Spasticity Treatment

Spasticity — the continual contraction of certain muscles — may interfere with movement and even limit your ability to function independently.

Treatment options for spasticity and related conditions, such as dystonia, cerebral palsy, and tremor, have advanced in recent years.

The Department of Physical Medicine and Rehabilitation's (PM&R) spasticity clinics can help reduce the debilitating effects of spasticity, whether the condition is new or chronic.

Most common treatments for spasticity include oral medication and injections, however depending on the severity of your spasticity; your doctor may recommend additional physical rehabilitation. Physical and occupational therapy for spasticity can include specific stretches and exercises designed to relax your muscles to keep your tendons from shortening.

A combination of treatments for spasticity provide the most benefit to patients for relief from symptoms and an increase in independent activities.

Oral Antispasticity Medication

Oral medications to treat spasticity are commonly used for those suffering from severe forms of spasticity, such as an inability to stretch or lengthen the muscles and increased muscle tightness. Common side effects of oral medications for spasticity can include drowsiness or dizziness.

The most common oral medications for treating spasticity are:

• Baclofen restricts the influx of calcium into the neural receptors and increases the influx of potassium, causing a decrease in the number of messages the nerve cells transmit.
• Diazepam depresses the central nervous system.
• Dantrolene sodium reduces the release of calcium that usually occurs after muscle action. This medication is unique because it affects muscle fiber rather than nerve fiber.
• Tizanidine prevents the release of glutamate and aspartate, two amino acids that can excite nerve cells.

Injections and Surgical Treatment Options for Spasticity

For patients not suffering from total spasticity and only one or a few limbs are affected, injections typically provide the most benefit. In addition to having fewer side effects than oral medication, injections have proven effective for many patients in the treatment of spasticity. The most common injections are Botulinum toxin type A and type B injections. For patients with spasticity, the injections improve the ability to stretch, decrease muscle pain and improve gait and range of motion.

Several non-oral treatments have been very successful in treating spasticity, such as:

• Botulinum toxin type A and type B injections — used in minute amounts at sites carefully determined by an electromyogram, these injections have proven effective in paralyzing spastic muscles. 
• Phenol injections — a type of alcohol that, when injected in a very small amount, can prevent the transmission of too many nerve impulses without causing a debilitating lack of control or sensation.

Read how botulinum toxin injections helped a patient regain movement and control after suffering a severe stroke.

Surgery for spasticity

When rehabilitation therapy, oral medications, and injections do not bring relief, a surgical procedure may be necessary to treat severe symptoms of spasticity. Various procedures to lengthen permanently shortened tendons to relieve spasticity will improve a patient’s mobility, however will not remove all symptoms of spasticity.

In more severe cases of spasticity, a pump surgically implanted in a person’s abdomen administers the drug baclofen. This treatment has been found to be very effective in treating spasticity in the lower extremities.

Make an Appointment at our Spasticity Clinics

The Department of Physical Medicine and Rehabilitation has three spasticity clinic locations in Pittsburgh which offer leading treatment options including clinical trials and state-of-the-art localization of the medication using either ultrasound or EMG guidance.