What is it?
Spasticity occurs when a muscle involuntarily contracts when you move. It sometimes happens in your limbs after a stroke. It can be painful — like a charley horse — and can create stiffness and tightness. When a muscle can't complete its full range of motion, the surrounding tendons and soft tissue can become tight. This makes stretching the muscle much more difficult. If left untreated, the muscle can freeze permanently into an often-painful position. Spasticity in the arm can cause a tight fist, bent elbow and arm pressed against the chest. Spasticity in the leg may cause a stiff knee, pointed foot and curling toes. This can seriously interfere with the ability to perform daily activities. Also available in Spanish: Un Día En La Vida De Un Sobreviviente de Ataque Cerebral con Espasticidad
How is it treated?
Health care providers consider the severity of spasticity, overall health and other factors to determine treatment, which may include:
- Physical exercise and stretching: Stretching helps maintain full range of motion and prevents permanent muscle shortening.
- Braces: These can hold a muscle in a normal position to keep it from contracting.
- Intrathecal baclofen therapy (ITB): Delivers medication where it’s most effective and minimizes side effects that often accompany oral medications. A small pump is surgically implanted to supply baclofen to the spinal cord.
- Oral medications: Several oral medications can help relax the nerves so that they don’t send a continuous message to the muscles to contract. Side effects may be weakness, drowsiness or nausea.
- Injections: Some medications can be injected to block nerves and help relieve spasticity in a muscle group. This treatment weakens or paralyzes the overactive muscle. Side effects are minimal, but there may be soreness where injected.
Which treatment is best for me?
Talk to your health care providers about the most effective treatments for you. Every person responds differently to the various treatments.
Tips for living with spasticity
Managing spasticity with assistive devices, aids and home adaptations can help enhance your safety. Physical and occupational therapists can recommend appropriate aid(s), safety procedures, maintenance and proper fit.
Modifications in your home to improve safety include:
- Grab bars
- Raised toilet seats
- Shower or tub bench
- Plastic adhesive strips on the bottom of the bathtub
- Braces, canes, walkers and wheelchairs Always follow your rehabilitation therapist’s recommendations about limitations and safety.
Functional Electrical Stimulation
Spasticity is muscle overactivity that occurs when communication between your brain and spinal cord is disrupted by a spinal cord or other injury or an illness. One possible treatment is functional electrical stimulation, which delivers a shock to your affected muscle, activating nerves and making the muscle move.
For example, electrodes can be placed on the wrist extensor muscles of the forearm. You relax your hand, then contract the wrist extensor muscle to cause movement. This movement triggers an electric shock, which causes greater movement of the hand. Electrical stimulation can be used on all parts of the body, including the shoulders and legs. The shock can range from a mild tingling sensation to almost a burning sensation depending on the intensity level chosen.
The benefits are improved movement and enhanced motor control. The main drawback is how well you tolerate the sensation of electrical shock. An electrical stimulation session at a rehabilitation center is billed like an ordinary physical therapy session and is reimbursable through Medicare.
Since 2004, FES is increasingly common. Multiple FES devices for drop foot are currently on the market which use surface electrodes to stimulate the peroneal nerve. This controls the movement of the ankle and foot to stimulate raising the foot at the right time.