Overview

What is spasticity?

Spasticity is an impairment of the control of muscles. The muscles feel stiff or tight and cannot be controlled voluntarily by the muscle. Some reflexes may be hyperactive (linger too long and be too strong). For example, in infants with a hyperactive grasp reflex, they are going to hold their fist in a tight fist.

What are the symptoms of spasticity?

Increased muscle tone
Active reflexes
Spasms, which result in brisk and/or sustained involuntary muscle contraction, and clonus, which is the rhythmic fast involuntary contractions
Pain
Reduced functional capabilities and late neurological development
Difficulty with hygiene and cleanliness
Abnormal posture
Contractures (permanent muscle and tendon contraction resulting from intense, persistent stiffness and spasms)
Bone and joint deformities

What causes spasticity?

An imbalance between signals from the central nervous system and the muscles creates spasticity. This is common among those who have cerebral palsy, traumatic brain injury, stroke, multiple sclerosis, and spinal cord injury.

How is spasticity diagnosed?

It is diagnosed by reviewing your medical history by your doctor. They will consider the history of medicines taken by you and also if you or your family members have any history of neurological or muscular disorders.

Several diagnostic tests can confirm a diagnosis. These include determining the movements of the arms and legs, muscular activity, passive and active range of motion, and self-care activity.

How is spasticity treated?

It is essential to treat spasticity to enhance the comfort, mobility and independence of the affected person. Spasticity in itself can cause pain, permanent joint deformity, urinary tract infection, chronic constipation and pressure sores if left untreated.

Treatment objectives include relaxing muscles as much as possible, relieving pain and stiffness, encouraging optimal long muscle growth in children, and improving your child's ambulation and independence.

This multidisciplinary team consists of doctors, nurses, physician assistants, therapists, and child life specialists who will work with you and your child to determine what combination of the following interventions makes the most sense.

Additional uses of physical and occupational therapy can include optimizing muscle flexibility, range of motion, coordination, and strength. Casting or bracing can include temporary splints or casts, the application of therapeutic heat and cold, electrical stimulation, and biofeedback.

Therapy could aim to optimize the child's ability to perform routine activities as he or she prepares to live a life as independent as possible.

Medications alone or in combination are primarily used. Your child's doctor and treatment team will work out a regimen for your child that appropriately balances optimal symptom relief with minimal side effects.

Intrathecal medications continuously release directly into the cerebrospinal fluid via a surgically implanted pump within the abdomen. Baclofen is one medication that can be delivered in this way.

Surgical treatment may be prescribed for patients who need a more definite approach to spasticity. Surgical intervention in the form of Rhizotomy involves the neurosurgeon accessing the cable-like sensory nerves running along the spine and, in a very delicate fashion, separating the nerves that convey contraction messages targeted to the affected muscles. The surgeon cuts the most abnormal of those fibres to relieve the spasticity and spare other motor and sensory functions.

How painful is spasticity?

Spasticity's pain may be as subtle as muscle tightness or of sufficient intensity to produce painful spasms of the extremities, usually of the legs. Spasticity can also contribute to low back pain, leading to feelings of pain or tightness in and around joints.

What is the prognosis for patients with spasticity?

Different people have different outlooks. The severity of one's spasticity and any disorder caused by it determines the individual's outlook.

When should I see my healthcare provider about spasticity?

If you first experience spasticity and you cannot say what it is due to, you should seek a doctor since the spasticity may indicate that your brain or spinal cord has been damaged.

Visit your doctor if you ever are diagnosed with spasticity, which can also worsen as it occurs more frequently or interferes with daily activities.