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| Muscle Spasticity |
Muscle spasticity is a common problem associated with many neurological conditions that results in stiff or tight muscles. It occurs when there is damage to the parts of the nervous system that control voluntary movements. While harmless, spasticity can cause major issues like pain, gait disturbances and limitations in daily activities. Understanding the cause and management options for spasticity is vital to improving quality of life for those affected.
What is Muscle Spasticity?
Muscle spasticity refers to an abnormal increase in muscle tone or stiffness.
It occurs when there is damage to the upper motor neurons, the nerve cells
located in the brain or spinal cord that send signals to the muscles and limbs.
Common causes of upper motor neuron damage include stroke, traumatic brain or
spinal cord injury, multiple sclerosis, cerebral palsy and spinal cord
diseases.
When these nerve fibers are damaged, they have reduced or impaired ability to
control voluntary muscle movement. The Muscle
Spasticity then remain contracted or partially contracted at all times
instead of relaxing normally. This results in stiffness, rigidity and
involuntary muscle spasms. Spasticity ranges from mild stiffness of the limbs
to very painful, severe muscle spasms that limit activities.
Factors that Worsen Muscle Spasticity
Certain factors can worsen the severity of spasticity including overuse of
affected muscles, inactivity or lack of movement, infections, constipation or
urinary tract infections, anxiety, stress or fatigue. Tight or constricting
clothing, hot weather, menstruation or alcohol consumption can also temporarily
heighten the tightening sensation caused by spasticity. Identifying triggers
and addressing underlying causes through appropriate treatments are important
for managing symptoms optimally.
Impact on Daily Life
The effects of spasticity can significantly impact quality of life and limit
the ability to perform daily activities independently. Severe stiffness and
painful muscle spasms make it difficult to care for oneself, walk or move
affected limbs easily. Routine tasks like bathing, dressing, cooking and
cleaning become challenging. Spasticity may interfere with sleep and also
complicate physical or occupational therapy regimens aimed at improving
strength and mobility. Muscle contractures or permanent shortening of muscles
is a common secondary complication if spasticity is left untreated over time.
Contractures further impair physical function.
Treatment and Management Options
A variety of treatment strategies are available for managing muscle spasticity
depending on severity and underlying cause. Non-medical options may include
physical or occupational therapy focused on range-of-motion exercises,
splinting and bracing to maintain flexibility. Heat therapy using warm
compresses or baths can temporarily relax muscles. Lifestyle modifications and
stress-reducing techniques may provide benefit for some.
For more significant spasticity, medical interventions are needed. Oral muscle
relaxants or anti-spasmodic medications are commonly prescribed long-term.
Botulinum toxin injections directly into affected muscles powerfully relax
muscle spasms for several months by blocking neurotransmitter release at nerve
endings. Intrathecal baclofen therapy, involving a programmable pump implanted
under the skin to deliver baclofen medication into the fluid surrounding the
spinal cord, provides another highly effective option.
Surgery is considered for refractory cases not controlled by conservative
means. Selective dorsal rhizotomy involves surgically cutting sensory nerve
roots in the lower spinal cord to reduce spasticity signals from reaching leg
muscles. Intramuscular phenol injections are also used as a long-lasting
chemical neurolytic (nerve blocking) agent for focal muscles. Goals of
treatment are to relieve pain and discomfort, prevent deformities, improve
mobility, care-giving and psychological well-being. An individualized,
comprehensive rehabilitation plan gives best results.
Muscle spasticity is a common complication of many neurological conditions that
can profoundly impact quality of life. Early recognition combined with proper
medical management as well as physical and occupational therapies aimed at
maintaining range of motion and preventing contractures are important for
optimizing outcomes. Newer treatment options continue to emerge to offer more
targeted relief for people living with disabling spasticity. With a
well-coordinated treatment approach and lifestyle modifications, individuals
can better cope with this challenging symptom and enhance physical function.
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