Spasms, cramping, and tightness in the legs are some of the most common and disruptive symptoms of multiple sclerosis (MS). These sensations can range from mildly annoying to downright painful, and finding relief can feel impossible. But why does MS cause muscle spasms in legs? Today, that’s exactly what I want to talk about.
By the way, have we met? I’m Dr. Gretchen Hawley, a physical therapist and MS-certified specialist. I created The MSing Link, a program and book for people with MS to improve mobility, strength, and balance through exercises and strategies that fit into your daily life.
In this guide, I’ll walk you through why MS causes muscle spasms in the legs and what you can do about it. Just because it’s a common symptom in MS, that doesn’t mean it has to be something you just put up with. The more you understand what’s behind your symptoms, the more empowered you’ll feel to manage them.
I hear people use the terms “spasm,” “cramp,” and “spasticity” interchangeably all the time—but they’re actually pretty different. Knowing what’s what can make a big difference in figuring out how to stretch, treat, or manage what you’re feeling. Here’s a closer look:
While spasms and cramps come from the muscle itself, MS spasticity is a neurological issue. When you’re living with MS, your leg muscles—especially the hamstrings, calves, and hip flexors—are often the first to be affected.
Multiple sclerosis interferes with the way your brain and spinal cord communicate with your body. That disruption can lead to muscle stiffness, tightness, and difficulty relaxing your muscles after they contract. In other words, your muscles are getting mixed messages from your nervous system.
MS-related muscle spasms in the legs can look like:
As an MS-specialized physical therapist, I use something called the Modified Ashworth Scale to get a better sense of how tight or stiff a muscle really is. It ranges from 0 (no tightness at all) to 4 (complete rigidity). Most of my clients with MS fall somewhere between a 1 and a 3, which means there's some tightness, but movement is usually still possible with the right strategies.
Now that we’ve covered why MS can cause muscle spasms in your legs, let’s talk about what you can do to manage it. These are the same strategies I recommend to members inside The MSing Link. When practiced consistently, they can make a big difference in how you feel.
Whether you’re dealing with occasional cramping or more frequent spasticity, these strategies can help reduce discomfort and improve your mobility over time. Here are 5 tips for relieving and preventing MS-related muscle spasms in legs:
Daily stretching is one of the most effective ways to reduce leg spasms—but only if you’re doing it right. I’ve had clients tell me they were stretching every day with no results, only to find out they were stretching the wrong muscle group or holding each stretch for just a few seconds.
If your calf muscles feel tight, try calf stretches. If your hamstrings feel tight, do some hamstring stretches. You get the point! Focus on the muscles that feel tight and follow this routine:
Longer, passive stretches (especially when supported by props or a partner) can be even more effective for MS spasticity. Go slow, listen to your body, and watch how it responds over time.
Dehydration is one of the most common causes of muscle cramps and spasms. Many people with MS intentionally limit water intake to avoid bladder issues. But when you’re dehydrated, your muscles are more likely to cramp and tighten up—especially in hot weather or after activity.
A few quick hydration tips:
Staying hydrated supports better muscle function and can help reduce the frequency of MS muscle spasms, especially in the legs.
What you eat plays a bigger role in muscle function than most people realize. Nutritional deficiencies can contribute to increased muscle tone, cramps, and fatigue. Prioritize whole, nutrient-dense foods and avoid processed foods that can deplete key nutrients.
For muscle repair and strength, try to include:
If you're not sure whether you're getting enough of the nutrients your body needs, talk to your provider or dietitian about running a nutrient panel.
Movement is one of the best ways to prevent muscle stiffness and keep your body feeling more flexible. That doesn’t mean you have to run or do a full workout. Even 5 minutes of gentle movement when you have the energy can make a difference!
Try to:
Your muscles and nervous system respond best when they’re regularly asked to move, so try to be consistent. And just like with stretching, pay attention to how your body feels. If reducing tightness makes you feel less stable, you may need to focus on strength training before you work on releasing tension.
There are so many tools out there that can help reduce tightness, calm spasms, and support muscle relaxation. The key is finding what works for you. Some people respond well to topical creams, others to massage or medication.
I personally love using a Theragun to release tension in tight or spastic muscles, usually for about 3 minutes per muscle group. It’s a great way to ease discomfort, especially when used on a regular basis.
Many people with MS-related muscle spasms find relief using:
My advice? Try one thing at a time and give it at least two weeks before you decide if it’s helping. Everyone responds differently, so just try to find what works best for you.
If you’ve tried multiple strategies to relieve the muscle spasms in your legs and still feel stuck, there are more advanced options you can explore:
These options are typically considered for more severe cases of spasticity, but they can make a meaningful difference for some people with MS.
Muscle spasms, cramps, and tightness are all common in MS, but that doesn’t mean you have to suffer through them without support. By using these tips for relief and prevention, it’s absolutely possible to reduce the discomfort and reclaim more freedom in your day-to-day life.
If you’re ready to take the next step, I’d love to invite you to join my free 5-day MS Strength Challenge. In just a few minutes a day, you’ll learn how to exercise effectively with MS—including how many reps to do, how long to move, and which MS-specific exercises actually create lasting results. Sign up today to start building strength that lasts.
Have questions about MS muscle spasms or figuring out which stretches are right for you? Feel free to reach out on Instagram @doctor.gretchen. I’m always here to help!
In this guide, I’ll walk you through why MS causes muscle spasms in the legs and what you can do about it. Just because it’s a common symptom in MS, that doesn’t mean it has to be something you just put up with. The more you understand what’s behind your symptoms, the more empowered you’ll feel to manage them.
Dr. Gretchen Hawley's The MSing Link offers a comprehensive guide to taking control of your MS symptoms and improving your mobility through MS-specific exercises and strategies.
6000+ copies sold in over 13 countries!
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As a physical therapist & Multiple Sclerosis Certified Specialist, I have spent the last 10 years teaching people with MS how to feel more confident & empowered through MS-specific exercises and strategies.
If you want support and encouragement, plus a healthy dose of tough love, come follow me on Instagram (@doctor.gretchen) or on YouTube @DoctorGretchenHawley. It's where I share daily tips, tricks, and information about new offers — plus, you’re bound to feel more empowered, hopeful, & motivated after watching each post and video!
Questions? Email me at Hello@DoctorGretchenHawley.com