Post-Polio Syndrome, or PPS, is a name that describes NEW symptoms that occur to an individual whose average age is 31 years old. The symptoms occur usually from 20 to 40 years after the onset of the initial polio infection and after a period of "recovery" of at least 10 years.

PPS symptoms often include NEW weakness, pain, breathing and/or swallowing difficulties, a variety of sleep disorders, muscle twitching, gastrointestinal problems, muscle fatigue and/or "central" fatigue. These symptoms can occur in muscles that were affected by the initial infection and/or in what were previously thought to be muscles that were not affected at onset of the infection.

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Complications of PPS often include nerve damage that causes an inability of the nerve to function properly (neuropathy), nerve entrapments, arthritis, scoliosis, osteoporosis and, sometimes, additional wasting (atrophy) muscles that is known as Post-Polio Muscular Atrophy (PPMA).

There isn’t one conclusive test to determine the diagnosis of PPS. It is an exclusionary diagnosis that is made by taking a detailed history and ruling out other possible causes that mimic these symptoms. Interestingly, those individuals whose initial symptoms of Polio were substantial and then subsequently made a good recovery were the ones who seem to have the worst PPS symptoms later on. Scientists do not understand this and can not isolate a particular cause for PPS.

The onset of PPS usually occurs over a period of years. However, it can sometimes abrupt, with major losses of function suffered over several months or a couple of years. Onset often occurs after a physical or emotional trauma, illness or accident.

The following is a list of guidelines for PPS sufferers from the Post Polio League

1. Take time to rest. Nap (if possible) during the day, work fewer hours, and take longer vacations.
2. If you are experiencing increasing muscle weakness, exercise only under the supervision of a knowledgeable physician.
3. Make sure your food intake is nutritious.
4. Be alert to (but not obsessed with) changes in your body, and heed your body's signals.
5. Take note of any new symptoms plus clear or gradual changes.
6. Get enough exercise to prevent disuse atrophy, but not enough to produce overuse damage.
7. Learn how to pace yourself.
8. Prevent the secondary complications of weakness, particularly falls; this might entail the use of crutches or a cane, a wheelchair for extended travel, or braces or other adaptive equipment.
9. Avoid weight gain. Too much weight only aggravates stress on joints and muscles.
10. Consider possible adaptations to your lifestyle, even minor adjustments (changes in hobbies or modes of transportation) can help.
11. Do not assume that every physician fully understands post-polio problems. Educate yourself and never hesitate to ask questions.
12. Minimize alcohol use, particularly at bedtime. Alcohol inhibits swallowing, interferes with nutrition, and causes falls and accidents.
13. Maintain a positive attitude towards your health. Accept change, adapt, and never equate your self-worth with physical disabilities.
14. Take common colds very seriously.
15. Get bulk-producing fiber in your diet. Avoid stimulant laxatives.
16. Medical evaluation of post-polio’s should include a complete history, physical exam, and appropriate lab studies.
17. Muscle strength evaluation should be done by a registered physical therapist or someone familiar with neuromuscular disease. Muscle testing is now advised every year even if there is no obvious change.
18. The current recommendation is that all post-polio’s have a complete medical evaluation covering the three major areas affected by the polio; neuromuscular, circulatory and respiratory.
19. Problems with extremities or joint function may require special consultation from physiatrist, orthopedist, and/or neurologists familiar with skeletal deformities and muscle weakness.
20. Experienced physical or occupational therapists can help determine functional losses and how best to adapt.
21. Muscle stretching and joint range-of-motion exercises are important where there is muscle weakness.
22. Swimming is the best cardiovascular endurance and general conditioning exercise. Water should be warm (at least 90 degrees).
23. Discontinue any exercise that causes pain, weakness, or muscle fatigue, including walking.
24. Muscles weakened by polio respond poorly to vigorous strengthening programs. Programs such as weight lifting often aggravate the condition.
25. Each of you should know your own strength limits or endurance, and avoid going repeatedly to that limit.
26. You should avoid narcotics for any reason; aspirin is preferred as an analgesic for muscle or joint pain.
27. Occupational therapists can assess extremity function, daily activities, and the need for assistive devices to help achieve the highest level of independence possible.
28. Rest is the best known treatment for aching muscles. Moist heat, anti-inflammatory medication, and avoiding exertion are also helpful.
29. Physical therapy - heat, massage, joint mobilization, and stretching exercises - can help chronic lower back pain.
30. Change of gait pattern, such as using crutches, may be needed to prevent recurrence of lower back pain.
31. You MUST learn to conserve energy.
32. Even though you were once rehabilitated, you must be re-evaluated and taught new techniques to replace those that no longer work.
33. Body positioning during sleep is important for post-polio’s with severe weakness and postural joint deformities.
34. Those with marginal respiratory reserve at sea level should be prepared to use respiratory aid when traveling above 3,000 feet.
35. Everyone with respiratory insufficiency is advised to get flu vaccination according to Public Service guidelines and recommendations.