Spasticity Management

Spasticity happens when muscles are continuously contracted. It makes the muscles stiff and possibly unable to move.

Spasticity can affect:

• One muscle
• A group of muscles
• Movement
• Speech
• Walking

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 C5 injury, for example, the arms, trunk and legs may have spasticity.

In a person with an T5 injury, however, only the trunk and legs will be affected.

   » Learn more about levels of spinal cord injury.

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 — such as:

• A urinary tract infection
• Constipation
• A pressure ulcer

These can cause an increase in spasticity.

If a cause is not found, the next step is to treat the spasticity. Stretching and ice may only do so much to help the spasticity. A spinal cord injury physician might have to prescribe medicine to treat it.

First-line medications include Lioresal (baclofen) or Zanaflex (tizanidine). These medications are started at low doses and adjusted gradually based on your body’s response.

Never discontinue Lioresal (baclofen) without contacting your physician.

Side effects include:

• Drowsiness
• Dizziness
• Nausea
• Vomiting
• Other types of abdominal discomfort

Your doctor may recommend injections of botulinum toxin if the spasticity is concentrated in one part of the body.

A doctor trained in the procedure:

• Performs injections with the help of electromyographic guidance
• Uses a needle that can detect specific points of muscle hyperactivity
• Injects only in the areas that are hyperactive

Another procedure that may be of benefit to some patients is placement of a medication pump into the abdomen. This pump can deliver baclofen directly to the spinal cord.