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Post-Polio Syndrome

Post-polio syndrome (PPS) is a condition that causes gradual muscle weakness and muscle atrophy (loss) that can affect people who’ve had polio. PPS usually happens 10 to 40 years after you’ve recovered from the initial polio infection.

Polio (poliomyelitis) is a disease caused by the poliovirus. It causes mild or no symptoms in most people. But it can sometimes cause paralysis or death.

There are three variations of poliovirus, called wild poliovirus types 1, 2 and 3. Wild polio types 2 and 3 have been eradicated (no longer exist), and wild polio type 1 only exists in a few parts of the world.

Who does post-polio syndrome affect?

Post-polio syndrome affects people who’ve had polio. PPS develops 10 years or more after the original illness and can occur as late as 40 years afterward.

Approximately 30% to 40% of people who’ve had polio will develop PPS. A person who was more severely affected by polio may develop a more severe case of PPS.

How common is post-polio syndrome?

Post-polio syndrome is rare because polio is rare. The polio vaccine has gotten rid of polio from the U.S. However, polio still exists in some countries, and cases of PPS still occur.

The most common first sign of post-polio syndrome is gradual new weakening in your muscles that were previously affected when you had polio.

The severity of symptoms can vary from person to person. Symptoms include:

  • Slowly progressive muscle weakness.
  • Fatigue.
  • Gradual muscle atrophy.
  • Muscle pain and twitches.
  • Joint pain.
  • Skeletal deformities such as curvature of your spine (scoliosis).

If muscles involved in breathing and swallowing are affected, you may experience difficulty with these functions.

Severe cases of PPS can resemble the symptoms of amyotrophic lateral sclerosis (ALS), but it’s not a form of that condition.

Scientists don’t yet know the cause of post-polio syndrome. One theory is that it could be due to the recovery from the initial polio infection. During recovery from polio, nerve cells (neurons) in the affected muscles may regrow many smaller branches (dendrites) from the large branches (axons) of nerve cells. These dendrites take over the function of neurons that the polio virus killed.

Scientists think that, after years of functioning beyond their capacity, the nerve cells weaken and lose their ability to maintain the dendrites. The dendrites then shrink, and the whole muscle becomes weaker.

Is post-polio syndrome contagious?

Post-polio syndrome isn’t contagious, meaning it doesn’t spread from person to person. However, the polio virus is very contagious. This is why it’s important to protect yourself with the polio vaccine.

There aren’t any specific tests that can diagnose post-polio syndrome.

Instead, healthcare providers diagnose PPS after performing a physical exam and asking questions about your medical history and symptoms. They must also rule out other conditions that could be causing your symptoms.

 

Your provider may order any of the following tests to help diagnose PPS and rule out other conditions:

  • MRI (magnetic resonance imaging) and CT (computed tomography) scans of your spinal cord.
  • Electromyogram (EMG).
  • Muscle biopsy.
  • Spinal fluid analysis.

How is post-polio syndrome treated?

There’s currently no specific treatment for post-polio syndrome (PPS). Instead, healthcare providers focus on managing symptoms and improving quality of life.

It’s important to see a healthcare provider who specializes in treating neuromuscular conditions if you have PPS.

Specific strategies that can help manage PPS symptoms include:

  • Non-fatiguing exercises: Exercises that don’t cause pain or fatigue may improve muscle strength and reduce overall fatigue.
  • Cardiorespiratory endurance training: Cardiorespiratory endurance is the level at which your heart, lungs and muscles work together when exercising for a prolonged time. You should talk to your provider before trying this type of training.
  • Mobility aids: Devices such as canes, walkers and scooters can help with mobility and help avoid rapid muscle tiring and exhaustion.
  • Occupational therapy: An occupational therapist can help you make adjustments in your home so you can perform daily tasks more easily.
  • Speech therapy: If PPS has made swallowing difficult, a speech therapist can help.
  • Lifestyle changes: Your provider will likely recommend eating a healthy diet, managing your weight, getting quality sleep and not smoking to help manage your symptoms and stay healthy.

Counseling (psychotherapy) may help you and your family adjust to life with PPS. Support groups that encourage self-help and sharing experiences can be beneficial as well.

Is post-polio syndrome curable?

At this time, there’s no cure for post-polio syndrome.

What is the prognosis of post-polio syndrome?

The prognosis (outlook) for post-polio syndrome (PPS) varies depending on which muscles are affected and the severity of symptoms.

The symptoms of PPS can significantly interfere with your ability to function independently, but mobility aids and occupational therapy can help with this.

Your overall health is more at risk if PPS causes respiratory muscle weakness and/or weakness in the muscles you use to swallow.

What is the life expectancy of post-polio syndrome?

In most cases, the life expectancy for post-polio syndrome is good. PPS is rarely life-threatening.

How can I prevent post-polio syndrome?

The only way to prevent PPS is to prevent getting polio. The only way to do this is to get the polio vaccine. The U.S. Centers for Disease Control and Prevention (CDC) recommends that children get four doses total of the polio vaccine beginning at the age of 2 months. If you didn’t receive the polio vaccine as a child, you can still get it as an adult.

If you’ve had polio, there’s nothing you can do to prevent developing post-polio syndrome. Scientists aren’t sure why some polio survivors develop PPS and others don’t.

When should I see my healthcare provider about post-polio syndrome?

If you’ve had polio and notice new gradual muscle weakness many years later, talk to a healthcare provider.

If you’ve been diagnosed with PPS, you’ll need to see your provider regularly to make sure your treatment plan is working for you.

  • MedlinePlus. Polio and Post-Polio Syndrome (https://medlineplus.gov/polioandpostpoliosyndrome.html). Accessed 1/8/2023.
  • National Institute of Neurological Disorders and Stroke. Post-Polio Syndrome Fact Sheet (https://www.ninds.nih.gov/post-polio-syndrome-fact-sheet). Accessed 1/8/2023.
  • National Organization for Rare Disorders (NORD). Post Polio Syndrome (https://rarediseases.org/rare-diseases/post-polio-syndrome/). Accessed 1/8/2023.
  • Wolbert JG, Higginbotham K. Poliomyelitis (https://www.ncbi.nlm.nih.gov/books/NBK558944/). [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Accessed 1/8/2023.

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