Spasticity management for spinal cord injury

Spasticity is a form of muscle overactivity. It occurs when there’s disruption in communication from the brain and spinal cord to the muscles. Spasticity can happen after a spinal cord injury. It also may result from another injury or an illness.

Spasticity increases muscle tone, which can help with posture and stability after a spinal cord injury. But spasticity also can cause stiffness, pain, muscle spasms, fatigue and other symptoms. It can be hard to perform daily activities such as walking, sitting and sleeping.

The goal of spasticity management for spinal cord injury is to help maintain muscle range of motion, prevent muscles from tightening and shortening, and reduce muscle spasms.

Spasticity management may be important in preventing pain and stiffness from getting worse after a spinal cord injury. If spasticity continues long-term without treatment, it can lead to limited movement, making it hard to function. Treatment also helps prevent pressure sores on the skin.

Spasticity management for spinal cord injury usually involves a combination of therapies that may include:

• Exercises. Physical and occupational therapy can teach you stretches, positions and exercises that may help you maintain range of motion. The therapies can help prevent muscles from tightening and shortening, known as contracture.
• Oral medicines. Certain prescribed medicines given by mouth may help reduce muscle spasticity.
• Intrathecal therapy. Sometimes spasticity may be treated with medicines administered 24 hours a day directly into the fluid surrounding the spinal cord. This type of therapy is called intrathecal therapy. The medicine is delivered by a pump and tube system that is implanted during surgery.

• Injections. OnabotulinumtoxinA (Botox) injections into affected muscles may decrease the muscle signals that cause spasticity. The injections provide short-term relief, allowing you to move and strengthen your muscles. You may need injections every three months.

  Phenol or alcohol injections into the peripheral nerve near the muscles that have spasticity may reduce muscle spasms.

• Neurosurgery and orthopedic surgery procedures. Surgical procedures to release tightened tendons or destroy the motor nerves of sensory spinal roots may stop the spasticity.

Spasticity management for spinal cord injury may help improve your muscles’ range of motion, reduce pain and make it easier to complete daily activities.