It is stiffness or tightness in the muscles. There is involuntary muscle overactivity, which commonly follows damage to the central nervous system (brain and spinal cord). Conditions that may have issues with spasticity include stroke, traumatic brain injury, multiple sclerosis and spinal cord injury.

Spasticity presents in varied ways, depending on the size, location and chronicity of the lesion and may have several harmful effects such as pain, deformity and impaired function.  Spasticity is not always harmful and some patients rely on the increased spasticity to maintain their posture or to aid standing or transfers. There are patients with spasticity who need little or no treatment. However, muscle spasticity may change over time and therefore requires repeated assessment and management.

Indicators for spasticity management include:

  • Pain
  • Spasms
  • Hygiene issues
  • Pressure care risks
  • Issues with 24 hour postural management (bed and/or wheelchair)
  • Change in function
  • Poorly fitting splints
  • Change in range of motion
  • Falls / change in gait pattern

Ways to help with spasticity include:

  • Stretching
  • Positioning wedges
  • Oral medication
  • Injectable medication, such as botulinum toxin injection
  • Posture management, motor training, sensory rehabilitation
  • Physiotherapy and occupational therapy interventions

Aims of spasticity management are:

  • symptom relief
  • improving function
  • preventing deterioration

Spasticity management is complex and should be undertaken by a coordinated multidisciplinary team, rather than by clinicians working in isolation. Therefore, a medical specialist who is qualified in the medical management of spasticity including botulinum toxin injection must be involved in the spasticity management process along with an interdisciplinary allied health team.

Dr Yan Chow provides management of spasticity at her Malvern rooms.