While there’s no cure for spasticity, treatments are available to help ease discomfort and improve quality of life.
Increased muscle tonePain or discomfortMuscle spasmsMuscle stiffnessMuscles that feel heavy and are difficult to moveContractures (permanent contraction and shortening of muscles and tendons)Involuntary crossing of the legs (called scissoring)Abnormal postureBone and joint deformitiesDifficulty walkingDifficulty speaking, eating, and drinking
While spasticity most commonly affects the leg muscles, it can also occur in the arms, neck, and torso, or trunk. Some people with spasticity only have mild pain and stiffness, while others have severe and disabling symptoms. Specific symptoms vary from person to person and may depend on the underlying condition leading to spasticity. For example, someone with MS is likely to experience spasticity of the leg and hip muscles, which can lead to flexor spasticity (the legs and hips lock in a bent position) or extensor spasticity (stiff muscles keep legs straight and sometimes crossed at the ankles). A person with cerebral palsy can have spasticity in both their arm and leg muscles. Children with cerebral palsy might not show symptoms of spasticity when they’re babies, but it can become apparent during childhood.
Muscle Spasticity vs. Muscle Spasms
A muscle spasm, which is a sudden, involuntary tightening or contracting of a muscle, is a normal, if painful, occurrence that can happen to anyone. Muscle spasms in otherwise healthy people are believed to be caused by muscle fatigue, dehydration, sitting for long periods, or engaging in too much high-intensity exercise. Spasticity, on the other hand, is caused by an underlying neurological condition. This damage can result from a variety of injuries or diseases, such as:
MSCerebral palsyTraumatic brain injurySpinal cord injuryStrokeAmyotrophic lateral sclerosis (ALS)Certain metabolic diseasesHereditary spastic paraplegiasOther conditions that affect the brain or spinal cord
Research suggests about 80 percent of people with MS and cerebral palsy will experience spasticity. Additionally, physicians may order imaging tests, such as magnetic resonance imaging (MRI), to figure out what’s causing the person’s spasticity and the extent of the damage.
Medical Experts That Diagnose and Treat Spasticity
People with spasticity and related diseases will likely see a team of doctors that may include the following experts:
NeurologistRehabilitation specialistPhysical therapistOccupational therapistSpeech-language pathologistNeurosurgeonOrthopedic surgeon
Prognosis of Spasticity
A person’s prognosis will depend on the underlying condition they have, the severity of their disease, the treatments they receive, and other factors. Treatment for spasticity can help improve a person’s mobility and independence. For some people, such as those who experience spasticity due to a traumatic brain injury, symptoms can improve over time as the injury heals. However, people who experience spasticity caused by other conditions, such as cerebral palsy, have damage that isn’t reversible, which means the spasticity symptoms won’t go away on their own. Still, certain treatments may relieve pain and improve functioning. A person is more likely to experience spasticity when they:
Have a urinary tract infection (UTI)Have a full bladderAre constipated or have hemorrhoidsStretch or move an arm or legAre stressedHave an injury to muscles, tendons, or bonesWear tight clothingHave skin irritationAre exposed to extreme temperatures
However, if symptoms interfere with daily activities or lead to a loss of function, doctors have a number of therapies they can recommend.
Oral Medications
Some oral medicines that are used to treat spasticity symptoms include:
Baclofen (Lioresal)Tizanidine (Zanaflex)Gabapentin (Neurontin)Dantrolene sodium (Dantrium)Diazepam (Valium)Clonazepam (Klonopin)
Injections
Doctors can inject phenol, alcohol, anesthetic medicines, or neurotoxins — onabotulinumtoxina (Botox), abobotulinumtoxina (Dysport), rimabotulinumtoxina (Myobloc), or incobotulinumtoxina (Xeomin) — directly into muscles and nerves to control spasticity. The results usually last three to six months.
Physical, Occupational, and Speech Therapy
Physical therapy (PT) and occupational therapy (OT) can be useful for helping people with spasticity manage their symptoms. With PT, therapists teach patients how to perform specific stretching and strengthening exercises that can improve mobility and range of motion. OT typically involves exercises that focus on improving coordination and strength, so individuals can better perform daily activities. Some people with spasticity also benefit from speech therapy.
Surgery
Surgical options for treating spasticity include:
Intrathecal Baclofen Therapy (ITB) With ITB therapy, a programmable pump is implanted under the skin of the abdomen, and a catheter connected to it delivers baclofen directly to the spinal cord. It’s sometimes used to treat spasticity that’s severe.Selective Dorsal Rhizotomy (SDR) SDR involves cutting selected nerve roots to reduce severe spasticity in the legs. It’s most commonly done in people with cerebral palsy.
Assistive Devices
Assistive devices, such as splints, braces, or casts can help people with spasticity maintain continuous muscle stretching and flexibility.
Canes, walkers, or wheelchairsGrab barsShower benchesRaised toilet seatsRamps
Complementary Approaches
Some people with spasticity turn to alternative or complementary approaches to ease their symptoms. While not all these therapies have been proven to work, they might be helpful for certain individuals.
AcupunctureBiofeedbackChiropractic treatmentMassage therapy
Home Remedies
Activities performed at home that may help ease symptoms of spasticity include:
Engaging in regular exerciseStretchingUsing cold packsDrinking plenty of waterEating a high-fiber diet
Frozen or immobilized jointsExtreme discomfortDisrupted sleepDifficulty performing tasks of daily livingFallsUTIsChronic constipationPressure sores, which can lead to infection
Dystonia is a movement disorder that causes muscles to contract involuntarily, causing slow, repetitive motions or abnormal postures.Hypertonia is a condition that occurs when someone has too much muscle tone, making it difficult to move. Spasticity is a type of hypertonia.Rigidity is a type of hypertonia in which the muscles remain stiff regardless of the type of movement a person is engaging in. Parkinson’s disease, in particular, is associated with rigidity as a symptom.Tremor is uncontrollable shaking, caused by rhythmic muscle contractions, in one or more parts of the body.Ataxia is a degenerative disease of the nervous system that’s characterized by poor muscle control, resulting in balance and coordination problems.Tardive dyskinesia is a neurological syndrome usually brought on by taking certain drugs that causes repetitive, involuntary muscle movements in the face and sometimes in the neck, arms, and legs.
NIH: National Institute of Neurological Disorders and Stroke (NINDS) The NINDS website offers good basic information about spasticity and has a link to all the spasticity clinical trials listed on ClinicalTrials.gov. Brain & Life This patient education website of the American Academy of Neurology regularly publishes news, feature stories, and patient profiles about all kinds of neurological conditions, including those that can cause spasticity. American Association of Neurological Surgeons (AANS) The patient page of the AANS offers basic information about spasticity, links to ongoing research trials, and links to recently published studies of surgical treatments for spasticity. American Stroke Association The American Stroke Association provides a video and a variety of fact sheets to help individuals understand the connection between spasticity and stroke, describe their symptoms accurately, and seek appropriate help. National Multiple Sclerosis Society (NMSS) Given how common spasticity is in MS, it’s no surprise the NMSS website has a variety of resources on this symptom. Cerebral Palsy Foundation The Cerebral Palsy Foundation’s website has information about all aspects of cerebral palsy, from symptoms to treatment to socializing and sexuality. Christopher & Dana Reeve Foundation The Reeve Foundation offers comprehensive information on spasticity, with a special focus on traumatic brain and spinal cord injury. American Academy of Physical Medicine and Rehabilitation Physical medicine and rehabilitation physicians are sometimes the professionals who coordinate spasticity treatment. Learn more about this specialty here. Model Systems Knowledge Translation Center (MSKTC) The MSKTC’s article on spasticity offers a wealth of information on spasticity resulting from spinal cord injury. Easterseals Easterseals provides care and rehabilitation services to adults and children with all types of disabilities. Individuals are encouraged to contact their local Easterseals affiliate to see what services are available in their area.
