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Spasticity

Spasticity may be caused by diseases such as cerebral palsy, multiple sclerosis, stroke, spinal cord injury and brain trauma. 

Muscle over-activity due to spasticity may cause disabling symptoms such as pain, spasm and deformity.

This can lead to having a difficult time opening joints to perform bathing, clothing and dressing due to the excessive tone in muscles.

You may also have a difficult time transferring and walking because it may be difficult to bend your knee.

Treatment options for spasticity

Oral medications

Baclofen, valium, clonazepam and zanaflex are some medications that are effective in treating mild spasticity.

At higher doses, the medications may cause daytime sleepiness and trouble concentrating.

Injected treatments

Botox

The same neurotoxin used to diminish the appearance of wrinkles may now help with upper motor neuron syndrome-related spasticity following stroke, spinal cord injury, traumatic brain injury, cerebral palsy, or multiple sclerosis.  

Botulinum toxin (Botox) injections into the spastic muscles help the muscles relax with minimal side effects. It works by blocking release of a neurochemical acetylcholine which is involved in sending the signal from the nerve to make the muscle contract.

This relaxes the affected muscles, reducing spasticity and helping patients function more normally, with improvements in hygiene, dressing, and pain.

Improvement is typically seen in a few days after the injections, and can last 3-6 months.

Trigger point injections

Trigger point injection (TPI) is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under your skin.

Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.  Referred pain from trigger points can mimic pinched nerves in the neck or low back. They can occur from direct muscle injuries, poor posture, repetitive strain, or secondarily from spine conditions such as a herniated disc.

In the TPI procedure, a physician inserts a small needle into the patient's trigger point. The injection contains a local anesthetic that sometimes includes a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Injections are given in a doctor's office and usually take just a few minutes. Several sites may be injected in one visit. If you have an allergy to a certain medication, a dry-needle technique (involving no medications) can be used.

Intrathecal baclofen

Baclofen pumps are a useful therapy to treat spasticity in the legs.

Before a pump is surgically implanted, you'll first get an injection of baclofen into your spinal fluid. If this is effective in relieving spasticity, then a baclofen pump will be implanted to deliver the baclofen directly into the spinal fluid.

The pump requires baclofen refills and occasionally the dose may be changed.

Multidisciplinary therapy

Physical and occupational therapists who specialize in neuron-rehabilitation will design exercise programs which help relieve stiffness and improve your independence.

The therapists will also help select the appropriate assist devices if needed for optimal quality of life.

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