Postpolio Syndrome

Postpolio syndrome is a condition that develops 15 years or longer after recovery from polio. Symptoms include muscle weakness, pain, and fatigue. Postpolio syndrome is not as dangerous as polio, but it can be severe enough to affect your quality of life. There is no way to prevent it from developing.

What are the causes?

The cause of this condition is not known. It may be caused by brain damage from a viral infection or overworked nerve cells in the brain and spinal cord.

What increases the risk?

You are more likely to develop this condition if you had severe polio or if you are a woman who had polio.

What are the signs or symptoms?

Signs and symptoms of postpolio syndrome can start 15 years or longer after recovery from polio. Symptoms start gradually and can vary greatly from person to person. They may include:

• Weakness in muscles, especially those that were previously affected by polio.
• Difficulty with:
  • Walking.
  • Breathing.
  • Swallowing.
  • Standing up straight.
• Fatigue.
• Muscle aches.
• Joint pain.
• Shrinking of muscles (atrophy).
• Loud snoring and short periods of interrupted breathing at night (sleep apnea).
• Difficulty tolerating cold.

How is this diagnosed?

This condition is diagnosed based on your medical history and a physical exam. You may be diagnosed with postpolio syndrome if:

• You had partial or complete recovery from polio 15 or more years ago.
• You have new symptoms of muscle weakness or fatigue that gradually get worse and do not go away.
• You have symptoms of postpolio syndrome for at least one year.
• You have no other explanations for your symptoms.

Tests may be done to rule out other problems that could be causing your symptoms. These tests may include:

• CT scans.
• MRI scans.
• Removal of a sample of muscle tissue (biopsy) to be examined under a microscope.
• Removal of a sample of spinal fluid to be examined under a microscope (lumbar puncture).

How is this treated?

There is no cure for this condition, but treatment can help to manage your symptoms and strengthen your muscles without wearing them out. Treatment may include:

• Avoiding activities that cause severe muscle fatigue. This includes activities that cause muscle pain or fatigue that lasts longer than 10 minutes.
• Using devices to help you move around (mobility aids), such as walkers, canes, or scooters.
• Using ventilation equipment to help with breathing problems.
• Moderate-intensity exercise, such as swimming.
• Taking anti-inflammatory medicines, such as aspirin, to help with pain.
• Working with a team of rehabilitation therapists. This can include:
  • A physical therapist, who can help you develop and maintain the right exercise routine.
  • A speech therapist, who can help you with swallowing problems.
  • An occupational therapist, who can help to adjust your home environment to make activities easier for you.

Follow these instructions at home:

Activity

• Pace yourself to save energy during the day.
  • Break down big tasks into smaller tasks.
  • Rest between tasks.
  • Use mobility aids to save energy.
• Exercise as directed by your health care provider or rehabilitation therapists.
  • Exercise enough to strengthen your muscles but not to tire them.
  • Do not do any types of exercise that cause weakness, fatigue, or aching. This includes activities that cause muscle pain or fatigue that lasts longer than 10 minutes.

Lifestyle

• Eat a healthy diet that includes plenty of vegetables, fruits, and whole grains.
• Maintain a healthy weight. If you are overweight, ask your health care provider to help you with a weight loss program.
• Get plenty of rest. Aim for 7–9 hours of sleep every night.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

• Work closely with your health care providers and rehabilitation therapists. If you are struggling at home, ask your health care provider about services that may be available to help you.
• Take over-the-counter and prescription medicines only as told by your health care provider. Make sure you know what side effects to watch for and when to call your health care provider.
• Have a good support system at home. Ask friends and family to help you with everyday tasks.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You develop new symptoms.
• Your symptoms get worse.
• You are coughing and choking during or after meals.
• You need more support at home.

Get help right away if:

• You can no longer care for yourself safely at home.
• You are having trouble breathing.
• You are unable to swallow.
• You have chest pain.

Summary

• Postpolio syndrome is a condition that develops 15 years or longer after recovery from polio. It is not as dangerous as polio, but it can be severe enough to interfere with your quality of life.
• You are more likely to develop this condition if you had severe polio or if you are a woman who had polio.
• There is no cure for this condition, but treatment can help manage your symptoms and strengthen your muscles without wearing them out.
• Work closely with your health care providers and rehabilitation therapists. If you are struggling at home, ask your health care provider about services that may be available to help you.
• You should not do activities that cause muscle pain or fatigue that lasts more than 10 minutes. Your health care provider will work with you to use exercises, techniques, and mobility aids (such as a walker, cane, or scooter) to avoid muscle fatigue.