Spasticity is common condition characterized with involuntary muscle spasms and stiffness of different muscles. When this occurs, you will notice sudden muscle movements and contractions. It can be mild where muscles move calmly or severe where muscle movements can be felt commonly in the legs. In extreme cases, the contractions are painful and can also cause lower back pain.
Spasticity is common in the legs even though it can occur in any limb. There are also two types of spasticity including flexor and extensor spasticity. Flexor spasticity is common in the hamstring where upper leg back muscles and flexors are affected. The knees and hips are affected causing a lot of pain as the muscles find difficulties trying to straighten.
In extensor spasticity, the adductors and quadriceps are involved. Therefore, muscles on the inside and front of the upper leg are affected. The knees and hips will remain straight as legs move or close/cross together at the ankles.
Spasticity can be aggravated by change in position and sudden movements. Temperature extremities, infections and humidity also worsen the situation. Tight clothing can also trigger and worsen spasticity.
When left untreated, the condition can lead to very serious complications in the future. They include contractures characterized by immobilized or frozen joints as well as pressure sores. These complications often act on triggers and can also escalate over time. Therefore, it is imperative to treat spasticity as early as possible.
Treatment options include occupational therapy, medication and physical exercises. Occupational therapy is essential as it disables contractures in the shoulders, elbows, ankles, knees and hips. Medication and more specifically surgical measures are ideal when other forms of treatment have not been effective.
How to manage spasticity
Managing spasticity is very important. The condition varies from one patient to the other. Therefore, it is managed at individual level with the help of a physical therapist, occupational therapist, nurse and a physician. Treatment begins exercises, change of daily activities and medication to help relieve the symptoms.
While the patient is on medication, a physician will check the progress and make referrals to physical therapist and occupational therapist for further exercises. Daily stretching with the help of the therapists will be used because they are effective in managing the symptoms and in treatment of the condition.
With the exercises, the patient will also be put on medication including Tizanidine and Baclfofen. Baclofen is the most commonly used spasticity medication. It is an effective muscle relaxant and works by targeting nerves in the spinal cord. The medication comes with slight side effects including drowsiness and muscle weakness. It can be administered by implanting a pump (intrathecal baclofen used in the event of severe spasticity) or orally.
Tizadine on the other hand is used to relax and calm spasms by working on tightened muscles. It is a very effective medication that does not cause muscle weakness. However, it can cause a dryness of the mouth and sedation and low blood pressure in some patients.
Other medications that are less commonly used include diazepam, phenol, Clonidine, Botulinum toxin and Dantrolene among others.
Despite the pain, spasticity offers some benefits including strengthening muscles in persons with significant leg weakness.
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