What is spasticity?
When muscles are tensed or contracted, they are said to have ‘tone’. Spasticity is a condition where muscles have a continually increased tone that is involuntary. This tension leads to stiffness and may cause pain as well as problems with movement. The severity can vary from a minor increase in stiffness, to very painful muscle spasms.
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What are the common causes of spasticity and who gets it?
Normally, nerve cells carry signals back and forth between the brain and muscles via the spinal cord. This allows the brain to co-ordinate movements by activating and deactivating muscles when needed.
Spasticity is caused by damage to nerve cells, which disrupts these signalling pathways. This prevents signals being carried between the brain and muscles, so the brain can’t tell the muscles to relax when they are supposed to. Unfortunately, nerve cells are often unable to heal and re-connect after they have been damaged.
Spasticity can occur due to a variety of conditions:
Brain or spinal cord injury
Brain or spinal cord injury can often damage nerve cells and cause spasticity, weakness and loss of sensation.
Infections such as meningitis (infection of the lining of the brain) or encephalitis (infection of the brain tissue itself) can cause inflammation that can result in nerve damage and spasticity.
Stroke can result in nerve cells dying off. It can be caused by a bleed into the brain or a loss of blood supply, and usually affects people aged over 65 years. Typical symptoms occur on one side of the body and can be identified by the acronym FAST: Facial drooping, Arm weakness, Speech difficulty, Time to call emergency services (if any of the F, A, or S symptoms are present).
Cerebral palsy is caused by abnormal development of the brain during pregnancy or complications around the time of birth. The damage usually occurs in parts of the brain that control muscle tone and movement.
Multiple sclerosis is a medical condition where the immune system wrongly attacks the nervous system. It often begins around the age of 30 years and affects women twice as much as men. Around 80% of people with multiple sclerosis will have spasticity. Other common symptoms include visual problems, pain and tiredness.
What are the common symptoms of spasticity and how is it diagnosed?
Spasticity symptoms usually affect the arms and legs and cause abnormal postures. The arms might be held in a flexed (bent) position, and the legs might be constantly extended (stretched out) or crossed over.
There may be some difficulty in moving the joints. The muscle spasms can be painful and will often make it difficult to carry out delicate tasks.
Constant muscle tension also leads to fatigue and weakness and may eventually cause deformities and other symptoms, including exaggerated reflexes and clonus (a series of rapid, uncontrolled muscle contraction).
Here at The London Clinic, we offer access to some of the leading specialists in movement disorders who can offer expert care. Our specialists will begin by asking questions about the symptoms, past history and any medical conditions that run in the family.
Diagnosis is based on this clinical information as well as a careful physical assessment of movement and muscle activity. MRI scans of the brain and spinal cord may also be performed to help with the diagnosis.
What are the common treatments for spasticity?
The treatment offered by our multidisciplinary team of specialists will depend on the cause of the spasticity. If an underlying medical condition is thought to be the problem, then treatment will aim to address this.
There is a wide range of spasticity treatment options available to provide relief for spasticity symptoms:
Physiotherapy delivered by experienced therapists can help with targeted stretching and strengthening exercises. These are often effective at relieving muscle tension, reducing pain, and improving mobility.
Medications such as muscle relaxants can target overactive nerves or muscles, while minor sedatives or nerve-specific painkillers can help relaxation. Medications may cause side effects of their own and it may take some time to find the most effective dose.
Botulinum toxin (Botox) injections can also be used. This involves injecting a small amount of a chemical toxin directly into the muscle that is affected. It can help to relax the muscle within a few days and offers a temporary improvement to symptoms. It is not a permanent solution, but the effects will normally last for several months.
Surgical procedures carry risks, so are generally used for severe cases of spasticity when other treatments have not worked. A special pump can be surgically placed into the abdomen to deliver a muscle relaxant directly to the fluid surrounding the spinal cord. In specific cases, an operation can be performed to cut the nerve fibres that carry signals causing spasticity.
Why choose The London Clinic?
At The London Clinic, we deliver quality, patient-centred care. We re-invest into our hospital to offer state-of-the-art facilities and innovative treatments. Our multidisciplinary teams comprise expert specialists in the field of movement disorders and clinical support teams that are second to none.