Blog > August 2019 > Spasticity: A multidisciplinary disorder

Spasticity: A multidisciplinary disorder

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If you or a loved one has been diagnosed with spasticity, it is important to gain a comprehensive understanding of the disorder and its impacts. Knowing the causes and effects of spasticity can give insight into treatment options and will improve your ability to manage the effects of the condition.

What is spasticity and how is it caused?

Spasticity is a condition that can be caused by damage to the area of the brain or spinal cord in which voluntary movement controls are located. It can also be caused by a number of velocity-dependent conditions affecting the Central Nervous System. Such conditions will result in specific muscles experiencing continuous contractions, stiffness or tightness.

Types of spasticity

There are two different kinds of spasticity:

  1. Static: Muscle contractions or stiffness can be triggered independent of activity or position
  2. Dynamic: The muscle stiffness and contractions associated with spasticity are only caused by specific positions or situations.

Signs of spasticity:

Spasticity can range from a feeling of mild tightness in a muscle to uncontrollable spasms, causing pain and tightness in your arms, legs or joints. Such uncontrollable spasms or stiffening can limit one’s ability to walk, to speak and carry out day-to-day activities.

An individual who is diagnosed with a form of spasticity may experience spasms in any muscle. However, it is most common in:

  • Lower extremities: the sides of the thighs, the gemellus and across the hip abductor muscles.
  • Upper extremities: wrists, biceps, flexor muscles of the fingers as well as shoulder adductor muscles.

There are a number of other symptoms linked to spasticity, including:

  • Stiffness in the muscles, causing an overall difficulty in movement
  • Abnormal posture
  • Muscular and joint pain
  • Muscle fatigue
  • Spasms
  • Lack of longitudinal muscle growth

Other, non-muscular complications can include:

  • Systematic illnesses or fevers
  • Pressure sores
  • Urinary Tract Infections (UTI)
  • Chronic constipation

Who is affected by spasticity?

Currently, there are twelve million people around the world that have been diagnosed with some form of spasticity. The two most common conditions associated with spasticity are cerebral palsy and multiple sclerosis, however, there are a number of neurodegenerative diseases and disabilities that can result in spasticity.

Any individual who has been diagnosed with one of the following conditions may experience spasticity:

  • Stroke
  • Ataxia
  • Spina bifida
  • Acquired brain injury
  • Meningitis
  • Encephalitis
  • Amyotrophic Lateral Sclerosis
  • Pathogens causing neurological damage

The intensity of spasticity is dependent on a variety of factors and can range between.

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How is spasticity diagnosed?

In order to determine if an individual has spasticity, the patient must undergo an extensive medical examination assessing a number of different factors.

Such factors include:

  • Gait
  • Signs of pain shown by the patient
  • Muscle spasms
  • Selective motor control; this is assessed by observing the individual’s ability to make different movements
  • Joint balance
  • Muscle tone; measured via examination of flexion and tension using the Ashworth Scale
  • Patient’s medical and family history

How is spasticity treated?

Unfortunately, there is no known cure for spasticity. However, the symptoms of spasticity can be easily managed through the use of therapeutic, pharmacological or surgical intervention. The treatment of those diagnosed with spasticity must be closely managed by neurologists, neurosurgeons, physiotherapists, traumatologists, rehabilitation physicians and in some cases, psychologists.

Non-pharmacological therapeutic interventions:

This approach to managing spasticity involves the use of gentle physical exercise, such as swimming, muscle stretching, standing exercises and hydrotherapy, in order to improve muscle tone and minimize the severity of any episodes experienced by the individual. Splints, prostheses and hot and cold packs can also be beneficial to the person with spasticity.

Pharmacological interventions:

Oral prescriptions such as baclofen, benzodiazepines, dantrolene and tizanidine are the most commonly used medications to assist in controlling the symptoms of spasticity. Botulinum is also common and is injected straight into the affected muscle group to reduce unwanted spasms or paralyse the muscle completely.

The use of prescription medication is effective; however, these drugs often have unwanted side-effects, including, drowsiness and nausea.

Surgical interventions:

The most popular surgical treatment for spasticity is the insertion of a ‘baclofen pump’. The small pump is placed in the abdominal area in a minimally invasive surgery. Once inserted, the pump can release a drug into the spinal cord via a catheter. This method is highly effective as it allows for a quicker delivery of medication directly to the muscles affected by spasms. This method also means that a lower dose of medication can be used during episodes.

If you would like to find out more about spasticity and its implications, visit the American Association of Neurological Surgeons. If you have learnt anything from this article, take a look through the Sunrise Medical blog to learn more about the causes and impacts of different mental and physical disabilities. 

Sunrise Medical  are fully equipped to help you or your loved ones to manage spasticity or any conditions relating to the disorder. With an extensive range of wheelchairs and seating options, you can take the time to find a product catered to your requirement.