Polio - Symptoms of post-polio syndrome

Post-polio syndrome (PPS) can cause a wide range of symptoms that can have a serious effect on everyday life.

Common symptoms of PPS

Fatigue

Fatigue is the most common symptom of PPS. It can take many forms in people with the condition, including:

• muscle fatigue – where your muscles feel very tired and heavy, particularly after physical activity
• general fatigue – where you feel an overwhelming sense of physical exhaustion, as if you have not slept for days
• mental fatigue – where you find it increasingly difficult to concentrate, have problems remembering things and make mistakes that you would not usually make

The fatigue experienced by people with PPS is usually worse in the early afternoon and improves with rest or brief naps.

Muscle weakness

Increasing muscle weakness is another common symptom of PPS. It can be easy to confuse muscle weakness with muscle fatigue, but they are different.

Muscle weakness means that you are increasingly unable to use affected muscles, whether you feel fatigued or not. Weakness can occur in muscles that were previously affected by an active polio infection, as well as in muscles that were not previously affected.

There may also be associated shrinking of affected muscles, known as atrophy.

Muscle and joint pain

Muscle and joint pain are also common in PPS. Muscle pain is usually felt as a deep ache in the muscles or muscle cramps and spasms.

The pain is often worse after you have used the affected muscles. It can be particularly troublesome during the evening after a day's activities.

Joint pain is similar to arthritis and consists of soreness, stiffness and a reduced range of movement.

Associated symptoms

As well as the common symptoms of PPS, several associated symptoms can arise from the combination of fatigue, muscle weakness and muscle and joint pain.

Weight gain

Because of the common symptoms mentioned above, most people with PPS become less physically active than they used to be.

This can often lead to weight gain and, in some cases, obesity. This in turn can make any fatigue, muscle weakness and pain worse.

Walking difficulties

As well as weight gain, the combination of fatigue, weakness and pain can lead to walking difficulties and increasing difficulty with mobility.

Many people with PPS will require a walking aid such as crutches or a cane at some stage, and some people may eventually need to use a wheelchair.

Sleep apnoea

Sleep apnoea affects many people with PPS. It is a condition in which the muscles in your throat relax during sleep, which can lead to problems sleeping.

Once the muscles relax, the airway in your throat can narrow or become totally blocked. This interrupts the oxygen supply to your body, which triggers your brain to pull you out of deep sleep so that your airway can be reopened and you can breathe normally.

Swallowing problems

Weakness in the muscles you use for chewing and swallowing may lead to problems swallowing (dysphagia), such as choking or gagging when you try to swallow.

You may experience changes in your voice and speech, such as hoarseness, low volume or a nasal-sounding voice, particularly after you have been speaking for a while or when you are tired. 

Swallowing problems are usually mild and progress very slowly. A speech and language therapist may be able to help.

Sensitivity to cold

Some people with PPS find that they become very sensitive to cold temperatures or a sudden drop in temperature as a result of poor blood supply.

Because of this intolerance to cold, people with PPS may need to wear extra layers of clothing to try to stay comfortable.