ABSTRACT
Multiple Sclerosis (MS) occurs as a result of genetic predisposition allied to environmental factors. Disease-modifying treatments for MS have so far been disappointing in relation to prevention of accumulation of disability, with clinical trial outcomes having been centred around relapse reduction. Spasticity is one of the commonest symptoms experienced by people affected by MS, occurring in up to 80% of patients at some stage of the disease, with approximately 50% of those affected having troublesome symptoms of pain and discomfort. The management of spasticity in MS requires a good understanding of the nature and natural history of the disease within an experienced multi-disciplinary team setting. Almost one-third of those with MS take no medications for their spasticity and rely on non-pharmacological methods of management. Differentiating between severe spasticity and fixed contractures may sometimes be difficult and regional anaesthetic blocks can be helpful in differential diagnosis and may prevent inappropriate treatment.
