Spasticity Management
Spasticity happens when muscles are continuously contracted. Spasticity can affect one muscle or a group of muscles; it can affect movement, speech, and walking. It makes the muscles stiff and possibly unable to move.
In spinal cord injury patients, spasticity usually affects the areas of the body that receive nerve signals below the level of injury. In a person with a T5 injury, for example, the trunk and legs may have spasticity. In a person with an L2 injury, however, only the legs will be affected.
Symptoms
Spasticity can range from mild muscle stiffness, to severe, painful, and uncontrollable muscle spasms. Other symptoms include:
- increased muscle tone
- hyperactive reflexes
- clonus — a series of rapid muscle contractions that produce movement
Treatment
The first step to treat spasticity is to look for a noxious stimulus — something bad or foreign to the body. A urinary tract infection, constipation, or a skin infection can cause an increase in spasticity. If a cause is not found, the next step is to treat the spasticity in a variety of methods. Stretching and ice may only do so much to help the spasticity. A physician might have to prescribe medication to treat it.
First-line medications include Lioresal (baclofen) or Zanaflex (tizanidine). These medications are started at low doses and adjusted gradually based on the body’s response to the medication. Never discontinue Lioresal (baclofen) without contacting your physician. Side effects include:
- drowsiness
- dizziness
- nausea
- vomiting
- other types of abdominal discomfort
The physician may recommend injections of botulinum toxin if the spasticity is concentrated in one part of the body. A physician trained in the procedure performs injections with the help of electromyographic guidance. The doctor uses a needle that can detect specific points of muscle hyperactivity and will inject only in the areas that are hyperactive.