Spasticity

Spasticity is a movement problem that causes muscles to stay contracted or tighten involuntarily. It often develops when an injury or neurological condition affects the pathways that help the brain and spinal cord control muscle movement.

Spasticity can range from mild stiffness to painful spasms that interfere with walking, dressing, hygiene, sleep or caregiving. It may occur after a stroke, spinal cord injury, multiple sclerosis (MS), brain injury or other neurologic conditions. Baptist Health Brain & Spine Care specialists evaluate the underlying cause and create a treatment plan focused on comfort, mobility and long-term function.

Spasticity may be described by the area of the body affected and by how symptoms appear during movement or rest.

Common types and patterns include:

• Focal spasticity: Affects a single area of the body, such as the hand, wrist, elbow, ankle or foot
• Generalized spasticity: Involves multiple muscle groups or larger areas of the body, often affecting both legs or both arms
• Segmental spasticity: Affects neighboring regions of the body, such as both legs or one side of the body
• Flexor spasticity: Causes muscles to pull a joint into a bent position
• Extensor spasticity: Causes muscles to keep a joint straight or rigid

Some people have spasticity mainly in the legs, while others have symptoms in the arms, neck, trunk or a combination of areas. Spasticity can also occur with other movement problems, including weakness, poor coordination, tremor or dystonia, which can make diagnosis and treatment planning more complex.

Spasticity symptoms may develop gradually or become more noticeable after illness, injury, surgery or a change in activity level. Symptoms can vary during the day and may worsen with pain, infection, constipation, skin irritation, stress or fatigue. Baptist Health Brain & Spine Care specialists work closely with patients to understand how symptoms affect mobility, comfort and independence.

Common symptoms include:

• Muscle stiffness or tightness
• Painful muscle spasms
• Difficulty bending or straightening an arm or leg
• Clenched fists, pointed toes or crossed legs
• Trouble walking, transferring or maintaining balance
• Muscle cramps or jerking movements
• Joint stiffness or reduced range of motion
• Fatigue from working harder to move
• Difficulty with personal care, dressing or hygiene

Spasticity happens when communication between the nervous system and muscles is disrupted. The brain and spinal cord normally send signals that coordinate movement and control reflexes. When those signals are damaged, reflexes can become overactive and muscles may tighten when they should relax.

Conditions that may lead to spasticity include stroke, multiple sclerosis (MS), spinal cord injury, traumatic brain injury, cerebral palsy and certain spine conditions. Spine-related problems such as cervical myelopathy, spinal stenosis or spinal tumors can also affect nerve pathways and contribute to abnormal muscle tone.

Risk factors for spasticity may include:

• A history of neurological injury
• Progressive neurological disease
• Reduced mobility
• Untreated pain
• Infection
• Pressure injuries
• Changes in medication

Identifying triggers is an important part of treatment because addressing them may reduce the severity or frequency of spasms. Baptist Health Brain & Spine Care teams evaluate both the underlying neurologic condition and contributing factors that may worsen symptoms over time.

Diagnosing spasticity begins with a detailed medical history and physical exam. Your specialist may ask when symptoms started, which muscles are affected, what triggers spasms and how stiffness affects walking, daily care, sleep and comfort.

During the evaluation, your care team may assess:

• Muscle tone and stiffness
• Strength and reflexes
• Sensation and coordination
• Range of motion
• Walking patterns, posture and balance
• Functional limitations that affect daily activities

Imaging or nerve testing may be recommended when symptoms suggest a brain, spinal cord or nerve condition. Depending on your symptoms, evaluation may include MRI, spine imaging, electroencephalogram (EEG), EMG or nerve conduction studies when another neurologic condition needs to be ruled out. Baptist Health Brain & Spine Care specialists use advanced diagnostic tools to identify the source of symptoms and guide individualized treatment planning.

Treatment depends on the cause, severity, affected muscles and personal goals. Some people need treatment to reduce pain and spasms, while others need a plan that supports walking, hand function, hygiene, positioning or caregiving. Baptist Health Brain & Spine Care offers coordinated treatment plans that may involve neurologists, rehabilitation specialists, pain management experts and spine surgeons.

Spasticity care may include:

• Physical and occupational therapy to improve flexibility, strength, positioning and safe movement
• Stretching programs, splints, braces or assistive devices
• Oral medications to reduce muscle overactivity
• Targeted injections, including botulinum toxin injections, for focal muscle tightness
• Intrathecal baclofen therapy for severe or widespread spasticity
• Treatment of triggers such as pain, infection, skin irritation or constipation
• Spine surgery when compression, instability or another structural spine condition is contributing to symptoms

If spasticity is related to a spine condition, treatment may overlap with procedures such as laminectomy, minimally invasive spinal fusion or other spine surgery approaches. Your team will explain which options are appropriate and how each treatment may affect movement, comfort and independence.

Untreated or poorly controlled spasticity can affect quality of life and increase the risk of secondary problems. Tight muscles can limit joint movement and make daily activities harder, especially when spasticity affects the legs, arms, hands or trunk.

Possible complications include joint contractures, pain, skin breakdown, poor sleep, falls, difficulty walking, reduced independence and increased caregiver burden. Severe spasticity may also contribute to abnormal posture or worsen pressure on the spine and joints. Early treatment from Baptist Health Brain & Spine Care specialists can help protect mobility, improve comfort and reduce preventable complications.

Not all spasticity can be prevented, especially when it results from a neurological injury or long-term condition. However, consistent care can help reduce flare-ups, maintain flexibility and prevent complications.

Prevention strategies may include following a therapy and stretching plan, using braces or positioning devices as directed, staying active within safe limits and treating triggers promptly. People recovering from stroke or living with multiple sclerosis (MS) may benefit from regular follow-up with Baptist Health Brain & Spine Care specialists so changes in strength, tone or function can be addressed early.

If muscle stiffness, spasms or changes in movement are affecting your comfort or daily life, a neurologic evaluation can help identify the cause and guide treatment. Baptist Health Brain & Spine Care offers coordinated care for spasticity related to neuromuscular disorders, stroke, spine conditions and other neurologic causes.

To schedule a visit with a Baptist Health Brain & Spine Care provider, fill out an appointment request form or call 833-596-3876.