14346 Spasticity

Overview

Spasticity is a condition where some muscles become tight, stiff, and hard to control. It happens because of damage to the nerves that control movement, often from conditions like cerebral palsy, stroke, or multiple sclerosis. It can make moving, walking, or speaking difficult, and may cause pain.

Spasticity is common in people with certain neurological conditions. For example, it affects many people after a stroke or with multiple sclerosis or cerebral palsy.

It can affect anyone with damage to the brain or spinal cord. This includes children with cerebral palsy, adults after stroke or brain injury, and people with multiple sclerosis or spinal cord injury.

Symptoms

Common symptoms

• Muscles that feel tight or stiff, especially in the arms or legs
• Muscle spasms or sudden jerking movements
• Difficulty moving a limb or doing daily tasks
• Pain or discomfort in the tight muscles
• Problems with walking, balance, or posture
• Difficulty with speech or swallowing if muscles in the face or throat are affected

Symptoms in children

• Delayed motor skills like crawling or walking
• Stiff movements or unusual posture
• Difficulty with feeding or speech
• Muscle tightness that may get worse during growth spurts

Symptoms in older adults

• Increased risk of falls due to stiffness and balance problems
• Pain that limits mobility
• Difficulty with self-care activities
• Muscle contractures (permanent shortening) if not managed

Causes

Main causes

• Damage to the brain or spinal cord from conditions like cerebral palsy, stroke, multiple sclerosis, spinal cord injury, or brain injury
• Neurodegenerative diseases such as motor neurone disease
• Sometimes no clear cause is found, but it is always linked to nerve damage

Risk factors

• Having a neurological condition that affects the brain or spinal cord
• Brain or spinal cord injury
• Genetic conditions like cerebral palsy

When to see a doctor

See a doctor urgently if:

• Sudden severe muscle stiffness that affects breathing or swallowing
• Severe pain or swelling in a limb
• High fever with stiff neck or confusion
• Signs of autonomic dysreflexia (severe headache, high blood pressure, sweating) if you have a spinal cord injury

Book a routine appointment if:

• Muscle stiffness that makes daily activities harder
• Pain from muscle tightness
• New or changing symptoms
• If you are caring for someone with spasticity and notice new problems

Diagnosis

Your doctor will ask about your symptoms and medical history. They will examine your muscles, movement, and reflexes. They may refer you to a specialist like a neurologist or rehabilitation doctor. Tests may be done to find the underlying cause.

Tests that may be done

• Physical exam to check muscle tone, strength, and reflexes
• Blood tests to rule out other causes
• MRI or CT scans of the brain or spine
• Assessment by a physiotherapist or occupational therapist

What to expect at your appointment

You may be asked to move your limbs in different ways. The doctor will look for stiffness and how it affects your movement. They may also check for pain and your ability to do daily tasks. The process is usually painless.

Treatment

Treatment aims to reduce muscle tightness, relieve pain, and improve function. It often involves a combination of therapies. Your healthcare team will create a plan that suits your needs.

Self-care at home

• Stretching exercises to keep muscles flexible
• Regular physical activity to maintain strength
• Using heat or cold packs to relax muscles
• Proper positioning and support aids
• Avoiding triggers like sudden movements or stress

Medical treatments

Doctors may suggest physical therapy, occupational therapy, and medications that help relax muscles. Some people benefit from injections into tight muscles to reduce stiffness. In some cases, an implanted device may deliver medication to help. Your doctor will discuss options and side effects. Never start or stop any treatment without medical advice.

When is surgery considered?

Surgery may be considered if other treatments don't work and spasticity causes severe problems like joint deformities or contractures. Procedures can include releasing tight tendons or other orthopedic surgery. Your specialist will discuss risks and benefits.

Living with this condition

Living with spasticity can be challenging, but many people find ways to manage. Work with your healthcare team to adjust treatments as needed. Pace yourself and ask for help when you need it.

Lifestyle tips

• Stay active with gentle exercise like swimming or walking
• Use assistive devices if needed, such as braces or walking aids
• Maintain a healthy weight to reduce strain on muscles
• Get enough rest and sleep
• Join a support group to share experiences

Diet and exercise

A balanced diet and regular exercise are important. Exercise can help maintain flexibility and strength. A physiotherapist can suggest safe exercises. Avoid overexertion, which can worsen spasms.

Mental health and emotional wellbeing

Spasticity can affect your mood and mental health. It's common to feel frustrated or worried. Talk to your doctor if you feel anxious or depressed. If you feel overwhelmed or hopeless, contact your local crisis support service or emergency services immediately. You are not alone.

Prevention

Spasticity is usually caused by nerve damage, so it can't always be prevented. But managing the underlying condition and getting early treatment may help reduce its impact. If you have a condition that can cause spasticity, regular check-ups are important.

Vaccines

Not applicable.

Screening programmes

Not applicable.

Complications

If left untreated

• Muscle contractures (permanent shortening of muscles and tendons)
• Joint deformities
• Pressure sores from limited movement
• Increased risk of falls and injuries
• Pain and reduced quality of life
• Difficulty with daily activities and mobility

Long-term outlook

With proper treatment and management, many people with spasticity can improve their comfort and function. It may not go away completely, but it can be controlled. Work with your healthcare team to find the best plan for you.

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