What is spasticity?
Spasticity occurs as a result of injury or damage to either the brain or the spinal cord, which together are called the central nervous system. Damage to the central nervous system can occur in many conditions.
These conditions include stroke, brain injury, cerebral palsy, multiple sclerosis and spinal cord injury.
Damage to the central nervous system will often result in a range of physical (as well as intellectual and emotional) symptoms. These physical symptoms include weakness or paralysis, loss of fine muscle control of movements, and muscle spasms and tightness.
It is the spasms and tightness of muscles that are usually referred to as spasticity.
What are the signs and symptoms?
Spasticity can have serious effects on people. For example, severe muscle tightness in the legs can cause difficulty with walking, usually causing patients to walk on their toes or outer feet resulting in poor balance, frequent falls, pressure on hips and knees and excessive (and expensive) shoe wear.
Tightness at the hips can also cause difficulty with walking, hygiene between the legs and with toileting and dressing. Tightness in the arms and hands can result in difficulties opening the fingers or extending the elbow or wrists resulting in problems with both hand and arm function and often with hygiene.
Muscle spasms can be painful, can interfere with sitting in a chair or even lying in bed, and can make moving from one place or position to another (transfers) very difficult. It is also common for the patient to experience increased tiredness due to the increased amount of energy required by the involved muscles and to undertake voluntary movement.
How long does spasticity last?
Spasticity is almost always a life-long condition. In many people, spasms will gradually worsen over the years increasing the problems with pain, comfort and transfers.
In people with spasticity, muscle tightness will also often gradually worsen over time.
If prolonged, this muscle tightness can result in permanent muscle shortening and even remoulding of joints such that the patient can no longer move the joint. This is known as ‘contracture’. Once contractures have occurred treatment can be very difficult, often requiring surgical intervention to achieve even partial correction.
Appropriate management of spasticity will often prevent the development of contractures.