What is spasticity?
Spasticity is a muscle disorder that involves an abnormal increase in muscle tone. Muscle tone is the amount of tension we have in our muscles and normal muscle tone is the natural level of tension needed to keep us standing. Increased tension in the muscles causes them to stiffen and can lead to involuntary muscle spasms.
Spasticity is common among people with certain long-term neurological conditions: it is present in 28-38% of stroke patients, 41-66% of patients with multiple sclerosis and 13% of patients with traumatic brain injury.
Prognosis of the disease
With proper diagnosis and treatment, the symptoms of spasticity can be reduced or improved.
Symptoms of spasticity
Symptoms of spasticity may include:
- Muscle tension
- Muscle stiffness
- Muscle fatigue
- Isolated, uncontrollable muscle spasms or a series of involuntary spasms (clonus)
- Exaggerated tendon reflexes
- Contracture (permanent tightening of muscles)
- Pain from tight muscles or muscle spasms
In some patients these problems may lead to
- Sleeping difficulties
- Changes in posture
- Decreased functional abilities — such as walking and toileting
Medical tests for spasticity
Diagnosis involves a thorough evaluation of your medical history, including the symptoms you have experienced, the conditions you have been affected by, and the medications you take.
Because some conditions that cause spasticity are linked to our genes, you will be asked about your family medical history.
Finally, the doctor will perform a physical examination, looking at muscle movements, range of motion and checking for spasm frequency and clonus over time. They will also analyze the activities with which you have the most difficulty and the extent to which your abilities are limited.
To prepare for your doctor’s appointment, it may be helpful to think about:
- How your symptoms vary during the day.
- What you do to improve your symptoms
- What makes your symptoms worse
What causes spasticity?
Spasticity is caused by damage to nerve cells in the spinal cord or brain. Aside from trauma to the brain or spinal cord, there are several conditions that can cause nerve damage, such as:
- Brain damage caused by lack of oxygen
- Multiple sclerosis
- Adrenoleukodystrophy
- Cerebral palsy
- Amyotrophic lateral sclerosis
- Neurodegenerative disease
- Spinal cord injury
- Stroke
- Phenylketonuria
Regardless of the cause, there are some factors that can worsen spasticity. These usually involve unpleasant sensations, such as infections, extreme temperatures, constipation, skin irritation, or even stress and anxiety.
Can it be prevented?
This disease cannot be prevented, but it is important to follow a series of precautions in case of spasticity. These include the following:
- Actively moving the body to reduce the risk of stiff joints and muscle contracture.
- Gentle stretching
- Wearing a splint or an alternative orthotic.
- Avoid pressure ulcers
- Care for and wash the skin to prevent fungus.
- Make use of the hand affected by spasticity.
- See a physical therapist for exercises.
Treatments for spasticity
Treatment aims to improve mobility, reduce pain and ultimately help you better perform the tasks that are important to you.
Treatment may involve:
- Exercises: these will be tailored to your needs to stretch and strengthen your muscles.
- Medications: this may include pills that are prescribed for the entire body to relax the muscles and injections for specific muscle groups.
- Surgery: sometimes recommended for tendon release or to implant a pump that delivers medications, muscle relaxants, continuously.
The correct combination of treatment will vary from patient to patient. This is because everyone’s priorities are different and some people respond better to certain treatments than others.
Which specialist treats you?
The expert in charge of the treatment of spasticity is the Physiotherapist and Neurologist.