What You Need to Know About Spasticity

What is spasticity?
Spasticity is a motor disorder characterized by tight or stiff muscles that may interfere with voluntary muscle movements. Spasticity usually involves the muscles of the legs and arms.

What are the characteristics of spasticity?
In addition to increased muscle tone, spasticity is characterized by increased muscle stretch reflexes, muscle spasms, involuntary contraction and relaxation of muscles, exaggerated tendon jerks or reflexes and increased resistance to movement of certain muscle groups. Spasticity may vary based on initial muscle tone, length of responding muscle groups, the person's position, posture and state of relaxation.

What is the difference between a muscle spasm and spasticity?
A muscle spasm is a localized muscle contraction that occurs when the brain signals the muscle to contract. Spasticity occurs when nerves in the spine cause the muscles to contract. With spasticity, the brain signals no longer communicate with the motor nerves to stop muscles from contracting.

What causes spasticity?
Spasticity is the result of an imbalance in the central nervous system, often caused by damage to the spinal cord or brain. This imbalance causes hyperactive muscle stretch reflexes that result in involuntary contractions and increased muscle tone.

Who is affected by spasticity?
Spasticity may affect people with neurological disorders, or brain or spinal cord injuries or diseases. Neurological disorders include multiple sclerosis, cerebral palsy, anoxia (an abnormal condition characterized by a lack of oxygen) or people who have had a stroke.

How is spasticity diagnosed?
Spasticity is diagnosed by first evaluating the person's medical history including what medications he or she has taken and whether there is a history of neurological or muscular disorders in the family. To confirm the diagnosis, several tests can be performed that evaluate the person's arm and leg movements, muscular activity, passive and active range of motion and ability to perform self-care activities.

How is spasticity treated?
Spasticity can be treated through therapy, medications, surgery or any combination of these treatments. Your health care providers will consider the severity of spasticity, your overall health and the following when prescribing an appropriate treatment plan:

The goals of treatment include:

Physical therapy
A basic stretching program is the first step in treating spasticity. Prolonged stretching can lengthen muscles to help decrease spasticity.

Occupational therapy
Splinting, casting and bracing techniques may be prescribed to maintain available range of motion and flexibility.

If physical and occupational therapy do not adequately control the spasticity, medications may be added to the treatment plan.

Common medications used to treat spasticity include baclofen and diazepam. These medications can be used to treat spasticity by causing the nerves to relax so they are not sending a message to the muscles to contract.

If medications taken by mouth (orally) are not effective, an implantable programmable pump can be used to deliver baclofen. Botulinum-toxin type A can also be injected locally into the affected muscle group.

Rhizotomy and tendon release are some surgical procedures used to treat spasticity when other treatment methods are not successfully controlling the spasticity.

Rhizotomy is the surgical resection of part of the spinal nerve, performed to relieve pain or decrease muscle tone. An alternative surgical spasticity treatment is the implanted baclofen pump that delivers medication directly into the spinal cord.

Tendon release may be performed to help reduce the frequency or magnitude of the spasticity, depending on the age of the patient. Tendon release procedures are irreversible and may need to be repeated.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact the Center for Consumer Health Information at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771. If you prefer, you may visit www.clevelandclinic.org/health/ or www.clevelandclinicflorida.org. This document was last reviewed on: 3/29/2002