Unmanaged Spasticity: Risks, Treatment, and More

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Unmanaged Spasticity: Risks, Treatment, and More


  • Spasticity creates chronic muscle tightness and stiffness, which reduces overall mobility.
  • If left unmanaged, spasticity may lead to complications, such as pain and frozen joints.
  • Treatment for spasticity often involves a combination of therapies and medications.

Spasticity is known for its impact on muscle movement. When you have this condition, your muscles stay in a contracted state, due to chronic muscle tightness and stiffness.

If left untreated, a person with spasticity can be at risk for serious complications beyond the typical pain and reduced mobility associated with the condition.

Learn more about these risks and what treatments are available to help improve your quality of life with spasticity.

While spasticity can affect gross motor skills involving the whole body, such as sitting and walking, it can also affect fine motor skills, such as eating, writing, and brushing your teeth. Even your ability to speak is controlled by your muscles.

Some of the most common symptoms of spasticity include:

  • muscle stiffness, ranging from mild to severe
  • inability to complete daily tasks, such as cooking or getting dressed
  • muscle spasms
  • painful muscle contractions
  • fatigue after mild activity
  • crossing your legs involuntarily

Complications that may arise from unmanaged spasticity. These concerns differ for adults versus children, whose joints and muscles are still developing.

But adults with unmanaged spasticity may still experience joint and muscle issues. Complications include:

  • Frozen joints. Also called fixed joints or joint contractures, frozen joints can develop when reduced range of motion causes them to splint and become immobile. Examples include stiff knees and curled toes, which can be painful and make it difficult to move.
  • Pressure sores. Also called pressure ulcers, these sores develop from prolonged bed rest or sitting in a chair due to inactivity. Severe pressure sore wounds can eventually reach muscle and bone.
  • Gastrointestinal (GI) issues. Some related complications include chronic constipation and frequent urinary tract infections (UTIs).

People living with spasticity may also be prone to frequent low-grade fevers and systemic illnesses.

Once your doctor has determined the cause of your spasticity, they can recommend specific treatment options to help improve your quality of life and decrease the risk of potential complications.

In addition to targeting the underlying cause of your spasticity, your neurologist may recommend a combination of the following treatment options.

Therapies

Physical therapy and occupational therapy are among the standard treatments for spasticity. With physical therapy, the muscles and stretched and strengthened to help improve overall mobility and range of motion.

Occupational therapy targets more fine motor skills, while also focusing on improving movements for everyday tasks. These tasks include eating, dressing, and brushing your teeth.

If spasticity affects your speech, your neurologist may also recommend speech therapy. Some speech-language pathologists are also trained in feeding therapies to help with difficulty swallowing.

Botulinum toxin (Botox) injections

For adults living with spasticity, botulinum toxin (brand name Botox) injections may help paralyze specific muscles so they stop contracting. This treatment option must be repeated every 12 to 16 weeks for your muscles to remain in a relaxed state.

One drawback of this treatment is that it may eventually become ineffective as new nerve endings are formed. For this reason, your doctor will likely recommend this treatment sparingly.

Medications

Medication doesn’t typically prevent spasticity symptoms from worsening, but it may help improve sleep and daily functioning to give you the stamina to keep moving throughout the day.

Options may include:

  • muscle relaxers, such as baclofen and dantrolene sodium
  • gabapentin, an anticonvulsant that may also treat nerve pain
  • benzodiazepines, depressant medications that may treat anxiety and insomnia
  • imidazolines for anti-hypertensive effects

Surgery

Surgery may be considered as a last resort for treating spasticity. A surgical procedure called selective dorsal rhizotomy may help treat severe spasticity in the legs by severing specific nerve-muscle pathways. This type of surgery is most common for spasticity in people with cerebral palsy.

Instead of taking it orally, baclofen may be administered directly to the spinal fluid through a pump surgically implanted in the abdomen. This helps the medication work more effectively while also minimizing side effects. This treatment measure is called intrathecal baclofen therapy (ITB).

You should see your doctor right away if you’ve been diagnosed with spasticity as part of an underlying medical diagnosis and are experiencing worsening symptoms.

Additionally, any new symptoms of spasticity, such as unexplained muscle stiffness and soreness, should be addressed right away.

Consult your primary doctor first. Depending on their findings, they may refer you to a neurologist for further evaluation and treatment.

If you have spasticity, it’s important to seek treatment right away and keep track of changing symptoms.

While your doctor will still want to treat the underlying cause of spasticity, they will also help you manage chronic muscle contractions to prevent serious complications. Complications include frozen joints, gastrointestinal problems, and pressure sores.

If you’re currently being treated for spasticity and aren’t seeing any improvements, contact your doctor for a follow-up. Treatments for spasticity may involve a combination of methods including medication, physical and occupational therapy, and sometimes surgery.



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