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Overview

What Is Spasticity?

Spasticity is abnormal muscle tightness or stiffness caused by disrupted nerve signals that control voluntary movement. It can affect people with conditions involving the brain or spinal cord, including stroke, cerebral palsy, multiple sclerosis, or spinal cord injury. The spasticity definition ranges from mild stiffness to severe tightness that restricts movement. Muscle spasticity may also cause involuntary movements, spasms, or difficulty controlling a limb.

Symptoms

Symptoms of Spasticity

  • Involuntary muscle tightening
  • Muscle stiffness
  • Sudden or repeated muscle spasms
  • Abnormal positioning of an arm, leg, hand, or foot
  • Difficulty walking
  • Reduced range of motion
  • Pain or aching in tight muscles

Symptoms may affect the arms, legs, trunk, or other muscle groups. Their pattern and severity can vary with the underlying neurological condition, the muscles involved, and the degree of muscle spasticity.

Causes

Causes of Spasticity

Spasticity develops when damage or disease disrupts the pathways in the brain or spinal cord that control voluntary movement. Without normal signals to balance muscle activity, muscles may remain overactive or tighten too easily.

  • Stroke can damage brain areas or pathways involved in muscle control and lead to spasticity.
  • Cerebral palsy results from early brain development or brain injury and may cause ongoing muscle overactivity.
  • Multiple sclerosis can affect nerve pathways in the brain and spinal cord that coordinate movement.
  • Spinal cord injury can interrupt signals between the brain and muscles below the injury.
  • Traumatic brain injury may damage movement-control pathways and cause abnormal muscle tone.
  • Other central nervous system conditions, including brain or spinal cord disorders, may also cause muscle spasticity.

Risk Factors

Risk Factors for Spasticity

  • A history of stroke
  • Multiple sclerosis or another neurological disease
  • Spinal cord injury
  • Traumatic brain injury
  • Cerebral palsy
  • Other conditions affecting brain, spinal cord, or motor pathways

Most risk factors are non-modifiable medical conditions rather than lifestyle choices. Infection, pain, stress, constipation, or a change in position may worsen symptoms in some people, even though these factors do not usually cause the underlying condition.

Complications

Complications of Spasticity

  • Falls
  • Pain
  • Reduced mobility
  • Joint contractures
  • Pressure injuries
  • Sleep disruption
  • Difficulty with hygiene
  • Challenges with dressing
  • Difficulty transferring between surfaces

Complications depend on which muscles are affected and how long they remain tight. Severe or persistent muscle spasticity can interfere with movement, comfort, skin care, and daily activities. Early assessment and treatment may help preserve range of motion and function.

Diagnosis

How Spasticity Is Diagnosed

A clinician reviews symptoms and medical history and observes movement patterns. The examination may include muscle tone, reflexes, strength, range of motion, walking, coordination, and the effect of symptoms on daily function.

Tests for the Underlying Cause

Depending on the symptoms and suspected condition, testing may include brain or spinal imaging, nerve or muscle testing, blood tests, or an assessment by a neurologist or other specialist. There is no single test that confirms every case of spasticity; testing is selected to identify the underlying neurological cause and assess its effects.

Treatment & Management

Treatment and Management of Spasticity

First-line management may include physical therapy, stretching, strengthening, occupational therapy, positioning, and braces or other orthoses. Treating triggers that worsen symptoms, such as pain or infection, can also help. A rehabilitation plan is adjusted to the person’s goals, abilities, and underlying condition.

ApproachTypical purposeImportant considerations
Oral medicinesReduce muscle overactivity throughout the bodyMay cause sleepiness, weakness, dizziness, or other side effects; dosing is individualized
Botulinum toxin injectionsRelax selected muscles and improve a specific movement problemEffects are temporary and injections must target appropriate muscles
Intrathecal baclofenDeliver baclofen around the spinal cord for severe, widespread spasticityRequires an implanted pump and ongoing specialist monitoring
Surgery or other proceduresAddress severe tightness, fixed contractures, or selected nerve and movement problemsUsually considered when less invasive treatments do not provide adequate benefit

Treatment is individualized and may combine several approaches. The goal may be better comfort, movement, hygiene, sleep, safety, or function rather than complete elimination of muscle tone. Long-term management of muscle spasticity often involves regular reassessment and rehabilitation.

Outlook and Prognosis

Outlook and Prognosis

Spasticity may be temporary, persistent, or progressive depending on its cause. The outlook also depends on the affected muscles, severity, overall health, and response to treatment. It is often manageable even when the underlying condition cannot be cured.

When Should You See a Doctor

When Should You See a Doctor?

When to get medical help

Sudden or severe changes

Seek prompt medical care for sudden new weakness or stiffness, rapidly worsening symptoms, severe pain, new trouble walking or using a limb, loss of bladder or bowel control, breathing or swallowing difficulty, fever with a new neurological change, or symptoms after a serious injury.

Arrange a nonurgent evaluation when muscle tightness, spasms, reduced range of motion, falls, sleep disruption, or difficulty with daily activities persists or worsens. A clinician can assess the cause and discuss treatment options for spasticity.

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