Post-Polio Syndrome

What is Post-Polio Syndrome?

Affecting polio survivors, Post-Polio Syndrome (PPS) is a return of muscle weakness that affects a different set of muscles than those originally affected by polio (poliomyelitis). PPS may develop several years or decades after the initial infection. Often characterized by periods of improvement and decline, PPS isn’t contagious and isn’t a relapse of polio.

Who Gets PPS?

Post-polio syndrome is limited to polio survivors, of which there are more than 400,000 in the U.S. alone; all of whom are statistically at risk to develop PPS at some point. Progressive muscle weakness is the most common sign of PPS. The condition may reach a point where it affects supporting joints and increases the risk of experiencing skeletal deformities.

What are the Symptoms of Post-Polio Syndrome?

  • Fatigue
  • Muscle atrophy (reduction in muscle size)
  • Related pain from joint degeneration
  • Respiratory muscle weakness

Post-Polio Syndrome Causes

No one knows for sure what causes post-polio syndrome to occur. There are several theories as to what the cause could be, though. One theory is that it happens because of degeneration in individual nerve terminals after a person has been infected with polio. A second theory is that post-polio syndrome is just the polio virus reactivating. A third theory suggests the cause could be another virus infecting the neurons that survived polio. The fourth theory is that post-polio syndrome is caused by the normal stress of aging and weight gain on a polio survivor’s body.

There are a few risk factors for polio survivors. These factors include:

  • The severity of the initial polio infection
  • The age the person was at the time they caught polio
  • How much damage the polio infection did and how much work it took to recover
  • How often a survivor exercises to the point of exhausting themselves

Post-polio syndrome is more likely to affect female polio survivors than male. It is most likely to occur somewhere between 30 and 35 years after the initial polio infection.

How is Post-Polio Syndrome Treated?

Possibly related to subsequent stress placed on motor units created by nerve cells or nerve terminals since the initial polio infection, PPS has no clear cause. Since symptoms vary, doctors look for signs of new muscle weakness and exclude other possible neurological and musculoskeletal issues to make a diagnosis. There is no definitive treatment for PPS, although exercise and dietary changes may help ease symptoms and reduce muscle weakness.

Management of symptoms may involve:

  • Mobility aids to prevent falls
  • Adjusting daily activities accordingly
  • Minimizing muscle strain
  • Counseling to deal with emotional stress and anxiety

There is nothing that will absolutely guarantee a polio survivor will not get post-polio syndrome. Maintaining a healthy lifestyle, getting regular and productive sleep, and adopting a regular exercise routine tailored to specific muscle groups and level of comfort (cardiopulmonary endurance exercises tend to be more effective) may help manage some of the symptoms. It’s estimated that anywhere from 25 to 50 percent of polio survivors may experience PPS.

Post-Polio Syndrome Prevention

Because no one knows what causes post-polio syndrome to occur, there is no way to prevent it for the time being. Doctors are more focused on management strategies after the onset of polio as a means of minimizing the effects of post-polio syndrome when it does occur.

Polio survivors should discuss strategies for managing their condition with a doctor familiar with neuromuscular disorders. Recommended management strategies for post-polio syndrome include, but are not limited to:

  • Exercises targeting muscle groups that were less affected by polio and supervised by medical professionals
  • Pacing daily activities so muscles do not tire rapidly
  • Getting enough sleep every night
  • Avoiding smoking
  • Using assistive devices properly
  • Taking prescribed anti-inflammatory medications