Spasticity is a condition described by stiff or rigid muscles and exaggerated deep tendon reflexes that interferes with muscular activity, gait, movement, or speech.
Spasticity generally results from damage to the motor area of the brain (the portion of the cerebral cortex that controls voluntary movement) and to any portion of the subcortical white matter (nerves travelling from brain down to spinal cord).
When control of the muscles from the central nervous system is damaged, muscle feedback pathways from the spinal cord produce symptoms such as exaggerated deep tendon reflexes (the knee-jerk reflex), scissoring (crossing of the legs as the tips of scissors would close), repetitive jerky motions (clonus), unusual posturing, and carrying the shoulder, arm, wrist, and finger at an abnormal angle.
Spasticity may also interfere with speech. Severe, long term spasticity may lead to contracture of muscles causing joints to be bent at a fixed position.
- Cerebral palsy
- Brain damage caused by lack of oxygen, as can occur in near drowning or near suffocation
- Brain trauma
- Severe Head injury
- spinal cord injury
- Some metabolic diseases
- Neurodegenerative illness
- Multiple sclerosis and other demyelinating diseases
Spasticity may often be helped by physical therapy. Daily routines of exercise including muscle stretching (to prevent joint contractures) will help reduce the severity of symptoms of severe spasticity. Physical therapy can be taught to parents who may then administer the care at home.
Medication for spasticity can be taken orally. These medications include Baclofen, Tizanidine and Benzodiazepines. Rarely, a pump can be inserted into the spinal fluid and medication can be administered directly into the nervous system.
Call your health care provider if
- The spasticity worsens.
- Contracture deformities appear to be developing.
- There is any deterioration in the condition.
What to expect at your health care provider’s office
The medical history will be obtained and a physical examination performed.
Medical history questions documenting spasticity in detail may include:
- When was it first noticed?
- How long has it lasted?
- Is it always present?
- How severe is it?
- What muscles are affected?
- What makes it better?
- What makes it worse?
- What other symptoms are also present?
A diagnosis of spasticity usually will have been made following a brain injury or the diagnosis of Cerebral palsy (often in a hospital setting). Physical therapy consists of stretching exercises, muscle group strengthening exercises, and repetitive motion exercises (for improvement of accuracy and performance at given tasks). Occasionally, surgery is required for tendon release or severing of the nerve-muscle pathway.
After seeing your health care provider:
If a diagnosis was made by your health care provider as the cause of spasticity, you may want to note that diagnosis in your personal medical record. Also note what treatment is being done for the muscle spasticity.
by Janet G. Derge, M.D.