What is Spasticity?
Spasticity is a condition characterized by involuntary muscle contraction and tightness due to injury or disease of the brain or spinal cord. The condition commonly involves the arm and leg muscles, however any muscle can be affected. Spasticity can be painful, disfiguring, and disabling. Poor skin hygiene is sometimes seen because the muscles are so tight making it difficult to keep areas such as the palm of the hand and underarms clean.
Causes of Spasticity
Spasticity is caused due to damage to the spinal cord or brain and is seen in people with neurological problems such as:
- Traumatic spine or brain injury
- Stroke
- Multiple sclerosis
- Cerebral palsy
- Tumors of the spine and brain - both benign and malignant
Symptoms of Spasticity
Some of the common symptoms of spasticity include:
- Involuntary contraction of the upper and/or lower extremity muscles
- Abnormal postures just as a fisted hand, a bent elbow with the hand fisted near the abdomen
- In the leg, stiff-legged walking, the knees being pulled together during walking causing 'scissoring,' and toes dragging the floor (footdrop) can be seen.
- Skin and joint deformities
Diagnosis of Spasticity
Spasticity of the arms or leg is a clinical diagnosis. It is based on a comprehensive medical history, physical examination including analysis of posture, walking, movement control, strength, and coordination.
Treatment of Spasticity
Treatment of spasticity will depend on its severity, location and patient goals. The underlying cause for the condition (stroke, multiple sclerosis, etc.) may come into play when determining treatment. A combination of the following treatment options may be recommended:
- Physical and/or Occupational Therapy: Special stretching exercises may be recommended to maintain flexibility and range of motion, and to prevent muscle shortening or tightening.
- Oral Medications: Medication may be prescribed to help relax the muscles such as baclofen, tizanidine or dantrolene sodium.
- Injections: Botulinum toxin injections into the muscles can be very effective to decrease muscle stiffness and improve function.
- Intrathecal Baclofen Therapy: This involves the surgical placement of a small pump and catheter under the skin that provides medications, usually balcofen, directly into the spinal fluid for better control of symptoms.
- Orthopedic Surgery: This involves surgical procedures to correct the position of affected muscles, bones, and connective tissue caused by prolonged spasticity.
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