Post-Polio Syndrome - Treatment Overview

Treatment Overview

Post-polio syndrome (PPS) is an ongoing condition. Your treatment will focus on controlling symptoms and learning new ways to stay active despite having muscle weakness. Careful exercise and proper rest are the cornerstones of successful treatment. Other aspects of treatment may include physical and occupational therapy, assistive devices such as canes or braces, medicines for pain or sleep problems, and respiratory therapy to help with breathing problems.

Initial treatment

If you have just been diagnosed with post-polio syndrome (PPS), your doctor will probably recommend that you start a program of regular exercise to increase your muscle strength and endurance. Exercise will also help you maintain a healthy weight, which reduces the stress on your joints and muscles. With your doctor's guidance, a physical therapist can design an exercise program for you and make sure that you do the exercises safely and correctly without overexerting yourself. Overexertion can make symptoms of fatigue, muscle weakness, and pain worse.

Getting adequate rest is another key component of early treatment, especially if fatigue is a problem for you. You may want to start looking for ways to adjust your daily schedule so that your routine is less stressful or tiring. If sleep problems are contributing to your fatigue, you may require further evaluation using a sleep study. Treatment for sleep problems and the type of doctor who treats them may depend on what is causing your sleep disturbances.

Your doctor may recommend that you use an assistive device such as a cane or brace if needed.

Because post-polio syndrome can weaken the muscles that help you breathe, some doctors recommend that people with PPS get an annual flu shot(What is a PDF document?) to avoid breathing problems from the flu. You might also consider getting the pneumococcal vaccine.(What is a PDF document?)

Ongoing treatment

Post-polio syndrome (PPS) can cause a wide variety of symptoms. Ongoing treatment focuses on dealing with your particular symptoms as they develop and become troublesome for you. New symptoms may arise after you've had PPS for many years. When new symptoms develop, it's important to see your doctor to make sure that they are caused by PPS rather than another medical condition.

Being aware of the effects of stress, anxiety, and depression on your symptoms is also an important part of your ongoing treatment. These problems are sometimes difficult to recognize. Talk with your doctor when existing problems get worse or new symptoms develop. Don't assume there's nothing you can do about them.

Exercise and rest

A continued program of moderate exercise and proper rest is the most important part of ongoing treatment for PPS. Staying active and conserving your energy may seem like conflicting goals, but both are needed to control your symptoms.

• Weight lifting and other strengthening exercises can help with muscle weakness and joint pain, as long they don't increase fatigue during or after exercise. Do not do strengthening exercises more often than every 2 to 3 days so that you do not overuse muscles that were damaged by polio.
• Moderate aerobic exercise may also help relieve fatigue by building enough endurance so that you can do more activity before getting tired. The goal of both strengthening and aerobic exercise is to work up to, but not beyond, a point at which you start to get tired.
• Stretching and muscle relaxation exercises may help relieve muscle pain and reduce stress.
• Regularly scheduled rest periods or naps during the day can help limit fatigue. When you can, plan activities around your need for rest periods. Make adjustments in your daily schedule so that your routine is less stressful or tiring. Have a family member or friend help with errands and household chores. Eliminate unnecessary tasks or activities that aren't a valuable use of your time and energy.

Ice, heat, and physical therapies

• Muscle pain may be treated with ice, heat, massage, or electrical stimulation. If the muscle pain is related to poor posture, correcting your posture under the guidance of a physical therapist can help.
• Joint pain may improve with ice and heat therapy.
• If you have abnormal curvature of the spine, a physical therapist can also help you with posture, body mechanics, and other back care.

Assistive devices

A variety of assistive devices can be helpful for people with PPS:

• If you have joint pain (in your knees or wrists, for instance), your health professional may prescribe a brace or splint to help hold the joint in its proper position, which may reduce pain.
• A back brace can often improve curvature of the spine (scoliosis).
• Problems doing everyday tasks because of weak arms and shoulders may be treated using arm supports and other types of splints. An occupational therapist can help with these problems.
• Leg braces, crutches, or a cane may help if you have problems walking or climbing stairs. If walking is very difficult for you, a wheelchair or powered chair may help you get around more easily.

Medicines for fatigue, pain, and sleep problems

In general, medicines have not been shown to be of great benefit in people with post-polio syndrome. But they may be helpful in relieving certain symptoms:

• Muscle and joint pain may be treated with over-the-counter pain medicines or prescription pain medicines. Nonsteroidal anti-inflammatory drugs (NSAIDs) available over-the-counter, such as aspirin and ibuprofen, are usually tried first and may provide enough relief for some people.
• Medicines can help treat abnormal movements in sleep, such as restless legs syndrome.
• There is some evidence that certain medicines may help some people with fatigue caused by PPS, but more study is needed before these drugs can be recommended routinely.

Treatments for breathing and swallowing problems

Breathing problems may be treated by a physical or respiratory therapist. A major goal is to maintain lung function and prevent pneumonia. This is done using coughing and other deep breathing exercises. The therapist may also recommend exercises to strengthen the muscles that are used in breathing. As with other exercises, people who have PPS should work up to, but not beyond, the point at which they start to get tired.

People who have PPS may need to have a test that measures the amount of oxygen in their blood to be certain they are getting enough oxygen, especially at night. Sleep apnea may be treated with supplemental oxygen therapy or continuous positive airway pressure (CPAP). For more information, see the topic Sleep Apnea.

Swallowing problems may require a swallowing test to learn how severe the problem is. A speech pathologist can give you exercises to help make swallowing easier. Changing what and how you eat may also be helpful:

• Thicker drinks make swallowing easier. Try milk shakes or juices in gelatin form.
• Avoid foods such as crackers or cakes that crumble easily. These can cause choking.
• Soft foods need less chewing. Use a blender to prepare food for easiest chewing.
• Eat frequent, small meals to avoid fatigue.

Treatment if the condition gets worse

Post-polio syndrome (PPS) usually progresses very slowly. Your symptoms may stabilize and not get worse for many years. If your condition does get worse, though, your treatment needs may change.

• If you develop breathing problems, you may require devices to deliver extra oxygen and help you breathe. In this situation, seeing a doctor who specializes in treating diseases that affect the lungs (pulmonologist) may be helpful.
• If muscle weakness and joint pain increase, you may have a greater need for assistive devices to help you with everyday activities. You may need a wheelchair if weakness in your leg muscles becomes severe.
• Severe curvature of the spine may require surgery.

It is also important to determine whether a problem other than PPS is making your symptoms worse or causing new symptoms. See your doctor whenever new symptoms occur or existing symptoms get worse to make sure that they are caused by PPS rather than another medical condition.