrome it’s important to discuss all of your options for management with your doctor. While there are no current treatments available to stop degeneration of PPS, supervised exercises may help improve muscle strength. Finding counseling will help you adjust to changes and encourage a more positive mindset. Maintaining a healthy lifestyle is also essential to your overall health and wellness.
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