Spasticity: How to Treat This Neurological Condition

Moving your hand, leg, or any part of your body might feel like an automatic process, but it starts with an impulse in the brain that then sends signals down the spinal cord to the nerves, which stimulate the muscle to contract. And when the brain decides to stop moving, the signal stops and the muscle relaxes.

But with a condition called spasticity, there is an abnormal firing of signals to the nerves and the brain, telling the muscle to contract and move all the time.

“When we lose that ability to relax the muscle, that tightness can cause abnormal positioning of the arms and stiffness in the joints,” explains Elspeth Hill, MBChB (a medical degree awarded outside the U.S.), PhD, a Yale Medicine plastic surgeon. “Depending on the severity, you might not be able to move at all.”

Spasticity can occur after a brain or spinal cord injury or with certain neurological conditions. It can range from mild to severe, which underscores the need to have tailored treatment plans.

“There’s no cookie-cutter approach to spasticity. We have to treat each patient and that particular pattern of muscle spasticity and their particular goals,” Dr. Hill says. “Otherwise we won't get the results that the patients are looking for.”

Often, treatment begins with physical or occupational therapy to work on the muscle range of motion and to help the muscle relax. If the spasticity is limited to certain muscles and not widespread, nerve blocks or Botox-type treatments might be an option. There’s also a new therapy called cryoneurolysis, a minimally invasive procedure that uses extreme cold to temporarily block nerve pain signals.

For some patients, surgery done by plastic and orthopaedic surgeons, is the best path forward. Yale Medicine specialists talk more about treatment options in the video above.