Definition

Spasticity is the involuntary contraction, stiffening, or tightening of muscles.

Causes

The amount of tone or tension in a muscle is determined by signals from the brain that travel through the spinal cord. Injury to tissue in the brain or spinal cord can cause a disruption of these signals which leads to the abnormal contractions of the muscle.

Risk Factors

Damage to specific areas of the brain or spinal cord increases the risk for spasticity. Conditions most often associated with this type of damage include:

• Cerebral palsy
• Multiple sclerosis
• Traumatic brain injury
• Spinal cord injury
• Brain damage due to lack of oxygen—such as stroke
• Brain damage from meningitis
• Amyotrophic lateral sclerosis (ALS)

Symptoms

Spasticity can range from a feeling of tightness in a muscle to severe muscle spasms or contractures. Depending on the severity of the spasticity and the location of the affected muscle other symptoms may include:

• Stiffness in muscles that can make fine movements difficult
• Muscle fatigue
• Pain in the affected muscles
• Difficulty controlling muscles needed to move and/or communicate
• Involuntary movement of limbs or joints
• Difficulty completing daily tasks

Over time, spasticity can cause:

• Deformity of bones, the spine, joints and muscle
• Impaired muscle growth in children

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done, paying particular attention to your ability to move. Spasticity can be identified through a physical exam. The cause may be apparent through a review of medical history, but further testing may be needed.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment goals include:

• Relieving muscle spasms
• Reducing pain
• Improving the ability to move and attend to personal hygiene and activities of daily living
• Improving motor function, such as the ability to grasp, move, and release objects
• Enabling normal muscle growth in children
• Preventing complications like deformities, constipation, or bed sores

Treatment options include any or all of:

Medications may be recommended for spasticity that interferes with daily activities. Options include:

• Oral medication—may be a combination of medication, may have a range of side effects
• Implanted medication pump—can deliver medication called baclofen directly to the spinal column, with fewer side effects than oral medication
• Botulinum toxin injection—may relax overactive muscles for a few months but number of injections allowed is limited

Prevention

Spasticity is usually the result of an accident or the progression of an illness. There are no general prevention steps.

Christopher and Dana Reeve Foundation http://www.christopherreeve.org

Canadian Neurological Sciences Federation http://www.cnsfederation.org

Spasticity. American Stroke Association. Available at:
http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/PhysicalChallenges/Spasticity_UCM_309770_Article.jsp
Updated January 16, 2014. Accessed January 28, 2015.

Spasticity. Christopher and Dana Reeve Foundation website. Available at:
http://www.christopherreeve.org/site/c.mtKZKgMWKwG/b.4453419/k.3757/Spasticity.htm
Accessed January 28, 2015.

Spasticity. National Multiple Sclerosis Society website. Available at:
http://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Spasticity
Accessed January 28, 2015.

7/20/2015 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Whiting PF, Wolff RF, et al. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA. 2015 Jun 23-30;313(24):2456-2473.