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Spasticity is a condition in which muscles are tight or stiff. For example, your hand may stay clenched in a fist or your knee may be hard to bend. At times the muscles may jerk or spasm uncontrollably. It can interfere with your ability to move, speak, or walk normally.
Spasticity usually occurs because of damage to the part of the brain or spinal cord that controls voluntary movement. It's often the result of a spinal cord injury, a stroke, or a disease such as multiple sclerosis, cerebral palsy, or amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease).
Common symptoms include:
If spasticity isn't treated, the muscles may freeze in an abnormal position. This can be very painful.
The main treatments are physiotherapy and medicines that help reduce muscle spasms. Surgery may be an option in severe cases.
Exercise and stretching are important treatments for spasticity. Therapists will work with you to increase your range of motion and keep your muscles from getting stiff. You will need to move the affected limb over and over again on a regular basis. You may do this on your own or with the help of a therapist, machine, or caregiver.
In some cases, cold packs and electrical stimulation are used on muscles. Casts or splints may be used to stretch the muscles and keep them from contracting.
Muscle relaxants (antispasmodics) are used to treat spasticity. They include baclofen and tizanidine (Zanaflex). These medicines relax tight muscles and stop muscle spasms. But they may cause sleepiness, muscle weakness, and nausea.
Baclofen is the medicine most often prescribed for spasticity. You can take it as a pill, or a surgeon can implant a small pump under your skin that delivers the medicine directly to your spinal cord. The advantage of the pump is that you will use less medicine. This reduces the side effects that are a problem with baclofen pills. Your doctor can tell you if the pump is right for you.
Other medicines that may be used include gabapentin (such as Neurontin), diazepam (Valium), clonazepam (such as Clonapam), and dantrolene (Dantrium). In many cases, taking small doses of a combination of medicines works better and causes fewer side effects than taking a larger dose of a single medicine.
Botulinum toxin (such as Botox) injections given directly into the muscle can block messages that cause the muscle to spasm. The effect of one injection lasts about 3 to 4 months.
Some forms of natural or man-made substances related to cannabis (marijuana), called cannabinoids, may help relieve spasticity. Talk to your doctor if you are considering cannabinoids.
Some people with severe spasticity may need surgery. For example, surgery may be done to:
Other Works ConsultedKeenan MAE, et al. (2014). Rehabilitation. In HB Skinner, PJ McMahon, eds., Current Diagnosis and Treatment in Orthopedics, 5th ed., pp. 595–642. New York: McGraw-Hill.Leussink VI, et al. (2012). Symptomatic therapy in multiple sclerosis: The role of cannabinoids in treating spasticity. Therapeutic Advances in Neurological Disorders, 5(5): 255–266. Also available online: http://tan.sagepub.com/content/5/5/255.abstract.Simpson DM, et al. (2008). Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 70(19): 1691–1698.
Current as of: March 28, 2019
Author: Healthwise StaffMedical Review: Anne C. Poinier MD - Internal MedicineBrian D. O'Brien MD - Internal MedicineAdam Husney MD - Family MedicineMartin J. Gabica MD - Family MedicineKathleen Romito MD - Family MedicineKarin M. Lindholm DO - Neurology
Current as of: March 28, 2019
Author: Healthwise Staff
Medical Review:Anne C. Poinier MD - Internal Medicine & Brian D. O'Brien MD - Internal Medicine & Adam Husney MD - Family Medicine & Martin J. Gabica MD - Family Medicine & Kathleen Romito MD - Family Medicine & Karin M. Lindholm DO - Neurology
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