What Is Post-Polio Syndrome?

Medically Reviewed by Dan Brennan, MD on February 15, 2024
Written by Cheryl Whitten
3 min read

Post-polio syndrome only affects polio survivors, but it’s not clear why it happens. 

Post-polio syndrome, or PPS, is a non-contagious disorder that affects your nerves and muscles. It happens to polio survivors years after a polio infection, sometimes as much as 30 to 40 years later.

Polio is a contagious disease stemming from the poliovirus. Polio causes include contact with infected stool, coughed or sneezed droplets, and contaminated food and water. The virus affects your nervous system and causes headache, flu symptoms, stiff neck and back, and paralysis. 

The polio vaccine prevents polio and has wiped out the disease in most countries around the world.  

There are some theories about post-polio syndrome causes, but the exact cause is unknown. 

The polio virus attacks nerve cells called motor neurons in your spinal cord and brainstem. These cells carry information from your brain to your muscles and tell them to move. Poliovirus destroys some of these cells, but the nerves that survive are enlarged and make new nerve fibers, so most people can recover and regain movement.  

It’s thought that these recovered nerves and fibers get overworked with the stress of years of movement, and they break down over time. It might also happen because your immune system attacks your own tissues, but researchers aren’t exactly sure. 

Eventually, you lose muscle strength and can have periods of stability mixed with periods of worsening weakness. 

PPS affects your nerves and muscles, usually in the same area that was originally affected. The main symptom is weak muscles, but the severity can vary. Some people only have minor symptoms, while others have severe muscle weakness and shrinking. 

Other post-polio syndrome symptoms include:

If you had bulbar polio, which affects nerves that lead to your chewing and swallowing muscles, you can have trouble with these again when experiencing post-polio syndrome. Symptoms include:

Sometimes, your breathing muscles can also become weak, which can cause breathing problems. You might have trouble coughing or taking deep breaths, which can cause mucus and fluid buildup. 

It’s not clear how many polio survivors have or might have PPS. Some factors might raise your risk and include:

  • Age you first had polio. If you had polio as a child, you’re less likely to get PPS than someone who had it as a teenager or adult.
  • Seriousness of polio infection. If you have had severe polio, you are more likely to get PPS.
  • Major recovery. A major recovery from polio might lead to PPS, likely because of greater stress on your recovered nerves.
  • Lots of exercise. Since stressed nerves are thought to cause PPS, intense training might raise your risk.

There is no cure for PPS, but treatment can improve your symptoms. PPS can greatly interfere with your life, so the goal is to find ways to improve your daily life. 

Exercise is a key treatment, as it can build muscle strength and slow down muscle weakness. Low-intensity exercise that won’t tire your muscles like swimming or water aerobics is best, but a physical therapist can help you find the right exercises. 

Overusing your muscles causes tiredness, pain, and weakness, and it’s common to feel worse after activity. You’ll need to pace yourself, take regular breaks, and rest during the day.

Other post-polio syndrome treatments include:

  • Pain relievers
  • Anti-inflammatories
  • Prescription pain medications
  • Epilepsy medication for nerve pain
  • Movement aids like a cane, walker, brace, or wheelchair
  • Fatigue medications
  • Occupational therapy to learn adapted self-care and daily living skills 
  • Speech therapy for swallowing problems
  • Positive pressure breathing machine
  • Emotional and mental support

Lifestyle adjustments can also help you stay healthy and manage your symptoms. You can:

In most cases, post-polio syndrome life expectancy is good. PPS is rarely life-threatening, though symptoms can vary from mild to severe. If you have PPS, talk to your doctor about how to manage your condition.