Spasticity: Causes, Symptoms, and Management Strategies

When working with spasticity, a condition marked by increased muscle tone and involuntary contractions, often seen after brain or spinal‑cord injury. Also known as muscle hypertonia, it can limit movement and cause pain.

Understanding spasticity starts with recognizing its role in neurological disorders. For example, Multiple sclerosis, a chronic demyelinating disease that frequently presents spasticity as a primary symptom challenges patients with stiffness in the legs and arms, making everyday tasks harder. The disease process damages nerve pathways that control muscle relaxation, so the muscles stay contracted longer than they should. This connection explains why spasticity often worsens during heat or fatigue, and why targeted therapies are essential for maintaining quality of life.

Another common source is cerebral palsy, a developmental motor disorder where spasticity is the most prevalent clinical presentation. Children with this condition may show tight calf muscles that cause toe walking, or elbow flexor tightness that limits opening the hand. Early intervention helps prevent contractures—permanent short‑ening of muscles—by keeping joints mobile while the nervous system matures. Parents often wonder if the spasticity will improve with growth; the answer depends on tailored therapy and consistent monitoring.

One of the most effective medical tools is botulinum toxin, a neurotoxin injected into overactive muscles to temporarily reduce spasticity. The toxin blocks the release of acetylcholine, the chemical that tells muscles to contract, giving the affected area a chance to relax for weeks to months. Clinicians choose injection sites based on functional goals—like improving gait or easing hand use—so patients can combine the effect with strengthening exercises. While not a cure, botulinum toxin often creates a window where active rehab yields better long‑term outcomes.

Physical therapy, or physiotherapy, the hands‑on practice of stretching, strengthening, and functional training to counteract spasticity, remains the backbone of management. Therapists use techniques such as prolonged stretch, weight‑bearing activities, and task‑specific drills to teach the nervous system new movement patterns. The goal isn’t just to lengthen tight muscles but also to improve motor control, balance, and endurance. Evidence shows that consistent, goal‑oriented physiotherapy can reduce spasticity scores and delay the need for surgical interventions.

Medication, orthotics, and surgery round out the toolbox. Antispastic agents like baclofen or tizanidine dampen nerve signals, while oral meds are easier to manage than intrathecal pumps. Braces and splints keep joints aligned during daily life, and when conservative measures fail, orthopedic surgeons may perform tendon releases or selective dorsal rhizotomies. The best plan stitches together these options based on the individual's functional goals, severity of tone, and overall health. Below you’ll find articles that dive deeper into each of these approaches, real‑world case examples, and practical tips to help you or a loved one navigate spasticity management.