Spasticity [SPAS-ti-si-tee] is when your muscles increase in tone and stiffness due to nerve damage between the brain and the spine. Your muscles normally have a small amount of tone, which helps keep them in the right shape even when you’re not using them. Spasticity increases the amount of tone, which can make your muscles contract all the time, and it also makes the muscles stiff and harder to move.
Spasticity can interfere with anything you use your muscles for, including aspects of daily living like walking, movement, or speech. The condition can interfere with your ability to walk, move, and talk, and can be painful. Spasticity can happen as a result of other injuries or conditions, such as:
- Spinal injuries. Damage to the spinal cord can interfere with the signals that the brain sends to muscles. Too much damage to the spinal cord can result in paralysis, which means that you are unable to move parts of their body.
- Multiple sclerosis. This is a condition where the sheaths around nerve cells break down and can’t effectively send signals to the brain. This leads to muscle weakness and trouble with coordination and balance.
- Cerebral palsy. This is a condition where brain damage occurs in the part of the brain that controls movement and coordination. Those with cerebral palsy may have a hard time walking or doing tasks with their hands.
- Stroke. When blood stops flowing to the brain due to a blood clot or hemorrhage [HEM-er-ij] — bleeding into the brain — the parts of the brain that control movement can be damaged.
- Brain or head trauma. Being hit in the head due to an accident can damage the parts of the brain that control your muscles.
Spasticity can be mild or severe. In mild cases, there is only a bit of muscle stiffness or paraparesis [par-uh-puh-REE-sis], which is partial paralysis of the limbs. In severe cases, the muscles will spasm, and there will be lots of pain.
Spasticity can start to interfere with aspects of one’s daily life, like walking, movement, or speech.
Other disorders like dystonia [dis-TOH-nee-uh] — which causes spasms of the trunk, shoulder, and neck muscles — and athetosis [ath-i-TOH-sis] — which impacts the fingers, toes, hands, and feet — can also cause stiff muscles. However, these disorders have different causes and treatments than spasticity.
The symptoms of spasticity can include:
- Increased muscle tone
- Rapid muscle contractions
- Exaggerated reflexes
- Muscle spasms
- Involuntary leg crossing
- Fixed joints
- Abnormal posture
These symptoms depend on the severity of the condition. Those with more severe cases will experience more of these symptoms and might have worse pain. In addition to spasms and pain, spasticity can also cause nerve weakness and poor coordination.
You should contact your healthcare provider if you think you have spasticity, or if you have recently had an injury that can cause this condition. If you have already been diagnosed with this condition, you should talk to your doctor if:
- Your spasticity worsens
- There is a noticeable deformity in the area affected by spasticity
Spasticity is caused by damage to the nerves that control muscle movement and run between the brain and the spinal cord. This damage can happen because of other conditions, illnesses, and injuries, such as:
- Brain damage caused by a lack of oxygen
- Cerebral palsy
- Head injury
- Multiple sclerosis
- Spinal cord injury
Normally, muscles maintain enough tension and tone to keep a straight posture and allow for function and movement. Muscles that have spasticity have mixed-up signals from the brain about how much tension and tone to flex, and that makes it hard for you to keep a normal posture.
When you visit your doctor, they will do a physical exam and ask about your symptoms. Some of the questions they might ask include:
- When did you notice the condition?
- How long has it been happening?
- Does it happen all the time?
- Does anything help with the condition?
- Are there other symptoms?
- Which muscles does it happen to?
Once your doctor finds the location and cause of the spasticity, they can start to work on a treatment plan for you. Sometimes, your doctor might recommend a few different treatments that work together to help you feel better. For example, a medicine might help more if it’s combined with physical therapy.
The main treatment method for spasticity is physical therapy. At physical therapy, you will do exercises to stretch and strengthen the affected muscles. Some of these exercises can be done at home.
Your medical care team will consider many factors when they decide how to treat your spasticity, including:
- Your ability to function in daily life
- Where the spasticity is and how severe it is
- The condition causing the spasticity
- Any other muscle disorders
- Goals to increase or improve the condition
There are several kinds of physical therapy that may help with spasticity.
- Positioning. It may help to position your body in certain ways or to use objects like corner chairs, standers, or wheelchairs.
- Bracing and splinting. Splints and braces can be made that align muscles to prevent them from acting up.
- Serial casting. A cast can be placed on the limb to hold the muscles in place. The cast may be used with muscle medicine, like Botox or phenol.
- Direct therapy. This includes exercises for stretching that help prevent spasms and contractures. They may make it easier to do things like walking, dressing, or going to the bathroom.
For best results, other treatment methods (typically combined with physical therapy or each other) include:
- Oral medicines. These are medicines that are swallowed to calm nerves and reduce spasticity in many areas of the body.
- Botox or phenol injections. Medicine is put into the body with a needle to improve motor function and comfort or to reduce the symptoms of spasticity.
- Surgery. An operation may be done to treat spasticity.
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