Post-Polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. PPS is characterized by a further weakening of muscles that were previously affected by the polio infection. This condition primarily involves new muscle weakness, fatigue, and pain, however, it can also involve other symptoms such as sleep apnea, difficulty swallowing, and intolerance to cold temperatures. It’s important to note that PPS is not a reactivation of the polio virus – instead, it’s the result of the gradual deterioration of nerve cells that were damaged by the polio virus. The exact cause of post-polio syndrome is unknown but it is not contagious. The treatment primarily aims at managing the symptoms and includes physical therapy, use of assistive devices, and lifestyle changes.

Post-polio syndrome

Causes of Post-polio syndrome

Post-polio syndrome (PPS) is a condition that can affect polio survivors years after recovery from an initial acute attack of the poliovirus. The specific causes of PPS are not well understood, but here are few theories:

1. Neuron loss: It’s believed that post-polio syndrome is connected to the degeneration of individual nerve terminals in the motor units that remained after the initial polio attack. After the poliovirus initiates, the surviving nerve cells can sprout new nerve endings to the orphaned muscle fibers and reinnervate them, thus restoring some function. However, these extra demands placed on neuron cells may overwork them, leading to their degeneration over time, which can cause the muscles that were reinnervated by these cells to weaken again.

2. Normal aging process: The natural aging process can exacerbate the physical stresses associated with post-polio syndrome. As you age, neurons naturally begin to die off. In those who had polio, their bodies already overcompensated for the loss of these neurons. The additional loss due to aging may amplify their symptoms season.

3. Inflammatory response: Some research suggests that there could be an ongoing inflammatory process, possibly triggered by the reactivation of a latent virus. This generalized inflammation can lead to muscle weakness and fatigue.

4. Immune system dysfunctions: It is also proposed that immune system dysfunctions may be involved. Changes in the body’s immune system could lead to an attack on the neurons causing fatigue and muscle weakness.

5. Overuse and disuse: Additionally, the overuse and underuse of muscles, joint deformities, and a lack of regular physical activity may contribute to the development of PPS.

Remember, the likelihood of developing PPS depends on the extent of the initial polio damage. People who had minimal symptoms from their initial polio attack are less likely to develop significant post-polio syndrome symptoms.

Risk Factors of Post-polio syndrome

Post-polio syndrome (PPS) is a condition that affects polio survivors years after they’ve recovered from their initial polio infection. The exact cause of PPS is unknown, but it’s not due to being reinfected with the polio virus. There are several risk factors that are associated with the development of PPS:

1. Age: Individuals who contracted polio at an older age appear to have a higher risk of developing post-polio syndrome.

2. Severity of initial infection: Those who experienced severe initial polio episodes, including paralysis, are said to be more likely at risk of developing PPS.

3. Recovery: People who had a significant recovery after their initial polio episode appear to be at a higher risk. This could be due to overuse or strain on muscles and nerves that were previously damaged, which may further deteriorate over time.

4. Length of time since initial infection: PPS generally occurs 15 to 40 years after the initial polio infection.

5. Physical activity: Overuse or excessive strain on the body due to physical activity or exercise can increase the risk of PPS. People living with polio are advised to maintain a balanced approach to physical activity.

6. Being female: For reasons not completely understood, post-polio syndrome appears to be more common among women.

Understanding the risk factors of PPS can be helpful when it comes to managing the condition. Anyone concerned about PPS or its symptoms should consult with a medical professional. Remember that having a risk factor or multiple risk factors doesn’t guarantee that you will get the disease. Different people have different responses and reactions to risk factors.

Signs and Symptoms of Post-polio syndrome

Post-polio syndrome (PPS) is a condition that can affect polio survivors many years after recovery from an initial acute attack of the poliomyelitis virus. The symptoms of PPS typically begin to appear about 15 to 30 years after the initial polio infection.

Here are some common signs and symptoms of post-polio syndrome:

1. Progressive muscle and joint weakness: This is often the most noticeable symptom. Polio survivors may discover they’re not as strong as they used to be, and regular physical activities become more difficult.

2. Fatigue: People with PPS often feel unusually tired, both overall and specifically in their muscles. This fatigue can come on suddenly and persist for an extended period.

3. Muscle pain and joint pain: After doing regular activities that were once easy, there may be aching or discomfort.

4. Muscle atrophy: Muscles may become smaller (which is what atrophy means), particularly in the limbs.

5. Breathing problems: Breathlessness due to weakness in the muscles that help with breathing. Some people may have sleep apnea.

6. Swallowing issues: There might be difficulties swallowing due to muscle weakness.

7. Cold intolerance: Due to poor circulation, a person may feel more sensitive to cold temperatures.

8. Reduced tolerance for activity: Activities that were once easy may become a struggle, such as walking or climbing stairs.

9. Problems with balance: Weak muscles can lead to a reduced ability to balance, leading to an increased risk of falls.

10. Weakness in both sides of the body: With some neurological disorders, the weakness is on one side, but with post-polio syndrome, both sides are generally affected.

It’s important to note that the severity of previous polio infection does not predict the severity of PPS. Even people who had a mild case of polio can develop serious PPS. It’s also important to remember that not everyone who’s had polio will develop PPS. If you’ve had polio and are experiencing these symptoms, it’s recommended you speak with your doctor or a neurologist.

Diagnosis Post-polio syndrome

Post-polio syndrome (PPS) is a disorder that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. It’s characterized by a further weakening of muscles that were previously affected by the polio infection.

The most common symptoms include progressive muscle and joint weakness and pain, general fatigue and exhaustion with minimal activity, muscle atrophy, breathing or swallowing problems, sleep-related breathing disorders, and decreased tolerance of cold temperatures.

It’s important to note that not all polio survivors will experience PPS. The exact cause of post-polio syndrome is unclear, but it seems to be related to the degeneration of nerve cells that were damaged during the original polio infection.

Diagnosis of PPS is based on clinical findings and patient history. Medical professionals usually consider a diagnosis of PPS after other possible causes have been ruled out. Also, to be diagnosed with post-polio syndrome, an individual must have experienced a period of recovery after the acute polio infection, followed by the gradual onset of progressive and persistent new muscle weakness or decreased endurance, with or without generalized fatigue, muscle atrophy, or muscle and joint pain.

Currently, there’s no cure for post-polio syndrome, but the symptoms can be managed with a combination of medications, physical therapy, occupational therapy, lifestyle modifications, and the use of assistive devices. The primary treatment is adequate rest and the conservation of energy.

Treatment of Post-polio syndrome

Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute attack of the polio virus. Its treatment approach is largely focused on managing symptoms, improving quality of life, and optimizing mobility.

Here are some treatment strategies for post-polio syndrome:

1. Physical Therapy: A tailored exercise program might improve muscle strength and function without making your symptoms worse. Gentle, non-fatiguing exercises are encouraged, as excessive activity can fatigue polio-affected muscles and accelerate the muscle weakness.

2. Occupational Therapy: Therapists can offer strategies to conserve energy, improve productivity at work, or perform daily activities more easily, such as dressing, bathing, and cooking.

3. Speech and Swallowing Therapy: Some individuals with PPS may experience difficulty speaking and swallowing. It aims to rectify this through specific techniques designed to improve function.

4. Energy Conservation: Managing energy wisely in daily life can help ease some symptoms. It’s important to get enough rest and avoid overexertion.

5. Assistive Devices: Devices such as braces, canes, walkers, wheelchairs, or powered scooters may be used to aid mobility and independence. Adaptive technologies could also be beneficial.

6. Medication: Although there’s no definitive drug treatment for PPS, some medications could be useful. Analgesics and anti-inflammatory drugs may be prescribed for those with severe muscle and joint pain. Sometimes, fatigue may be managed with drugs like modafinil.

7. Lifestyle Changes: A balanced diet, maintaining a healthy weight, and getting adequate sleep can all contribute to overall wellness and manage symptoms.

8. Psychological Counseling: This can help individuals cope with physical changes and loss of function.

9. Respiratory Therapy: Some individuals may experience respiratory problems. Non-invasive ventilation options, such as positive pressure ventilators, can help breathing.

Regular from care medical professionals experienced with PPS is crucial to properly manage the disease. Not all individuals with PPS will require all of these treatment strategies. The strategy will be individualized based on symptoms, severity, and individual needs.

Medications commonly used for Post-polio syndrome

Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute attack of the poliovirus. PPS is characterized by a further weakening of muscles that were previously affected by the polio infection.

While there’s no specific drug to treat post-polio syndrome, several types of medication have been used to help manage the symptoms. Here are some commonly used medications for post-polio syndrome:

1. Analgesics: These are used to alleviate pain that some individuals with PPS experience. Over-the-counter pain relievers like acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB) may help. For severe pain, your doctor may prescribe stronger pain relievers.

2. Antidepressants: Some practitioners prescribe low doses of tricyclic antidepressants like amitriptyline to help with the fatigue and muscle pain that some people with PPS experience.

3. Pyridostigmine (Mestinon): Some research suggests that this drug, which is used to treat muscle weakness in people with a condition called myasthenia gravis, may provide some benefit to patients with post-polio syndrome.

4. Modafinil (Provigil): This medication is used to combat fatigue in PPS patients. Modafinil has been prescribed off-label for patients with PPS who have excessive daytime sleepiness or fatigue.

5. Muscle Relaxants: These drugs, such as diazepam (Valium), baclofen, and tizanidine (Zanaflex) can be used in the management of muscle spasms or stiffness.

Please remember, it’s absolutely essential to consult with your healthcare provider before starting any medication regimen, as these medications can have varying effects and can interact with other medications you may be taking. Your healthcare provider will consider your overall health and medication history while prescribing these drugs.

Prevention of Post-polio syndrome

Post-polio syndrome (PPS) is a condition that can affect people who have had polio in the past. It typically occurs several years after the initial infection and can cause a range of symptoms, such as fatigue, joint pain, and muscle weakness or shrinkage. While it’s not possible to reverse PPS, certain measures can be taken to prevent its severity and manage its symptoms:

1. Healthy lifestyle: Regular exercise within your limits can help maintain muscle strength and function, and a balanced diet can provide necessary nutrients for overall health.

2. Mobility aids: Proper use of mobility aides such as braces, canes, or wheelchairs can prevent joint strain and overuse of your muscles.

3. Regular check-ups: Regular visits to your healthcare provider can help catch any potential complications early and improve your overall health.

4. Rest: Make sure to get plenty of rest and avoid overexerting yourself.

5. Physical Therapy: Regular physical therapy can help strengthen your muscles and improve your flexibility & mobility.

6. Healthy Weight: Maintain a healthy weight to reduce stress on your muscles and joints.

7. Avoid exposure to cold: Cold can make symptoms of post-polio syndrome worse, so try to avoid being in cold environments for long periods.

8. Vaccination: The polio vaccine doesn’t prevent post-polio syndrome, but it’s still necessary to prevent polio itself, which must occur before you can get PPS.

Post-polio syndrome

Remember, while these measures can help manage and possibly prevent the severity of PPS symptoms, they may not prevent the development of post-polio syndrome in individuals who had polio earlier in life. It is always best to consult with a healthcare professional for the best course of action.

FAQ’s about Post-polio syndrome

Post-Polio Syndrome (PPS) is a condition that affects polio survivors many years after their recovery from the initial bout of the poliovirus. Here are some commonly asked questions about PPS:

1. What is Post-Polio Syndrome (PPS)?
PPS is a condition that can affect polio survivors around 15 to 40 years after they recover from the initial viral infection. It’s characterized by weakening muscles, severe fatigue, and pain in the muscles and joints.

2. Who gets Post-Polio Syndrome?
Any person who has had polio can develop PPS. However, it’s more common among people who had severe cases of polio.

3. What are the symptoms of PPS?
Typical symptoms include fatigue, decreased muscle endurance during activities, muscle and joint pain, muscle weakness, muscle atrophy (shrinkage), swallowing or breathing problems, intolerance to cold, and difficulties with sleep, concentration, and memory.

4. What causes PPS?
The exact cause isn’t known. However, researchers suggest that it happens due to the degeneration of individual nerve terminals in the motor units that were recovered during polio infection.

5. How is PPS diagnosed?
There is no specific laboratory test for PPS. Diagnosis is typically based on medical examination, patient’s medical history, and the presence of hallmark signs and symptoms.

6. How is PPS treated?
Treatment is focused on managing symptoms and improving quality of life. This could include physical and occupational therapy, use of assistive devices, lifestyle modification, and pain management.

7. Is it progressive?
PPS can be slowly progressive, with periods of stability lasting 3 to 10 years in between. It varies greatly from person to person with some experiencing only minor symptoms, while others develop visible muscle weakness or atrophy.

8. Is PPS preventable?
Since PPS only affects individuals who have had polio, the most effective prevention method is to immunize against polio. As of now, there is no known cure or prevention for those who have already had polio.

9. Is PPS contagious?
No, PPS is not contagious.

Remember, it’s always important to seek advice from healthcare professionals if you think you may be experiencing symptoms of PPS.

Useful links

Post-Polio Syndrome (PPS) refers to a cluster of disabling symptoms that affect polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. PPS is characterized by a further weakening of muscles that were previously affected by the polio infection. The most common symptoms include slow onset muscle weakness, fatigue, and pain in joints or muscles.

Here are some useful journal links and articles discussing Post-Polio Syndrome:


Please remember that reading health articles and journals should not replace consulting a healthcare professional. If you or someone else has symptoms related to Post-Polio Syndrome, please seek medical attention.

Complications of Post-polio syndrome

Post-Polio Syndrome (PPS) is a neurological disorder that can present itself in polio survivors, typically several years after recovery from an initial bout of acute poliomyelitis. The complications associated with this syndrome can be varied and complex, including:

1. Muscle Weakness and Fatigue: The primary complication is progressive muscle weakness. Affected individuals may experience new weakness in muscles, as well as fatigue. Sometimes, the muscles thought to be affected during the initial polio infection might be affected.

2. Pain: People with PPS often complain of joint and muscle pain. This is most common in the back and legs, but it can occur anywhere.

3. Respiratory Difficulties: Polio can damage the muscles involved in breathing. As a result, people with PPS are at greater risk for respiratory infections. In severe cases, they may require breathing assistance.

4. Dysphagia (Difficulty Swallowing): If the muscles involved in swallowing are affected, this can lead to difficulty swallowing, potentially causing malnutrition or choking.

5. Sleep Apnea: This disorder, characterized by pauses in breathing during sleep, can occur if the muscles that maintain open airways are affected.

6. Musculoskeletal Deformities: Individuals can experience postural changes due to muscle weakness, which can lead to joint deformities and osteoporosis.

7. Post-Polio Fatigue: This is a generalized sense of exhaustion and decreased endurance for physical and mental work.

8. Mental Health Issues: Dealing with the changes brought by PPS can lead to emotional and psychological issues like stress, anxiety, and depression.

9. Cold Intolerance: Many people with PPS also report experiencing increased sensitivity to cold.

10. Mobility Issues: As symptom progresses, walking or moving may be affected, often requiring the use of mobility aids such as canes, crutches, or wheelchairs.

It’s crucial for every individual experiencing post-polio syndrome to follow a personalized care plan under the supervision of a medical professional. This can help manage their symptoms and improve their quality of life. Treatment for PPS often aims at managing symptoms effectively as there is currently no cure for the syndrome.

Home remedies of Post-polio syndrome

Post-polio syndrome (PPS) is a condition that can affect polio survivors decades after they’ve recovered from their initial illness. It’s characterized by progressive muscle weakness, fatigue, and a gradual decrease in the size of muscles (atrophy).

Although there’s no specific cure for PPS, several measures can be taken at home to manage its symptoms:

1. Physical Therapy: Regular, moderate, non-fatiguing exercises are crucial. They can improve muscle strength and reduce fatigue.

2. Nutrition: A balanced diet gives the body and muscles the nourishment they need to function correctly. Avoiding overweight can also ease the strain on your muscles.

3. Proper Rest: Adequate rest is essential for managing fatigue, one of PPS’s key symptoms. Nap during the day if needed and maintain a regular sleep schedule.

4. Heat and Cold Therapy: Applying heat can relax muscles, while cold can reduce inflammation.

5. Assistive Devices: Using aids like braces, canes, or wheelchairs can help to cope with the limitations caused by PPS.

6. Pain Management: Over-the-counter, non-prescription drugs can be used to help manage pain. Always consult with a healthcare provider before starting a new medication.

7. Conserving Energy: Adapt your daily activities to conserve as much energy as possible. This decreases fatigue.

8. Breathing Exercises: Some people with PPS might suffer from breathlessness. Breathing exercises can help maintain lung capacity and manage these symptoms.

9. Stress Management: Activities like yoga, meditation, or mindfulness can help in dealing with the emotional stress related to PPS.

Remember, despite these measures, it’s crucial to consult with a doctor or a specialist for professional medical advice based on your specific case and symptoms. The goal is to manage symptoms in the best possible way optimizing overall health and quality of life. PPS case management often involves a team of healthcare professionals including doctors, physiotherapists, and occupational therapists.

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Last Update: January 10, 2024