Spasticity

Spasticity is a condition in which muscles become tight and stiff, which makes movement, especially of the arms or legs, difficult or uncontrollable. Approximately 40 percent of stroke survivors live with spasticity.

After a stroke, damage to brain tissue can inhibit messages between muscles and the brain, limiting coordination and muscle movement. Spasticity can make daily activities such as bathing, eating and dressing more difficult. There are many management strategies and treatments to help stroke survivors recover, return to work and regain strength.

Symptoms

Spasticity can cause long periods of forceful contractions in major muscle groups, causing painful muscle spasms. The spasms produce a pain similar to athletic cramping.

Symptoms include:

A tight fist
Bent elbow
Arm pressed against the chest
Stiff knee
Pointed foot
Stiffness in the arms, fingers or legs
Painful muscle spasms
A series of involuntary rhythmic contractions and relaxations in a muscle or group of muscles that lead to uncontrollable movement or jerking, called clonus
Increased muscle "tone"
Abnormal posture
Hyperexcitable reflexes

Treatment

In order to achieve the best results possible, a mixture of therapies and medications are often used to treat spasticity. It’s important to note that all therapies and medications have potential risks and side effects. Ask a healthcare professional about the best treatment plan for you.

Stretching

Range-of-motion exercises at least three times a day
Gentle stretching of tighter muscles
Frequent repositioning of body parts

For exercises you can do at home, watch and listen to iHOPE: Rehabilitation at Home.

Medication

There are many medications that treat the general effects of spasticity. These drugs act on multiple muscle groups in the body.

Generic Name	Brand Name	Assistance Program	Class	What It Does
Tizanidine Hydrochloride	Zanaflex Capsules™	AcordaTherapeutics	Skeletal Muscle Relaxant	Reduces spasticity by blocking nerve impulses. It is effective without loss in muscle strength.
Baclofen	Lioresal^® (Capsules and Intrathecal Injection)	Medtronic Inc. (Contact information only)	GABA Receptor Antagonist	Acts on the central nervous system to relax muscles. It decreases the rate of muscle spasms, pain and tightness and improves range of motion. Baclofen is not indicated for stroke survivors with spasticity due to problems with the brain (of cerebral origin).
Benzodiazepines	Valium^®, Klonopin^®	Genentech	Benzodiazepines	Acts on the central nervous system to relax muscles and temporarily decrease spasticity. These drugs can be sedating for stroke survivors.
Dantrolene Sodium	Dantrium^® (Capsules or Injection)	JHP Pharmaceuticals (Contact information only)	Muscle Relaxant	Acts directly on the muscle by blocking the signals that cause muscles to contract. Use can lessen muscle tone.
Onabotulinumtoxin	Botox^®	Allergan	Neurotoxin	Prevents the release of chemicals that cause muscle contraction. The shots target specific limbs or muscle groups and help control side effects to other areas of the body.

Surgery Surgery can be done on the muscles or tendons and joints. Surgery may block pain and restore movement. Back to Top \| Symptoms \| Treatment \| Management \| Resources
Management Managing spasticity with assistive devices, aids and home adaptations can help ensure safety and reduce the risk of spasticity-related falls. Always follow rehabilitation therapists’ recommendations regarding limitations and walking needs. Assistive Devices and Adaptations
	Grab bars Ramps Raised toilet seats Tub bench Hand-held shower head	Plastic adhesive strips on the bottom of the bathtub Long-handled brushes, washing mitts with pockets for soap Electric toothbrushes and razors
Movement Aids Braces, canes, walkers and wheelchairs may help stroke survivors move about freely as they gain strength. Physical and occupational therapists will recommend the appropriate aid as well as safety procedures, maintenance and proper fit. Lifestyle Changes Making simple lifestyle changes can help prevent falls and promote a healthier recovery. Some examples include: Remaining active Strengthening leg muscles and balance through exercises Wearing flat, wide-toed shoes Eating calcium-rich foods/taking calcium supplements Using prescribed assistive devices and not relying on furniture for support while walking Taking precautions when taking medications that cause drowsiness Paying close attention while walking Back to Top \| Symptoms \| Treatment \| Management \| Resources