When your muscles contract, become stiff, or spasm involuntarily, it is called spasticity. Spasticity can make it difficult to walk, move, or talk. It can be uncomfortable and painful at times.
Spasticity occurs when the nerve impulses that control muscle movement are interrupted or damaged. A variety of conditions can cause this, including spinal cord injury, brain injury, and diseases such as amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS).
According to the National MS Society, spasticity has some benefit for people with very weak legs. The rigidity from spasticity can help them to stand or walk, (NMSS, 2012). For these people, the goal of treatment should be to relieve pain while maintaining the rigidity needed to function.
Prolonged spasticity can lead to frozen joints, pressure sores, and an inability to function normally. Make an appointment with your doctor if you have spasticity with an unknown cause.
Stretching exercises can help relieve spasticity. Your doctor may recommend physical therapy or massage. Prescription medications for spasticity include muscle relaxants, sedatives, and nerve blockers. Surgery is used in some cases.
Episodes of spasticity can range from very mild to debilitating and painful. Signs of spasticity include:
- muscle tightness
- joint stiffness
- involuntary jerky movements
- exaggeration of reflexes
- unusual posture
- abnormal positioning of fingers, wrists, arms, or shoulders
- muscle spasms
- involuntary crossing of the legs (this is called "scissoring" because the legs cross like the tip of a pair of scissors)
- difficulty controlling the muscles used to speak
- muscle contraction that limits your range of motion or prevents your joints from extending all the way
- pain in the affected muscles and joints
- back pain
- difficulty moving
Spasticity can be triggered when you change position or move suddenly. Other spasm triggers include high humidity, extreme heat, extreme cold, infection, and clothing that is too tight. Your ability to perform normal tasks can be affected if spasms become too frequent.
The main cause of spasticity is damage to the nerve pathways that control the movement of muscles. This can be a symptom of a variety of conditions and diseases, including:
- brain injury
- spinal cord injury
- cerebral palsy
- multiple sclerosis (MS)
- amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease)
- hereditary spastic paraplegias
- Krabbe disease
If spasticity is not properly managed, it can result in frozen joints and pressure sores on your skin. Prolonged episodes of spasticity can lead to the inability to move your ankles, knees, hips, elbows, and shoulders. This can affect your ability to move, walk, and function normally.
When to Seek Treatment
Contact your physician if:
- you are experiencing spasticity for the first time and do not know the cause
- your spasticity is getting more severe or is happening more frequently
- your spasticity has changed considerably
- you have a frozen joint
- you have pressure sores or red skin
- your level of discomfort or pain is increasing
- you are finding it difficult to perform everyday tasks
Treatment will be based on the frequency and level of your spasticity and the underlying condition that is causing it. Your doctor may suggest physical therapy or exercises you can do at home. In some cases, a cast or splint may be used to prevent your muscles from becoming too tight.
Many medications are used to treat spasticity, including:
- botulinum toxin (injected directly into spastic muscles)
- baclofen (muscle relaxant)
- diazepam (sedative)
- phenol (nerve blocker)
- tizanidine (calms spasms and relaxes tight muscles)
Some of these medications can cause uncomfortable side effects such as fatigue, confusion, and nausea. Do not stop taking your medication on your own if you experience the side effects. Consult with your doctor.
Surgery may be recommended for tendon release or to sever the nerve-muscle pathway when medications and physical therapy don’t improve symptoms. Remain under a doctor’s care and receive regular monitoring for spasticity.
- A physical therapist or physician can teach you the best stretching exercises for spasticity and overall health. You may need someone to help with your exercises.
- Avoid extremely hot or cold temperatures.
- Wear loose-fitting clothing and avoid restrictive garments.
- Avoid fatigue by getting plenty of sleep.
- Be sure to change your position often to avoid getting pressure sores if you use a wheelchair or stay in bed for long periods.