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MS and Walking Difficulties

By Matt Cavallo

If you have multiple sclerosis and have difficulties walking, then you are not alone. Difficulty in walking, also referred to as gait disorders, is one of the more common symptoms reported among people with MS. A 2011 study on MS and walking found that 41 percent of people living with MS had difficulties walking, with 13 percent unable to walk at least two times per week. Another interesting correlation uncovered by the study found that only 34 percent of the people living with MS that had walking difficulties were employed. One could deduce from the study that walking has a profound effect on the quality of life of those living with MS.

Difficulty in walking could be attributed to one or more of the following factors:

Weakness: Muscle weakness can result in difficulty raising the leg when attempting to walk which causes the toe to drag. When a person has foot drop, they may try to compensate by a technique called vaulting. Vaulting is when you put your weight on your strong leg and swing through your weak leg so as not to drag your toe when walking.

I found myself doing this with my recent relapse. The vaulting technique is slow and unsteady and works best on straightaways. Vaulting also was necessary for me to get in and out of my car. I had to lift my weak leg and swing it into position in the vehicle. Also, as a result of the weakness, I could not drive because of my inability to operate the gas and brake pedals safely.

Balance: Problems with balance can result in an unsteady gait swaying from side to side. This is referred to by some as the “drunk” walk. This is caused by a neurological condition called Ataxia. Ataxia is when the part of the nervous system that controls the coordination of voluntary muscles needed for things like balance, walking, picking up objects is affected. Often times those with balance problems and MS will walk with their feet more spread apart to compensate and to avoid falls.

My balance was mostly affected when I was on uneven surfaces or when I stood still. When trying to climb stairs or get over curbs, I almost fell on several occasions. As my problems with walking became more substantial, I found the only way to overcome my balance deficits was too avoid steps and use the handicap ramps on the sidewalks. This further limited my ability and desire to leave the house.

Sensory deficits: Sensory deficits result from severe numbness in the feet and can be referred to as sensory ataxia which can cause a hard stomping, heavy, delivery gait. There is a definite correlation between numbness and balance. When I had transverse myelitis, I was numb from the waist down and could not walk. When I started to learn how to walk again, I had to look at my feet to ensure they were firmly planted on the ground before making my next step. I also had to make sure that I was wearing shoes that were tied on tight. Footwear like flip-flops or slippers that don’t hold your foot snug and secure are difficult to keep on your feet. When I have numbness in the feet, my steps are slow, deliberate, and loud stomps.

Spasticity: Spasticity is caused by an inbalance of signals from the central nervous system (brain or spine) resulting in muscle tightness. This is more common in the legs and is treatable by stretching or talking to your doctor about available antispasticity medications, like baclofen. The only time I experienced spasticity was when my legs were waking up from a relapse. As the numbness was subsiding, I experienced spastic legs mostly while laying down which made it hard to get comfortable when trying to sleep.

Fatigue: Fatigue is generally reported with walking difficulties and is also the hardest thing to explain. Having just experienced a relapse that caused right-side weakness and drop-foot, impaired balance with sensory deficits and spasticity, I found that the more I tried to walk the more fatigued I became. Not only was I physically fatigued, but the concentration and mental fortitude I needed to keep walking was extremely fatiguing. The more my relapse progressed, the more I gave into the fatigue and reduced my walking to only necessary steps around the house, like to the kitchen, bathroom or bedroom.

MS and walking are difficulties are common with people living with MS. Symptoms include weakness, balance, sensory deficits, spasticity and fatigue. People who have difficulty walking become more of a fall risk making it tough to get around and affecting their quality of life.