RehabifyWhat it is
After damage to the brain or spinal cord, the signals that normally keep muscles relaxed are disrupted, so some muscles stay overactive. Spasticity is not always harmful. Some stiffness can help a weak leg bear weight. Treatment aims at the stiffness that causes pain or gets in the way of function or care. Without treatment, muscles and joints can shorten and become fixed (contractures).
Who should see a doctor
Signs to get checked
- Stiffness that makes walking, dressing, washing or sleeping harder
- A hand that stays clenched, an elbow that stays bent or a foot that points down or turns in
- Painful spasms or stiffness
- Skin problems in the palm, armpit or between the legs because of tight muscles
- Children with cerebral palsy whose stiffness affects movement or care
What happens at Rehabify
- 01
History
The cause of spasticity, what it affects in daily life, and current medicines and therapy.
- 02
Examination
Muscle tone scales, range of movement, walking and arm use, and checks for pain, skin and contractures.
- 03
Goals
Such as easier hand hygiene, a flatter foot for walking, or less pain at night.
- 04
Follow-up
Therapy and splinting after any injection, with review of the effect against your goals.
The doctor decides the right tests and treatment for you after examining you.
Before and after your visit
How to prepare
- Bring discharge summaries, a list of medicines and any splints you use
- Note which tasks the stiffness makes hard, and when it is worse
- Bring a family member or carer, especially if they help with daily care
- For children, a parent or guardian gives consent and attends the visit
After your visit
You leave with a written plan, stretching and positioning routines and a review date. You can send questions on WhatsApp between visits.
When to get help urgently
Medical emergency
Seek urgent care or call 108 or 112 if, after an injection, there is difficulty swallowing, breathing or speaking, or new widespread weakness. Also seek urgent care for a sudden large increase in spasms with fever, a swollen hot leg, or, in spinal cord injury, a pounding headache with high blood pressure.
Common questions
Is spasticity the same as weakness?
No. Weakness means a muscle cannot produce enough force. Spasticity means a muscle stays tight and resists stretching. They often occur together after a stroke or spinal cord injury, and treating spasticity alone does not restore strength, so rehab works on both.
What are botulinum toxin injections for spasticity?
Botulinum toxin is a medicine injected into selected overactive muscles to relax them for a few months. It can ease stiffness and make stretching, splinting and care easier. It works best alongside therapy, and the effect varies from person to person.
Can spasticity be stopped completely?
Usually not, because it comes from the original brain or spinal cord injury. It can often be reduced and managed so that it causes less pain and gets in the way less. Regular stretching and review help prevent fixed joints.
Do medicines for spasticity have side effects?
Oral medicines such as baclofen or tizanidine can cause drowsiness, dizziness or weakness. The doctor starts with a low dose and adjusts it. Do not stop these medicines suddenly, as this can cause withdrawal effects.
Why are splints important?
Splints and orthoses hold a muscle in a stretched position for longer periods, which helps prevent contractures and can improve walking or hand position. They need to fit well and be checked regularly to avoid skin damage.
Sources
- [1]
Royal College of Physicians (UK). Spasticity in adults: management using botulinum toxin, national guidelines 2018
- [2]
American Academy of Neurology (AAN) practice guideline update on botulinum neurotoxin for spasticity. 2016
- [3]
National Institute for Health and Care Excellence (NICE) guideline CG145. Spasticity in under 19s: management
This page is for general education and does not replace a consultation. The right plan depends on your examination.