Spasticity

Neuromuscular specialists at UT Southwestern Medical Center have extensive expertise in diagnosing and treating spasticity, offering the most advanced, evidence-based therapies to relieve symptoms and improve quality of life.

Expert Care to Manage Spasticity

Spasticity is a neuromuscular condition that causes continuous contraction in certain muscles, resulting in tightness or stiffness that interferes with movement or speech. It can affect movements, walking, and speech. Spasticity usually happens after damage to the part of the brain that controls voluntary movement or to the nerves in the spinal cord that control muscles.  

Our neurology and physical medicine and rehabilitation specialists use the latest treatments for spasticity and other neuromuscular disorders, and many of these treatments are based on research conducted at UT Southwestern. Our multidisciplinary team of doctors, surgeons, physical therapists, and other health care providers use the latest tools and technologies to diagnose and treat spasticity.

Causes of Spasticity

Spasticity can result from these causes:

• Adrenoleukodystrophy, an inherited genetic disorder that damages the membrane surrounding nerve cells in the brain and results in the buildup of certain fats in the brain and nervous system
• Brain damage caused by lack of oxygen
• Cerebral palsy, a group of movement and muscle disorders that can involve brain and nervous system functions
• Head injury
• Multiple sclerosis, an autoimmune disorder that affects the central nervous system
• Neurodegenerative illness, which damages the brain and nervous system over time
• Phenylketonuria, an inherited genetic disorder in which the body can't break down the amino acid phenylalanine
• Spinal cord injury
• Stroke

Symptoms of Spasticity

Signs and symptoms of spasticity can range from mild, such as muscle tightness, to severe, such as uncontrollable muscle spasms. Some common symptoms include:

• Abnormal posture
• Exaggerated deep tendon reflexes, such as the knee-jerk reflex
• Muscle spasms that can cause uncontrollable painful muscle contractions
• Muscle stiffness
• Pain and tightness in and around joints and the lower back
• Repetitive jerky motions (clonus), especially when the person is touched or moved
• Scissoring (involuntary crossing of the legs)
• Abnormal walking pattern

Diagnosis of Spasticity

When patients come to UT Southwestern, our neurologists conduct a thorough evaluation, which includes:

• A physical exam
• Neurological testing
• Discussion of personal and family medical history
• Discussion of symptoms

Our doctors can usually diagnose spasticity based on the patient’s symptoms, without requiring additional testing. But we often perform tests to determine the extent of the spasticity to help guide treatment. We use tests to evaluate:

• Arm and leg movements
  
• Muscle activity
  
• Range of motion
  
• Ability to perform self-care activities
  
• Walking pattern, if patient is ambulatory
  

Treatment for Spasticity

The goals of treatment for spasticity are to:

• Relieve signs and symptoms such as pain and frequency of muscle contractions
• Improve gait, activities of daily living, and ease of care
• Improve voluntary motor functions such as reaching for, grasping, moving, and releasing objects
• Relieve pain and discomfort
• Improve sleep

At UT Southwestern, we offer the following treatments for spasticity:

• Physical therapy to improve strength, flexibility, range of motion, coordination, balance, and overall comfort
  
• Occupational therapy to regain function and ability to perform daily activities
  
• Medications to relieve symptoms, especially if spasticity is disturbing sleep or interfering with activities
  
• Injections of botulinum toxin (Botox, Dysport, Xeomin, and Myobloc) to relax the overactive muscles
  
• Surgery, in some cases, either to install a pump in the patient’s abdomen to deliver baclofen intrathecally (in the spinal canal) to reduce spasticity and pain or to cut specific nerve roots to reduce muscle stiffness
  

Support Services

Whether symptoms are mild or severe, people with spasticity and other neuromuscular disorders can benefit from neurological rehabilitation at UT Southwestern.

Our multidisciplinary team approach to rehabilitation addresses the physical and psychological management of spasticity. Our goal is to help patients find ways to participate in activities at work, at home, and in the community, with input, as necessary, from:

• Physicians
  
• Nurses
  
• Neuropsychologists
  
• Psychologists
  
• Occupational, physical, recreational, vocational, and speech therapists
  
• Orthotist
  

Our multidisciplinary Wheelchair and Durable Medical Equipment Clinic evaluates patients for their equipment needs. Wheelchairs or durable equipment maximize mobility for patients with spasticity. The team makes sure the equipment is fitted properly and can be easily transported by patients and their family members.