Spasticity

Spasticity is a movement disorder characterized by involuntary muscle stiffness and tightness. This condition usually affects a group of muscles, typically in the upper or lower extremities. Spasticity can be painful and often debilitating, particularly when it prevents movement or produces abnormal joint positioning.

It is estimated that spasticity affects 500,000 people in the US and 12 million worldwide. The rates of spasticity also depend on the cause of the movement disorder. There are many common causes of spasticity. Lack of oxygen before, during, or after birth can lead to cerebral palsy. Approximately two-thirds of patients with cerebral palsy experience spasticity. Traumatic brain injury and spinal cord injury are major causes of spasticity. Stroke, caused by blockage or bleeding of a blood vessel in the brain, is also a cause of spasticity. Eighty-five percent of people with multiple sclerosis have spasticity. Brain and spinal cord infection, encephalitis and meningitis, respectfully, can also cause spasticity.

Spasticity can vary in severity and produce muscle group-specific symptoms. Some people experience mild spasticity, while others experience pain and significant disability as a result of spasticity. When spasticity affects one or both arms, a person may experience bent elbows and wrists and clenched fists. They may have difficulty grasping objects, dressing, eating, and writing. Spasticity can also interfere with balance, making walking difficult. Spasticity of one or both legs can cause a flexed hip, stiff and flexed knee, and hyperextended big toe. This can greatly hinder one’s ability to sit, stand, transfer weight, walk, and position in bed.

There are two common problems that can occur with spasticity. Contracture is one of the biggest, and most painful, concerns associated with spasticity. This is a condition whereby the muscles permanently shorten, causing disfiguration of the joint. Clonus, rapid and repeated spasms of the muscles, is also a common concern related to spasticity.

When a diagnosis of spasticity is made, a doctor will evaluate a patient’s health and potential response to treatment based on three criteria: the patter of motor dysfunction, patient’s ability to control their muscles, and the effect of spasticity and contractures on functioning. There are a number of studies that a doctor or therapist can perform to determine the extent and effect of spasticity. From this information, a treatment plan can be developed by a team of professionals including physician specialists, physical and occupational therapists, and more.

Treatment for spasticity is intended to reduce pain and symptoms and increase one’s functional ability. This may be achieved through various rehabilitative therapies, oral medications, a procedure called chemodenervation, and surgery. Botox and other treatments have proven effective in some patients with spasticity. A patient’s treatment will be catered to their specific condition and response to previous treatment.