Spasticity (1301)

Key points below


What is spasticity?

Spasticity is tightness of muscles.  It is usually caused by injury to the brain or spinal cord. 

What are the symptoms?

Muscles can be tight or stiff.
Muscles can have spasms.  This means muscles have uncontrolled, quick, jerking movements.  These are also called involuntary movements.
Muscles can also have clonus.  This means that a muscle may shake after an attempt has been made to stretch it. 

How is spasticity diagnosed?

Your child will need to see providers from different specialties.  They will work together to give treatment to your child.  You can learn more about them on the last page.  

How is spasticity treated?

Physical and occupational therapy 
Therapy will be tried first.
Daily exercises are used to keep your child’s muscles and joints moving.  These are called range of motion exercises.  
Exercises that stretch the muscles are important. When muscles get too short, your child’s joints will not work well.  

Braces and splints  
Braces and splints help to control involuntary muscle movements. They also help to prevent contractures. A contracture is when a muscle gets too short.  

Serial casts
Casts may be used to help stretch muscles that have contractures. A new cast will be put on every week. With each new cast, the muscles are stretched a little more. If you child is walking, they can still walk with the casts.  

Medicine
There are some oral medicines that can help decrease muscle tightness.  They can be taken by mouth or through a feeding tube.
Some medicines that the doctor may prescribe are: Baclofen, Dantrium, or Valium. 
These medicines may cause sleepiness and other side effects. Some children cannot take the medicine because of the side effects.
Botox, Xeomin, Dysport, Myobloc, Ethyl Alcohol or Phenol shots  
Shots (injections) may be used for short term relief. The shot may help muscles to relax. 
Shots are given in clinic, operating room or at the SurgiCenter.  The shots usually last 3 to 6 months.  The shots are usually given again when the effect wears off. 

Surgery
Some surgeries can help make the muscles or tendons longer. Others help reduce spasticity in the arms or legs. Surgery is not right for every child.  Some children are too young or too small in size for surgery. Your provider will talk to you if surgery is a treatment option.
  
Words to remember
Baclofen.  A medicine that helps reduce spasticity.  It can be given through a pump or by mouth.
Botox.  A medicine that helps reduce spasticity.  It is given as a shot (injection). 
Catheter.  A tube that is used to give medicine or fluids.
Contracture.  A muscle or tendon that got too short.  This reduces a joint’s range of motion. 
Neurosurgery.  These doctors perform surgery on the brain, nerves or spine.
Occupational therapy.  Exercises and skills to teach your child to do daily things like eating with a spoon or picking up a glass of water.
Orthopedics: Doctors who take care of bones. 
Physical medicine and rehabilitation.  Doctors who focus on function and independence for kids with strength and muscle problems.
Physical therapy. Exercises that stretch and strengthen muscles.
Range of motion. The ability of a joint to move. Bending and straightening an arm using the elbow is an example of range of motion.
Rehabilitation. Helping a person to get around their home and their community.  This can include both occupational and physical therapy.
Social services.  Professionals that help families to manage their resources, get counseling, housing and other special needs.

Other teaching sheets that may be helpful
#1227 Intrathecal baclofen pump   
#1232 Phenol nerve blocks for spasticity  
#1231 Botulinum Toxin Treatment for Tone Management 

ALERT

Call your child’s doctor, nurse, or clinic if you have any questions or concerns or if your child has special health care needs that were not covered by this information.