What is Post Polio Syndrome?

After the initial acute phase of the polio infection, people “recovered”. They regained the use of muscles or learned to live with paralysis. Some people had operations; others had some sort of physiotherapy or another treatment. They fought hard to regain a “normal live”.
People then go into a phase of neurological and functional stability.
Around 20 to 40 years after the initial polio infection some people start to experience a decline in their health and functionality. This is known as Post Polio Syndrome (PPS).

One can have two or more of the following health problems:

  • New weakness in muscles (previously affected or believed to be unaffected)
  • New muscle atrophy
  • Pain in muscles and/or joints
  • Extensive fatigue
  • Functional loss, less endurance
  • Respiratory and/or swallowing difficulties
  • Cold intolerance

There is no known cure but people may respond to a range of therapies to alleviate the symptoms, often requiring modification of life style.

It is important that healthcare professionals with knowledge of polio and Post Polio Syndrome see people with late effects of polio.

What causes Post Polio Syndrome?

It is not completely clear what causes Post Polio Syndrome. However, many experts believe that overburdened nerve cells cause it.
After the acute stage of the disease, surviving nerve cells gradually send out new nerve connections to orphaned muscle cells (sprouting) in an attempt to take over the function of nerve cells that were destroyed. By doing so, muscles might recover, partially or completely. These surviving nerve cells have been working very hard for decades to innervate too many muscle cells. The resulting motor units can be up to eight times normal size. Eventually they begin to fail.


There is no specific definitive test to diagnose PPS. People should be thoroughly evaluated by a doctor who is an expert in neuromuscular disorders (preferably PPS), i.e. neurologist or rehabilitation specialist. This evaluation must include looking at the patient’s complete medical history and exclude other disorders with the same or similar symptoms.


Unfortunately, there is no cure for PPS. However, appropriate management can lessen some of the symptoms and help make the patient as comfortable and independent as possible. Aids and appliances can be advised, orthoses can be prescribed. Appropriate, individual, non-fatiguing exercise or treatment in warm water might be beneficial. Lifestyle changes often are needed. Pain might be eased, depending on what causes it. Some can benefit from breathing assistance or swallowing techniques. In addition, psychosocial help might be needed.

Every polio survivor is different, so seek expert advice.