07 September 2015
Spinal Cord Injuries – What is Spasticity?
What is Spasticity?
Spasticity is the involuntary contracting or tightening of muscles. Spasticity is a side effect of paralysis which can be localised, affecting a particular part of the body, or generalised, affecting a wider area. The four most common causes of paralysis are spinal cord injuries, strokes, head injuries and multiple sclerosis.
What Causes Spasticity?
The nerves of the spinal cord and brain form a complex communication apparatus that helps control our body’s movements. The spinal cord sends information regarding sensations and movement processes to the brain. The brain, in turn, interprets these signals and sends the relevant commands back down the spinal cord to the body to instigate the correct response or reflex.
If the spinal cord is damaged, this crucial exchange of information is disrupted, meaning the brain may no longer be able to transmit signals to the muscles. This is what causes paralysis.
Involuntary muscle spasms are usually caused by the section of the spinal cord below the injury site misfiring and sending abnormal nerve signals to the limbs, resulting in twitches, and stiffening or jerking of the muscles.
What Are the Symptoms?
Spasticity symptoms can vary from abnormally stiff and rigid muscles to severe, uncontrollable limb movements. Other symptoms may include increased muscle tone, fixed joints, sudden, involuntary flexing or extending of the limbs, hyperactive deep tendon reflexes, and the involuntary crossing of the legs. The most common muscles to be affected by spasms are those that bend the elbow or extend the leg.
Problems Caused by Spasticity
Spasticity can often be painful and result in restricted movement in the joints. Spasticity can affect breathing as involuntary movement of the chest muscles can inhibit the ability to breathe deeply.
Severe muscle spasms can obviously affect mobility and curtail activities such as feeding oneself, driving, and transferring to and from wheelchairs. In addition, muscle spasms can cause unwanted skin friction resulting in skin breakdown, while constant spasms at night can affect sleep, causing fatigue during the day.
Is Spasticity Always Such a Bad Thing?
Although spasticity can be painful and interfere with rehabilitation and day to day activities, it is not always harmful and does not always need treatment.
In some cases, it can even be useful as it helps maintain circulation in the legs and can help with functional activities such as standing. For people with partial paralysis in their legs, muscle stiffness may help to control their legs. Similarly, spasticity that causes someone’s fingers to bend may help them with gripping objects.
Some people find that muscle spasms help them with emptying their bladder or bowel – one of several areas we take for granted that is severely affected by spinal cord injuries.
Spasticity can also be an indicator that someone has a medical problem they may not be aware of. An increase in muscle spasms can serve as a warning mechanism to identify pain in areas with little or no sensation. Problems outside the nervous system such as urinary tract infections, fractures and pressure sores, can increase spasticity.
How Can I Treat Spasticity?
Regular physical therapy is key to maintaining flexibility and thereby reducing spasticity. Daily stretching and range of motion exercises help to reduce muscle stiffness and prevent muscles from shortening.
Orthotics, such as ankle-foot or knee-ankle-foot braces as well as progressive casting can provide continuous muscle stretching and place muscles in a desired position so as to limit spasticity.
Careful application of hot or cold packs, avoiding areas with little or no sensation, can calm muscle activity, while more expensive treatments such as a neuroprosthesis - a device that uses electrodes to deliver electrical currents to muscles in the arms and legs - can stimulate the muscles to move in the same way they would ordinarily.
When physical measures are insufficient to control spasticity, medication including muscle relaxants such as baclofen, tizanidine or dantrolene can be taken in tablet form.
If muscle relaxants are ineffective, Botox injections may be given for localised spasms to block signals from the brain to the affected muscles. Such treatments are most effective when combined with stretching regimes and physiotherapy.
If you have sustained a spinal cord injury, our dedicated spinal injury experts can help you with a spinal injury claim to enable you to get the support, rehabilitation and financial compensation you need to live with such an injury.
Slater and Gordon Lawyers will work to secure interim payments of compensation whenever possible to relieve any financial pressures you may be facing. We can also provide advice on long-term financial planning and rehabilitation.
If you or a member of your family are affected by spinal cord injury, please call our Spinal Injury team on freephone 0800 916 9046 or contact us online and we will call you.