Spasticity happens when muscles continuously contract, causing tightness or stiffness.
It can affect:
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An SCI disrupts the normal flow of signals from the nerves of the spinal cord to the brain.
Since these signals help control muscle reflexes, disruption can cause a person with SCI to jerk, contract, or stiffen.
As many as 78% of people with SCIs have some degree of spasticity. It's more common with neck injuries than with chest or lower back injuries.
In people with SCIs, spasticity often affects places on the body that receive nerve signals below the level of injury.
For instance, spasticity may affect:
Some spasticity can be helpful, especially when standing or transferring into and out of a wheelchair.
But it can cause problems too, such as:
Over time, spasticity may decrease or be less of an issue for people with SCI.
This is often due to:
Spasticity can range from mild muscle stiffness to severe, painful, and uncontrollable muscle spasms.
Other symptoms include:
Spasticity symptoms after SCI vary, but may include:
The first step to treat spasticity is to look for a noxious stimulus — something bad or foreign to the body — such as:
These can cause an increase in spasticity.
If there's a clear cause, doctors will treat that cause. If there's no clear cause, doctors will treat the spasticity directly.
Maintaining flexibility can help reduce spasticity and prevent losing range of motion. Stretching at least twice daily can help reduce muscle stiffness.
People with SCI often work with a physical therapist, who can provide stretches and instruction.
Splints and braces also help. They can continuously stretch a muscle, so that it doesn't lose flexibility.
Stretching, splints, braces, and ice can only do much to help spasticity.
A spinal cord injury expert may need to prescribe medicine.
First-line medications include Lioresal (baclofen) or Zanaflex (tizanidine).
Your doctor will start by prescribing a low dose and then gradually adjust based on your body's response.
Side effects of oral drugs to treat spasticity include:
Never stop taking your medicine without talking to your spine doctor.
Your doctor may suggest botulinum toxin (BOTOX) shots if the spasticity affects only one part of the body.
These shots block the nerve signals by paralyzing the muscle to help stop painful contractions.
A doctor trained in BOTOX shots to treat spasticity will:
Medication pump to treat spasticity
A pump may help some people since medicine gets directly to the spine — the source of their pain and spasms.
Through a small surgery, doctors place this pump near the abdomen. Via an attached catheter, the pump sends Lioresal (baclofen) — a muscle relaxer and anti-spasm drug — to the spinal cord.
A pump often works better than taking oral drugs because it delivers a steady dose of medication. It also has fewer and milder side effects.