What is spasticity?
Spasticity is a stiffness of the muscles. Also called hypertonia, the condition causes unusual tightness or increased toning of the muscles. Spasticity can make reflexes stronger and more exaggerated, which can interfere with walking, movement, speech, and many other daily activities. It can also cause sudden loss of mobility and locking of the limbs for short periods.
Spasticity often affects those with cerebral palsy (CP), multiple sclerosis (MS), traumatic brain injury (TBI), and stroke. The condition occurs in children and adults but can be particularly concerning for growing children because of its potential impact on permanent muscle development.
Neurologists at Penn Medicine can help you manage your spasticity symptoms and improve your ability to perform daily activities with greater ease.
Symptoms of spasticity
Symptoms of muscle spasticity can include:
- Abnormal posture
- Carrying the shoulder, arm, wrist, and finger at an unusual angle because of muscle tightness
- Exaggerated deep tendon reflexes, such as the knee-jerk
- Repetitive jerky motions (clonus), especially when you are touched or moved
- Pain or deformity of the affected area of the body
While spasticity can affect any muscle group in the body, it’s most common in the leg muscles.
Causes of spasticity
Spasticity is often caused by damage to the cerebellum, the part of the brain involved with muscle movement. It can specifically be triggered by an imbalance in the signals sent from the brain to muscles or from damage to the nerves that run from the brain to the spinal cord.
Certain health conditions can lead to spasticity, including:
- Head injury
- Spinal cord injury
- Brain damage caused by a lack of oxygen, such as in near-drowning or near-suffocation
- Cerebral palsy (a group of disorders that can involve brain and nervous system functions)
- Multiple sclerosis
- Adrenoleukodystrophy (disruption of the breakdown of certain fats)
- Neurodegenerative illness (illnesses that damage the brain and nervous system over time)
- Phenylketonuria (a disorder in which the body can’t break down the amino acid phenylalanine)
- Stroke
Conditions associated with spasticity
Spastic muscle activity is generally linked to a more serious condition. Your health care provider can help determine its origin. Some of the more common conditions associated with muscle spasticity include cerebral palsy (CP), multiple sclerosis (MS), and traumatic brain injury (TBI).
Cerebral palsy can impact the part of the brain that controls muscle movement, leading to spastic muscle activity. Spasticity is usually more evident as patients with CP age, but it can also be exhibited during infancy. Cerebral palsy is one of the most common causes of spasticity in children.
Approximately 25 to 40 percent of stroke survivors experience spasticity. It's more common in a hemorrhagic (brain bleed) stroke when the spinal and supraspinal mechanisms (parts of the brain that control muscle tone) are affected. Spasticity is more common in younger stroke survivors. Symptoms can include stiff joints, muscle fatigue, and contraction of the muscles.
Spasticity can occur quickly after a traumatic brain injury as signals from the brain to the muscles are disrupted. It can range from mild to severe and vary in duration. TBI-related spasticity can often be helped with brain exercises that increase neuroplasticity (the brain's ability to adapt to growth, aging, and injury).
Spasticity is one of the most common symptoms of MS. It can be a mild, temporary tightening of the muscles or a more severe, sharp, and painful spasm. It generally occurs in the groin, legs, and buttocks. Common causes of MS-related spasticity include tight clothing or shoes and irritation from other external sources.
Diagnosing spasticity
Spasticity is diagnosed through a comprehensive physical exam. Your health care provider will examine your posture, reflexes, coordination, strength, mobility, range of motion in the arms and legs, and cognitive response. Telling your doctor as much as possible about the timeline, location, and intensity of your spasticity can help them offer informed treatment guidance.
If your doctor suspects that your spasticity is related to an underlying neurological condition, they may order more tests, such as a magnetic resonance imaging (MRI) scan, to identify the cause of the spasticity in the brain or spine.
Complications from spasticity
Spastic muscle activity poses a variety of long-term health and safety issues. In the short term, it can pose safety risks while driving, walking, running, and engaging in other daily activities. Long-term health complications can include:
- Permanent joint deformity
- Urinary tract infections (UTI)
- Chronic constipation
- Fever or flu-like symptoms
- Pressure sores
- Frozen or locked joints, such as fingers, toes, or knees
Muscle spasticity is often painful and can decrease mobility as time goes on. The sooner you’re able to get treatment for spasticity, the better you can manage its symptoms and avoid complications. Neurologists at Penn Medicine are among the leading neurology providers in the greater Philadelphia and New Jersey region who can help diagnose and treat spasticity effectively and improve your quality of life.
Managing and treating spasticity
There are multiple treatment and management options for muscle spasticity, depending on the causes and intensity of the condition, your age, and co-occurring health issues. Your doctor may also recommend medication or therapy. Casting and bracing the affected areas can also help stabilize muscles during involuntary movements.
Penn Medicine’s neurology specialists can help you or your loved one manage your spasticity. Our care team works collaboratively to address the origins and daily impact of your muscle spasticity so you can live with greater comfort and predictability.