Understanding Muscle Spasticity
Muscle spasticity is a condition in which certain muscles are continuously contracted and unable to be stretched. This article aims to explain what causes muscle spasticity, its common symptoms, and some treatment options available.
What is Muscle Spasticity?
Muscle spasticity refers to increased muscle tone or stiffness in muscles that makes them difficult to stretch. It occurs when the parts of the nervous system that control voluntary movement are damaged due to conditions such as cerebral palsy, multiple sclerosis, spinal cord injury, stroke, or traumatic brain injury. In these conditions, the brain is unable to appropriately control muscle relaxation and contraction.
The main causes of muscle spasticity are lesions or damage in the brain or spinal cord that interrupt messages between the brain and the muscles. This disrupts the delicate balance of contraction and relaxation in muscles. The muscles then remain in a shortened or contracted state much of the time rather than relaxing normally.
Common Symptoms
Some common symptoms of muscle spasticity include stiff, tender, or contracting muscles that are difficult to stretch; painful muscle spasms; increased muscle tone; exaggerated reflexes; and involuntary muscle contractions. The severity of spasticity can range from very mild to very severe. It usually affects the limbs - often the legs more than the arms. Some people experience overall body stiffness.
The stiffness and muscle contractions associated with Muscle Spasticity can interfere with daily activities like getting dressed, bathing, walking, and using the hands. It can also lead to contractures where the joints become permanently stiff. Pain from muscle spasms is another problematic symptom for many. Spasticity sometimes fluctuates, coming and going throughout the day.
Areas Affected by Spasticity
- Legs: Tight calf muscles are very common, making it hard to point the toes or walk properly. Thigh muscles may also contract.
- Hips: The hip adductor muscles on the inner thighs can pull the legs together tightly.
- Arms: Biceps and triceps muscles may contract, making arm movement difficult. Wrist and finger flexors are often involved too.
- Trunk: Back extensor muscles can cause the trunk to arch backwards. Abdominal muscles may tighten as well.
- Neck: Neck flexor muscles can cause the head to pull down towards the chest.
Treatment Options
There is no cure for spasticity itself but several treatment approaches can help reduce symptoms:
Medications: Drugs like baclofen, diazepam, and tizanidine work to relax overactive muscles. They help decrease pain and spasms.
Botulinum Toxin Injections: Botox injections temporarily block nerve signals in specific muscles to relax them. This treatment targets specific areas.
Physical/Occupational Therapy: Stretching, massage, splinting, and range-of-motion exercises can maintain flexibility and improve function. Heat treatments may also relax muscles temporarily.
Orthoses: Braces, splints and other customized devices can position limbs properly and prevent contractures.
Neurosurgery: Selective dorsal rhizotomy surgery cuts some sensory nerves in the lower spine to reduce spasticity in the legs. Intrathecal baclofen pumps deliver medication directly into the spinal fluid.
Managing Spasticity Complications
Even with treatment, some complications of spasticity can occur over time if not managed properly. Contractures are one major issue where muscles become permanently shortened and tight. This greatly limits joint movement. Caregivers need to perform stretches regularly, especially at night, to prevent contractures from developing.
Bruising and skin sores are another problem from muscle tightness. Proper positioning, padding of pressure areas, and carefully assisting with movement can avoid skin breakdown. Pain caused by spasticity also requires monitoring and aggressive relief methods to prevent disuse and regression.
Overall, muscle spasticity progressively impacts quality of life if not addressed properly. An individualized treatment program that incorporates all management strategies can provide the best outcomes to reduce spasticity severity and related complications long-term. With diligent care and ongoing rehab, people can maintain mobility and functionality despite this debilitating condition.
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