Muscle twitching, or fasciculations, are involuntary contractions of small muscle fibers that can occur in various neurological conditions, including multiple sclerosis (MS). While generally harmless, these twitches can be frequent and disruptive for some individuals with MS. They are often linked to demyelination, nerve misfiring, muscle fatigue, or medication side effects.

Fasciculations in MS differ from spasticity or tremors—they are typically brief, localized, and painless but may become bothersome when persistent. Understanding why they occur and how to manage them can help improve comfort and minimize their impact on daily life.

Why Does MS Cause Muscle Twitching?

Muscle twitches in MS are caused by nerve misfiring due to damage from the disease. Here’s why it happens:

🔹 Nerve Misfiring & Demyelination – MS damages myelin, the protective sheath around nerves. This can cause erratic nerve signaling, leading to involuntary muscle contractions.

🔹 Overactive Reflexes – As the nervous system tries to compensate for weakened nerve connections, it can lead to increased muscle excitability.

🔹 Muscle Fatigue & Weakness – Weak muscles are more likely to twitch as they recover from exertion, especially after activity.

🔹 Medication Side Effects – Some MS treatments, such as disease-modifying therapies, steroids, or muscle relaxants, may increase muscle excitability and lead to twitching.

How to Reduce Muscle Twitching

Although muscle twitches are often benign, several strategies can help reduce their frequency:

✔ Stay Hydrated & Balance Electrolytes – Low magnesium, potassium, or calcium can make twitching worse. Drinking enough water and maintaining a balanced diet with these nutrients may help.

✔ Stretch & Move Regularly – Gentle stretching and movement help prevent muscle fatigue and tightness, reducing the likelihood of twitching.

✔ Manage Stress & Fatigue – Poor sleep, anxiety, and stress can increase nerve excitability, worsening twitching. Relaxation techniques such as breathing exercises, meditation, or gentle yoga may be beneficial.

✔ Warm Compress or Massage – Applying a warm compress or massaging the affected area can improve circulation and relax the muscle, helping to stop twitching.

✔ Check Medications – Some medications can exacerbate muscle excitability. If twitching is frequent or bothersome, consult your doctor to see if any medications need adjusting.

When to Seek Medical Advice

🚩 If twitching becomes painful or frequent

🚩 If accompanied by muscle weakness, stiffness, or spasticity

🚩 If it significantly affects daily activities

Most muscle twitches in MS are harmless, but persistent or worsening fasciculations may indicate underlying nerve irritation or progression. Keeping hydrated, active, and stress levels low can help manage symptoms. If twitching persists, discussing it with a neurologist can help identify potential treatment options.

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