POST-POLIO SYMPTOMS & EFFECTS:  A BRIEF GUIDE
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        The past few years have seen a great deal of research devoted to
what are generally referred to as "the late effects of polio."  This
research continues; its pace accelerated.  The symptoms and examples
listed here are known or suspected to be associated with post-polio.
Not every one will apply to any individual.  There are many variables,
including your age, degree of disability, and how severe the polio was.
These symptoms are, however, a useful guide and beginning point for
assessing one's own life, seeking appropriate medical treatment, and
perhaps making necessary changes in lifestyle.

        Known or suspected post-polio problems tend to fall into four
main categories.  The are:  1) unaccustomed fatigue; 2) joint and/or
muscle pain; 3) muscle weakness and/or loss of muscle use; and 4)
respiratory problems.

unaccustomed fatigue
--------------------

-Marked fatigue after moderate exercise or activity is common in
   post-polios; fatigue can indicate muscle overuse.

joint and/or muscle pain
------------------------
-More common new musculosketal problems in post-polios include
   osteorathritis of spine and peripheral joints, scoliosis, bursitis,
   tendonitis, osteoporosis, myofascial pain syndrome, foot and toe
   deformities, carpal tunnel syndrome, chronic pain from strain to back
   and neck muscles.  These symptoms in post-polios generally result
   from longstanding muscle weakness and imbalance; they are not merely
   part of the normal aging process.
-Chronic strain on joints used in compensatory ways, e.g. weight bearing
   with upper extremities, can lead to premature degenerative
   osteoarthritis.
-Osteoporosis of spine and long bones is very common in more severely
   disabled post-polios.  Lone bone fractures may occur with minimal
   stress.
-Generalized pain in the spine and extremities is very common in
   post-polios.
-A non-localized "flu-like" aching in muscles is frequent in
   post-polios.
-Pains in the lower back are common, often caused by movements used to
   compensate for weak hip muscles; this transfers weight to small facet
   joints at the back of the vertebra, which are not designed to handle
   such stress.

muscle weakness and loss of muscle use
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-Muscles most commonly affected in post-polios are those that recovered
   well from the initial attack and have been used strenuously since.
   Common manifestations are:  new muscle weakness, increased weakness
   or pain, generalized fatigue and weakness, post-exercise weakness
   and/or pain.
-Post-polios work 2-3 times as hard as normal to accomplish the same
   activity.  The added strain may result in overuse damage.
-Early symptoms of overuse before lasting muscle weakness occurs are:
   post-exercise transient fatigue, post-exercise transient weakness,
   pain in specific muscles after exercise, or muscle twitching.
-Weak abdominal muscles tend to foster chronic back strain and injury.
-Post-polios have less muscle reserve, and may need more time to resume
   normal activity after surgery or severe illness.

respiratory problems
--------------------

-Combined deterioration of respiratory muscles--from polio AND
   aging--may necessitate the use of breathing aids.
-Symptoms of failing respiratory reserve can be insomnia, restless
   sleep, nightmares, morning headache or confusion, shallow breathing
   patterns, breathlessness even during speaking.  A combination of
   these symptoms requires expert evaluation.
-Post-polios with severe respiratory impairments can develop sleep
   apnea.

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Compiled by the Post-Polio League for Information and Outreach (P-POLIO)

Sources:

Handbook on the Late Effects of Poliomyelitis, 1984 by Gini Lauri,
   Frederick M. Maynard, M.D., D. Armin Fischer, M.D., Judy Raymond;
   published by Gazette International Networking Institute, St. Louis,
   MO.

1st Annual Research Symposium on the Late Effects of Poliomelitis, Warm
   Springs, GA

1981 Rehabilitation Gazette, reporting on the 1st International Symposium
   on the Late Effects of Poliomyelitis.