What is Spasticity?
Spasticity is a disorder of the muscles where an individual is not able to control their muscles and they feel tense or stiff all the time.1 Along with this, the patient may also suffer from hyperactive reflexes, such as a man/woman may keep a tight grip over a pen or a spoon etc.
The pain felt with spasticity can be mild or very severe, sometimes so severe that it results in painful spasms in the extremities, especially the legs. Spasticity also may cause pain in the lower back with pain or tightness surrounding the joints. This condition can be treated with medications, injections given locally to relax the muscles, rehab, PT, and surgery.
Causes of Spasticity
In a human body, the central nervous system, i.e. the brain and spinal cord, sends signals to the muscles and any imbalance of these signals results in this muscle control disorder, which is known as spasticity. People who suffer from traumatic brain injury, cerebral palsy2, multiple sclerosis, stroke, and spinal cord injury commonly have these imbalances.
Sign and Symptoms of Spasticity
- The patient experiences an increase in the muscle tone.
- The patient experiences hyperactive reflexes.
- The patient experiences movements, which are involuntary such as spasms or and clonus, which is a series of rapid involuntary contractions.
- Pain is also felt.
- There is reduced functional ability with hindered motor development.
- Patient is not able to maintain proper care and personal hygiene.
- Patient adopts an abnormal posture.
- Patient experiences contractures where the muscles are contracted for prolonged periods due to extreme and persistent stiffness and spasms.
- There are deformities of the joints and bones.
Tests to Diagnose Spasticity
- Medical history and family history is taken to assess for history of neurological or muscular disorders which can be inherited.
- To assess the patient’s arm and leg movements, activity of the muscles, range of motion etc., the following diagnostic tests are done:
- X-rays of the spine and hips
- Physical and occupational therapy helps in determining the movement patterns and passive range of motion of the upper and lower extremity.
- Diagnostic blocks are given with local anesthetics to find out the usefulness of potential treatments.
- Nerve conduction studies are done to assess the damage to the nerve and muscle.
- Electromyogram (EMG) helps in detecting any abnormal electrical activity in the muscles.
- Nerve conduction studies can be done along with the electromyogram (EMG).
Treatment of Spasticity
- Treatment for spasticity includes use of medications such as baclofen, tizanidine, dantrolene, diazepam, and clonazepam.
- Occupational and physical therapy are also done to stretch the muscles and increase the range of motion through range of motion exercises.
- Sometimes braces are used to prevent tendon shortening.
- Rehabilitation also helps in stabilizing the symptoms and enhancing the functional performance.
- Injections of phenol or botulinum toxin may be given locally to relax certain muscles.
- Surgery can be done for tendon release or to cut the pathway of the nerve-muscle.
- Intrathecal baclofen therapy is done where baclofen is implanted via surgery.