Presentation
Patients often present with associated pressure ulcers, deformed toenails, shoe or brace fitting challenges, and pain with ambulation or transfers. [ncbi.nlm.nih.gov]
Is it always present? How severe is it? Which muscles are affected? What makes it better? What makes it worse? What other symptoms are present? After determining the cause of your spasticity, the doctor may refer you to a physical therapist. [nlm.nih.gov]
Although spasticity is part of the upper motor neuron syndrome, it is frequently tied to the other presentations of the said syndrome. [doi.org]
Entire Body System
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Pain
The presence of pain during shoulder abduction or contracture of the shoulder adductors had no influence on the reliability of the MMAS (κ w 0.75, 0.77, respectively). [ncbi.nlm.nih.gov]
Poor management leads to contractures, pressure ulcers, pain and can impact on function, care needs and quality of life. Pain post - SCI is commonly divided into neuropathic pain and nociceptive pain. [rnoh.nhs.uk]
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Fatigue
In addition to depression, high correlations were found between spasticity and fatigue, pain, and bladder dysfunction. [mymsaa.org]
The drug most commonly used to treat spasticity, Lioresal (baclofen), can cause you to feel weak or fatigued. The challenge with Lioresal is finding a dosage that relieves spasticity without causing excessive weakness. [multiplesclerosis.net]
This reduces the surface area of weight bearing and decreases stability of the base of support, and again contributes to falls and fatigue. [archive.myelitis.org]
Things like shoulder joint pain, fatigue, or general weakness may make it harder to deal with what once was a reasonable amount of spasticity. The result is the same as if the spasticity actually had increased. [web.archive.org]
Other spasm triggers include: fatigue stress high humidity extreme heat extreme cold infection clothing that is too tight Your ability to perform normal tasks can be affected if spasms become too frequent. [healthline.com]
Musculoskeletal
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Muscle Spasm
One of the most common and most varied is muscle spasms. So what are muscle spasms? Muscle spasticity is an uncontrollable tightening or relaxing of muscles. [pushnationfest.org]
Botox : Not used for solely beauty procedures, Botox is frequently used to treat muscle spasms. [spinalpedia.com]
The drug was effective in reducing muscle spasms, clonus, muscle tone, and the force of muscle contraction elicited by Achilles tendon tap and tibial nerve stimulation, but improvement of function was seen less often. [ncbi.nlm.nih.gov]
These medicines relax tight muscles and stop muscle spasms. But they may cause sleepiness, muscle weakness, and nausea. Baclofen is the medicine most often prescribed for spasticity. [northshore.org]
The authors evaluated Functional Independence Scores, Ashworth Scale, muscle spasm severity and freequence, Timing Walking Test, active and passive joint mobility in both groups at the beginning and at the end of the treatment period. [doi.org]
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Joint Deformity
deformities Decreased quality of life Cleveland Clinic is a non-profit academic medical center. [my.clevelandclinic.org]
Other symptoms include contractures (a state of permanent contraction of a muscle /tendon due to severe and repetitive stiffness and spasms), decreased functional abilities, difficulty with care or hygiene, bone and joint deformities, abnormal posture [csatc.org]
It can also cause joint deformities and skin breakdown. [courierpostonline.com]
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Muscle Contracture
All patients had increased muscle tone of the triceps surae (TS) but no muscle contractures. Perturbations were applied by rotating or translating a platform with increasing intensity in four sagittal-plane directions. [ncbi.nlm.nih.gov]
Symptoms The signs and symptoms of spasticity may include: Increased muscle tone (hypertonicity) Involuntary muscle spasms Involuntary muscle clonus Exaggerated tendon reflexes Pain or discomfort Muscle contracture Bone and joint deformities As a result [news-medical.net]
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Low Back Pain
Spasticity can also produce feelings of pain or tightness in and around joints and can also cause low back pain. [friendswithms.com]
Spasticity also can cause low back pain and result in feelings of pain or tightness in and around joints. What Is the Outlook for People With Spasticity? The outlook varies per person. [webmd.com]
Pharmacological management of low back pain. Drugs. 2010 Mar 5; 70(4):387-402. Chou R, Qaseem A, Snow V, et al. [consumerreports.org]
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Joint Stiffness
BACKGROUND: Skeletal muscle spasticity is a major physical complication resulting from traumatic brain injury (TBI), which can lead to muscle contracture, joint stiffness, reduced range of movement, broken skin and pain. [ncbi.nlm.nih.gov]
There are a number of symptoms: increased muscle tone, joint stiffness, overactive reflexes, involuntary jerky movements, which may include spasms and clonus, pain, decreased functional abilities and delayed motor development, difficulty with care and [go.gale.com]
Signs and symptoms of spasticity include: muscle tightness joint stiffness involuntary jerky movements exaggeration of reflexes unusual posture abnormal positioning of fingers, wrists, arms, or shoulders muscle spasms involuntary crossing of the legs, [healthline.com]
Urogenital
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Bladder Distention
These include: Bladder distention Bowel impaction Deep venous thrombosis Extreme temperatures Fatigue Infection Noxious stimuli Poor posture Pressure sore Stress These factors are believed to cause a temporary worsening of the condition and further increase [news-medical.net]
distention Bowel impaction Cold weather Fatigue Seizure activity Stress Malpositioning Prognosis Spasticity can have a devastating effect on function, comfort, and care delivery, and it also may lead to musculoskeletal complications. [emedicine.medscape.com]
Neurologic
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Clonus
RESULTS: The overall results of the study suggest that there was a decrease in ankle plantar flexor spasticity, ankle clonus and timed up and go score in all the groups. [ncbi.nlm.nih.gov]
The presence of clonus can be a sign of neurologic problems but alone is not enough for diagnostic purposes. Perisistant clonus can interfere with putting shoes on and can be stopped generally by putting the calf muscle on a end range stretch. [pediatricservices.com]
Some consider clonus as simply an extended outcome of spasticity. Although closely linked, clonus is not seen in all patients with spasticity. [en.wikipedia.org]
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Hyperreflexia
Spasticity is usually accompanied by HYPERREFLEXIA and variable degrees of MUSCLE WEAKNESS. [profiles.umassmed.edu]
Positive components include muscle overactivity, flexor and extensor spasm, hyperreflexia, athetosis, spastic dystonia, clonus, and an extensor plantar response. [bjmp.org]
The cerebral palsy diagnosis is a clinical one and it includes motor development delay, abnormal muscle tone and hyperreflexia. [dergipark.org.tr]
This ultimately leads to hyperreflexia, an exaggerated deep tendon reflex. Spasticity is often treated with the drug baclofen, which acts as an agonist at GABA receptors, which are inhibitory. [en.wikipedia.org]
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Involuntary Movements
Increased muscle tone Involuntary movements Spasms (quick and/or sustained involuntary muscle contractions) Clonus (series of fast involuntary contractions) Pain or discomfort Less ability to function Problems with care and hygiene Abnormal posture Contracture [my.clevelandclinic.org]
It can also cause involuntary movements, which may include spasms and clonus (a series of fast involuntary contractions). Orthotics, such as ankle-foot braces (AFOs), are sometimes used to limit spasticity in legs. [strokewise.info]
Increased muscle tone Overactive reflexes Involuntary movements, which may include spasms (brisk and/or sustained involuntary muscle contraction) and clonus (series of fast involuntary contractions ) Pain Decreased functional abilities and delayed motor [webmd.com]
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Posture Abnormal
abnormal positioning of fingers, wrists, arms, or shoulders, contractures or muscle tightness. [go.gale.com]
Signs and symptoms of spasticity include: muscle tightness joint stiffness involuntary jerky movements exaggeration of reflexes unusual posture abnormal positioning of fingers, wrists, arms, or shoulders muscle spasms involuntary crossing of the legs, [healthline.com]
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Unable to Walk
When I get stressed however, I immediately feel my legs start to tighten up and cramp causing me to feel like if I don't start stretching and massaging them right away that they might (but probably not) lock up rendering me unable to walk. [mattsms.com]
Workup
[…] to quantify, [3] but clinically useful scales include the following: Ashworth Scale/Modified Ashworth: From 0-4 (normal to rigid tone) Physician's Rating Scale: Gait pattern and range of motion assessed Spasm Scale: From 0-4 (no spasms to 10/h) See Workup [emedicine.medscape.com]
Treatment
Before treatment, the HmaxlMmax ratio was significantly higher in the affected side than in the unaffected side. However, it was similar at both sides after treatment. [ncbi.nlm.nih.gov]
Disability index reduction during baclofen treatment was maintained in five patients. [doi.org]
Prognosis
Physical therapy also plays a key role in the fight against spasticity and the prognosis of spinal cord injuries in general. By helping you control your muscles, physical therapy can steadily reduce the effects. [spinalcord.com]
This surveillance is an important part of treatment, because continued monitoring lets doctors recommend intervention when it best helps a child’s long-term prognosis. [nyulangone.org]
(See Prognosis, Treatment, and Medication.) While the incidence of spasticity is not known with certainty, the condition likely affects over half a million people in the United States and over 12 million people worldwide. [emedicine.medscape.com]
Etiology
Although the exact etiology is unknown, it is believed that the CNS damage increases the excitability of the stretch reflex receptors in the muscles, causing the muscles to contract in response. [news-medical.net]
Approximately 2 million Americans, including more than 300,000 people over 60 years of age, are prescribed muscle relaxants. 3 Spasticity and spasms are distinct etiologies, and each condition responds differently to certain medications. [practicalpainmanagement.com]
(See Pathophysiology and Etiology.) Spasticity usually is accompanied by paresis and other signs, such as increased stretch reflexes, which collectively are called upper motor neuron syndrome. [emedicine.medscape.com]
Epidemiology
Authors’ Affiliations (1) Epidemiology & Database Analytics, United BioSource Corporation, Lexington, MA, USA (2) Neurosciences, Medical Affairs, Allergan, Inc, Irvine, CA, USA (3) Health Economics and Epidemiology, Evidera, Lexington, MA, USA (4) Rehabilitation [bmcneurol.biomedcentral.com]
Cerebral palsy epidemiology: Where are We Now and where are We going? Dev Med Child Neurol. 1992;34:547–51. View Article PubMed Google Scholar Dunne JW, Heye N, Dunne SL. Treatment of chronic limb spasticity with botulinum toxin A. [jneuroengrehab.biomedcentral.com]
Pathophysiology
Pathophysiology The specific pathophysiology of spasticity is not clear but several theories have been suggested to explain the cause of the condition. [news-medical.net]
Spasticity Management Determining the impact of spasticity and need for treatment Spasticity in SCI varies with location and degree depending on the injury pathophysiology. [rnoh.nhs.uk]
Pathophysiology The pathophysiologic basis of spasticity is incompletely understood. [emedicine.medscape.com]
Prevention
It allows passive limb mobilization in a comprehensive rehabilitation program that attempts to prevent fixed soft tissue contractures. [ncbi.nlm.nih.gov]
Our neuromuscular experts work together to provide children who have cerebral palsy with the care they need to relieve spasticity and prevent progressive damage to muscles and joints. [nyulangone.org]
Simple coordination and stability exercises can help prevent falls among older adults. [livestrong.com]
Physical therapists can do periodic assessment to try to prevent long term problems, such as excessive wear and tear on shoulders from wheeling. [archive.myelitis.org]
These medications work by preventing nerves from signaling the muscles to contract, thereby preventing muscle contractions. [encyclopedia.com]