What is Spasticity?
We see a number of patients who present with spasticity. Spasticity is involuntary muscle overactivity, which encompasses a range of conditions. It commonly follows damage to the central nervous system; the brain and or the spinal cord.
Spasticity can be present in the following conditions:
- Multiple sclerosis
- Parkinson’s disease
- Spinal cord injury
- Traumatic brain injury
- Stroke
It presents in a variety of ways depending on the size, location of affected muscles. Spasticity has harmful secondary effects such as pain, deformity and impaired function.
Spasticity is a disruption of muscle movements it causes groups of muscles to contract when you try to move or even at rest. The muscle remains contracted and resists when being stretched. It can be mild so you have a feeling of tightness or it can be severe that causes pain and uncontrollable stiffness.
Sometimes spasticity can make it look like your arm or leg is moving on its own, this is associated with activity and your effort. Some examples maybe your arm maybe out stretched but with the effort of standing becomes flexed. This also may happen when you sneeze or yawn.
Patients may experience involuntary crossing of their legs, difficulties performing everyday tasks such as getting dressed and bathing, their posture may change and sleep maybe disrupted due to spasms or muscle tightness.
What is the difference between spasticity and rigidity?
Muscle rigidity and muscle spasticity are both hypertonic states, high muscle tone but they are different!
Rigidity is most commonly associated with basal ganglia injuries such as Parkinsons. Rigidity affects all muscles surrounding a particular joint. When a joint is taken through a range tone remains the same this is rigidity. Spasticity is when there is rapid movements and you get a stronger involuntary contractions of the affected muscles.
Complications of Spasticity
It interferes with daily function which can make performing hygiene and basic care difficult. This can lead to the risk of developing pressure injuries(bed sores) which can lead to infection and sepsis.
How is spasticity treated?
There are several treatment options, most patients have a combination of more than one treatment. Usually there are different professionals involved in your treatment; physiotherapist, neurologist, occupational therapist, speech and language therapist, orthopaedic surgeon.
Oral medication may be prescribed such as baclofen, diazepam, gabapentin. Local injections of botulinium toxin (Botox) can be very effective for treating spasticity. The injection is applied to a specific muscle or muscle group. It takes seven to ten days to take full affect. Management afterwards is needed in the form of splints and physiotherapy.
Orthopaedic surgery is used as a consequence of spasticity on the muscles, bones and connective tissues such as a contracture and or deformities it may be tendon lengthening to the achilles.
Patients goals are often very clear:
- To have pain relief
- To be able to use the affected limb
- To make it easier to care for the limb, for example clean the palm of the hand
- To have a reduction in involuntary movements (spasms,jerks)
- Not to get contractions and deformities
- To gain mobility
Your goals are discussed with us and any family members. Should you wish to be assessed by one of our specialist physiotherapists please contact 01245 377118
