Post-polio syndrome is a condition that affects approximately 25–40% of people who have previously survived the virus Polio. Typically the symptoms appear 15–30 years after recovery from the original paralytic attack. Symptoms include muscle weakness, muscle and joint pain and fatigue. The same symptoms may also occur years after a nonparalytic polio (NPP) infection.

PPS is similar to chronic fatigue syndrome, but unlike that disorder, it tends to be progressive, and can cause loss of muscle strength. Treatment is primarily limited to adequate rest, conservation of available energy, and supportive measures, such as leg braces and energy-saving devices such as powered wheelchairs, analgesia (pain relief) and sleep aids.

Prognosis - The symptoms of post-polio syndrome are slowly progressive, with periods of stability lasting 3-10 years. According to Dr Richard Bruno from The Post-Polio Institute  life expectancy is not affected by Post-Polio Syndrome.

 
 

As mentioned above the symptoms of PPS are muscle weakness, muscle and joint pain and fatigue. There are currently no effective medical treatments that can stop deterioration or reverse the effects caused by the syndrome so it is a case of managing symptoms and improving quality of the patient's life. Patients should consider seeking medical advice from a physician experienced in treating neuromuscular disorders.

Note: Always seek advice from a doctor before beginning any listed treatments. Treatments can affect everyone differently.

Managing Fatigue in Post Polio Syndrome

Medical Treatments

Professional Support:

Working with a trained practitioner can assist you to develop skills to calm anxiety and can also equip you with knowledge to find your next steps towards wellness. Please ensure that you find a practitioner who understands how to navigate the territory of complex chronic health conditions.

Exercise for Post Polio Syndrome:

Overuse of muscles and joints can have negative effects such as pain, weakness and fatigue, however when monitored by an experienced doctor, exercise is safe. Exercise generally benefits the patients muscles that were least affected by Polio. Cardio endurance training is usually more effective than strengthening exercises, especially when activities are paced correctly with frequent breaks and strategies are used to conserve energy. Weights and strength training can have an adverse effect and further weaken the muscles.

Exercise prescriptions should include the specific muscle groups to be included and excluded, the type of exercise and the frequency and duration that the exercise is to be performed. Exercise should be discontinued if it has any negative effects.

Assistive Devices for Post Polio Syndrome:

Mobility aids and ventilation equipment can help to avoid muscle tiring and exhaustion.

Pacing for Post Polio Syndrome:

It is advised that patients revise daily activities to avoid rapid muscle tiring and total body exhaustion, and avoiding activities that cause pain or fatigue lasting more than 10 minutes.

Alternative Treatments

​Yoga and Tai Chi for Post Polio Syndrome:

Are ancient martial arts/exercises which involve breath control, simple meditation and specific body stances and movements. These disciplines have been used to help patients with fatigue.

Acupuncture, Acupressure and Reiki for Post Polio Syndrome:

Are treatments designed to balance a person's energy flow. Treatments typically promote a sense of well-being and relaxation. Improvements in pain and fatigue have been frequently reported.

Mindfulness for Post Polio Syndrome:

Mindfulness is a set of skills for healing, intuition, insight, calmness, focus, resilience and hope that you can develop to counter the stresses that chronic illness brings. You can literally "train your mind to promote healing. Mindfulness has a positive flow on affect into every aspect of a person’s life. More info

Post Polio Syndrome Pain Management

Medical Treatments

NSAIDs for Post Polio Syndrome:

Such as aspirin, ibuprofen and naproxen are sometimes prescribed to ease muscle pain in PPS patients.

Tricylic Antidepressants for Post Polio Syndrome:

Especially amitriptyline, can help with easing pain and decreasing fatigue.

Biomechanical Solutions for Post Polio Syndrome:

Improving posture and body mechanics to help decrease the stress on unstable or degenerating joints. A physical therapist can recommend the appropriate actions and aids to improve biomechanical alignment and reduce pain. Decreasing activity of the painful muscles during the day is the best way to manage muscle pain in PPS patients. 

Alternative Treatments

Acupuncture, Acupressure and Reiki: Environment improvements for Post Polio Syndrome:

Alternative treatments that can help to relieve pain and fatigue in PPS patients.

Hydrotherapy for Post Polio Syndrome:

May include immersion in a bath or body of water (such as the ocean or a pool), use of water jets, douches or the application of wet towels to the skin. According to secondary sources, this therapy may ease pain and muscle spasms in those affected by post-polio syndrome. Sudden or prolonged exposure to extreme temperatures in baths, wraps, saunas, or other forms of hydrotherapy should be avoided. Patients should consult their physician before starting hydrotherapy.

Hypnotherapy for Post Polio Syndrome:

Hypnosis may improve relaxation and pain relief in those affected by post-polio syndrome. Use cautiously in patients with mental illness and always consult a doctor before proceeding.

Massage for Post Polio Syndrome:

May help relive pain in PPS patients.

Mindfulness for Post Polio Syndrome:

Mindfulness is a strategy that has many health benefits including controlling pain. Mindfulness is a set of skills for healing, intuition, insight, calmness, focus, resilience and hope that you can develop to counter the stresses that chronic illness brings. You can literally "train your mind to promote healing. Mindfulness has a positive flow on affect into every aspect of a person’s life. More info

Traditional Chinese Medicine (TCM) for Post Polio Syndrome:

Chinese herbs may help to relieve pain and fatigue. Chinese herbs can be potent and may interact with other herbs, foods, or drugs. Using Chinese herbs may further complicate an existing health condition so always consult your doctor first.

 

To diagnose a patient with PPS, doctors look or 3 key indicators.

They include:

  • A previous diagnosis of polio. This may require finding old medical records or getting information from older family members for acute polio primarily occurs during childhood. The late effects of polio usually occur in patients who had severe symptoms initially and those who were adolescents or older during the initial Polio attack.

  • Long interval after recovery. The onset of PPS typically begins at least 15 years after the initial diagnosis.

  • Gradual onset. Weakness may not be noticed at first and gradually increase over time.

Your doctor may use certain tests to rule out other conditions, including:

  • Electromyography (EMG) and nerve conduction studies. to help identify and exclude conditions such as an abnormal conditions of the patients nerves (neuropathy) and muscle tissue disorders (myopathy).

  • Imaging tests such as magnetic resonance imaging (MRI) or computerized tomography (CT),  can help exclude spinal disorders.

  • Muscle biopsy tests help rule out other conditions that may be causing the weakness.

  • Blood tests. Patients with PPS usually have normal blood test results. Abnormal blood test results may indicate another underlying problem that is causing the patients symptoms.

Which medications or supportive therapies have helped your Post Polio Syndrome?

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