May 22, 2024
Muscle Spasticity

Muscle Spasticity: Understanding the Condition

What is muscle spasticity?
Muscle spasticity is a condition in which certain muscles are continuously contracted and rigid. It occurs because of damage to the parts of the nervous system that control voluntary movement. The muscles receive signals to contract but there is no signal for them to relax, leaving them in a state of constant contraction. It is a common symptom of conditions like cerebral palsy, spinal cord injuries, stroke and multiple sclerosis.

Causes of muscle spasticity
Damage to the brain or spinal cord is usually the root cause of muscle spasticity. The two main causes are:

– Injury or damage to the parts of the brain and spinal cord that control movement. This includes conditions like stroke, traumatic brain or spinal cord injury, multiple sclerosis etc. The damaged areas are unable to properly receive and send signals to relax the muscles.

– Neurological disorders that affect the motor function controlling areas. Diseases like cerebral palsy and multiple sclerosis can cause inflammation or damage in these areas, leading to abnormal nerve signalling and spasticity.

Affected muscles and severity
The Muscle Spasticity most commonly affected are those controlling movement in the arms and legs like biceps, triceps, hamstrings, quadriceps etc. However, muscles in other parts like shoulder, back, neck can also develop rigidity.

The severity of spasticity varies from person to person and also depends on the underlying condition. It may range from mild tightness of muscles to very painful contortions making movement difficult. The stiffness can either be continuous or episodic, coming and going in spasms.

Effects and complications of muscle spasticity
If not properly managed, spasticity can severely hamper mobility and daily living abilities. Some common effects are:

– Contractures: Prolonged contraction of muscles leads to shortening of connective tissues and joints getting permanently fixed in flexed positions.

– Muscle fatigue: Overwork of hypertonic muscles can cause early exhaustion and weakness.

– Joint and bone issues: Abnormal positioning stresses joints raising risk of pain, deformities and fractures over time.

– Care difficulty: Personal hygiene, dressing, feeding become effortful due to rigid limbs. It also makes physiotherapy challenging.

– Sleep difficulties: Muscle jerks/spasms at night can disrupt natural sleep cycles.

– Social embarrassment: Uncontrolled spasms in public can cause self-consciousness for patients.

Evaluating and diagnosing spasticity
A thorough physical exam is conducted to assess range of motion, presence of contractures or abnormal postures. Tests like electromyography and imaging like MRI help identify the underlying cause. Diagnosis is mainly clinical based on symptoms and ruling out other conditions.

The modified Ashworth scale is widely used for objectively grading the severity on a scale of 0-4. This helps determine suitable treatment approach for each case.

Managing and treating muscle spasticity
There is no complete cure for spasticity caused by permanent neurological damage. Treatment aims to relieve symptoms, prevent complications and improve quality of life. Management involves a combination of:

– Physical/occupational therapy: Stretching, range of motion exercises, splinting to prevent contractures. Heat/cold therapies, massages for relaxation.

– Oral medications: Baclofen, dantrolene sodium, benzodiazepines are commonly prescribed antispastic drugs. They work by interfering with reflex muscle overactivity.

– Botulinum toxin injections: Botulinum toxin A (Botox) effectively paralyzes targeted hypertonic muscles when injected locally for 2-6 months.

– Neurostimulation therapy: Electrical stimulation techniques like deep brain stimulation or functional electrical stimulation offers relief through controlled muscle contraction-relaxation.

– Neurosurgery: Procedures like selective dorsal rhizotomy are conducted for severe, drug-resistant cases to sever hyperactive nerve pathways at spinal cord level.

– Lifestyle modifications: Physiotherapy, proper body positioning, use of assistive devices, bracing and splinting when needed. Balanced diet and regular sleep.

With a comprehensive treatment approach tailored as per individual’s needs, muscle spasticity is manageable in majority of cases. Constant follow-ups help monitor progress and make required adjustments in long-term management.

*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it