Spasticity is a symptom of a chronic neurological disorder. It happens when nerve signals increase excessively, causing involuntary muscle contractions, stiffness, and deformities.
This condition is caused by damage to the brain or spinal cord, such as from a stroke or cerebral palsy. Stiffness may affect a small group of muscles or an entire side of the body, depending on how much of the nervous system is affected.
Spasticity is diagnosed by doctors who specialize in the nervous system and muscles, such as neurologists and physiatrists (doctors who specializes in physical medicine and rehabilitation). Treatment may include physical therapy, medications, and botulinum toxin injections.
Main symptoms
The main symptoms of spasticity are:
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Involuntary muscle contractions
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Difficulty stretching or bending the leg or arm
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Pain in the affected muscles
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Involuntary crossing of the legs
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Joint deformity
A person with spasticity may develop permanent posture changes, such as flexed arms, extended legs and feet, and the head tilted to one side.
According to the American Association of Neurological Surgeons, prolonged and untreated spasticity can lead to complications such as frozen joints and pressure sores
Symptoms of muscle spasticity vary depending on the severity of the brain or spinal cord injury. They can make activities such as speaking, moving, or eating more difficult.
Confirming a diagnosis
The diagnosis of spasticity is made by a multidisciplinary team, which may include a neurologist and a physiatrist. It is based on a physical evaluation to assess muscle tone, gait, reflexes, mobility, pain level, and independence in daily activities.
The severity of spasticity may be measured using clinical tools such as the Modified Ashworth Scale and the Modified Tardieu Scale.
To investigate the underlying cause, the doctor may order additional tests, such as an MRI or CT scan, metabolic or genetic testing, or hypercoagulability testing.
Possible causes
The most common causes of spasticity include:
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Perinatal asphyxia
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Stroke
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Spinal cord injuries
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Head trauma
Other conditions can also cause muscle spasticity. These include brain infections, such as Lyme disease and HIV, vitamin and mineral deficiencies, and inhaled toxins, such as nitrous oxide, also known as laughing gas.
Treatment options
Treatment for spasticity should be guided by a neurologist or physiatrist and may include:
1. Medications
To reduce spasticity, the doctor may prescribe medications such as baclofen or diazepam. These help relax the muscles and relieve pain.
Benzodiazepines, clonidine, or tizanidine may also be prescribed. These medications reduce the transmission of nerve impulses and help promote muscle relaxation.
2. Physical therapy
To manage spasticity symptoms, your doctor may recommend physical therapy. These sessions help maintain joint flexibility and prevent increased stiffness.
Physical therapy for spasticity may include the following methods:
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Cryotherapy: applying cold to the affected muscles to temporarily reduce the nerve impulses that cause excessive muscle contraction
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Thermotherapy: applying heat to relax the muscles and reduce pain
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TENS: applying electrical stimulation to reduce pain and spasticity
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Mobilization: passive movement of the limb to prevent stiffness
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Stretching: to prevent stiffness and possible deformities
People with spasticity are often advised to attend physical therapy regularly, which may be several times per week depending on their condition. A physical therapist may also recommend exercises that can be done at home.
3. Botulinum toxin
Botulinum toxin injections (Botox) may be recommended by the doctor to reduce muscle stiffness and make joint movement easier. According to the FDA-approved prescribing information for Botox, botulinum toxin is indicated for treating spasticity in patients 2 years of age and older.
The effects of this treatment usually last between 4 months and 1 year, and treatment may be repeated every 6 months. It aims to improve mobility during daily activities and make physical therapy sessions more effective.
4. Immobilization
Immobilization is done with splints and orthoses. The goal is to prevent deformities and reduce movement limitations by keeping the affected body part in a position that is as close to normal as possible.
5. Surgery
Surgery may be recommended by the doctor in cases of irreversible deformities. It may include procedures such as muscle release, tendon lengthening, or bone realignment.