What is Spasticity? Causes, Symptoms, and Treatment

It’s not just a muscle spasm.

By Beth KrietschMedically reviewed by Jessica Ailani, MD

June 22, 2022

Living with spasticity can make you feel as though you have no control over your own body. Spasticity causes your muscles to contract so much that they become rigid or stiff and interfere with your quality of life. It’s a chronic and common symptom in people with neurological disorders like multiple sclerosis and stroke, as well as among people who have experienced spinal cord injuries or traumatic brain injuries.

To quickly clear up any confusion: Spasticity is not the same thing as a muscle twitch, which is when your muscles unexpectedly contract or relax, causing them to jerk, according to the Cleveland Clinic. Twitches are generally fleeting and can happen when you’re stressed, anxious, or fatigued, though it’s not clear why they happen in the first place. Spasticity, on the other hand, is caused by a disruption in the nerve signals that are sent from your brain and spinal cord to your muscles, resulting in chronic, uncomfortable, and oftentimes painful sensations of stiffness and rigidity.

Interested in learning more? Here’s what you need to know about what spasticity feels like, what causes it, how spasticity is treated, and more.

Spasticity can be a symptom or side effect of many different neurological conditions.

Amanda K Bailey

What is spasticity?

First, it’s helpful to understand what’s happening inside your body when you use your muscles to do something like stand up from a chair, for example. Your brain sends and receives signals to your muscles through neurons, or nerve cells that travel along pathways located in your brain and spinal cord, according to the National Institute of Child Health and Human Development. Typically these signals tell some of your muscles to contract and others to relax, which gives you control of your muscles so you can do the things you want—like stand up or take a step forward, according to the Cleveland Clinic. “Otherwise we’d walk with really stiff legs if all the muscles contracted at the same time,” Natalie Diaz, MD, a neurologist at the Pacific Movement Disorders Center at Providence Saint John’s Health Center in Santa Monica, tells SELF.

When a part of the brain or spinal cord responsible for these signals is damaged, more muscles contract, resulting in symptoms as mild as stiffness and as severe as painful, uncontrollable spasms. This is what is known as spasticity.

Spasticity symptoms

Spasticity can cause muscle tightness, lack of muscle control, and difficulty performing typical activities of daily life, according to Paul Haffey, MD, assistant professor of rehabilitation medicine at Columbia University Irving Medical Center.

Here are more details on the most common spasticity symptoms and what each may feel like, according to the Cleveland Clinic:

Stiffness: Your arms, legs, or other areas of your body may feel really heavy when you try to move.
Restricted movement: You might have difficulty moving your hands, straightening a leg, or walking because of the stiffness.
Muscle contractions: You might have involuntary muscle movements that feel painful.
Posture problems: You could have a hard time staying balanced and upright.
Complications: You could develop bone, muscle, and joint deformities if you don’t get treatment. In extreme cases, some people develop pressure ulcers, or sores, because of the friction that tight muscles create against bony areas like the shoulders and hips.¹
Decreased quality of life: Doing day-to-day tasks like washing your hair or trying to exercise can feel physically impossible when you’re really stiff.

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What causes spasticity?

After a hard workout you might be thinking, Hmm, my muscles are stiff and tight right now—do I have spasticity? The tightness that sometimes happens after a new or really tough workout is not the same as spasticity. Spasticity is caused by nerve damage, which makes it hard for your brain to effectively communicate with the rest of your body. This type of damage typically results from injuries or from different medical conditions that affect your nervous system.

Spasticity can be a symptom or side effect of many different neurological conditions, including:

Stroke is a serious condition that happens either when your brain’s blood supply is blocked off, perhaps by a blood clot, or a blood vessel bursts, robbing your brain of important nutrients and oxygen, according to the Mayo Clinic. Spasticity is common among people who have had a stroke.²
Traumatic brain injury is an injury that affects how your brain works, according to the Centers for Disease Control and Prevention. It can happen after a really forceful blow to your head, like after playing contact sports. Spasticity can set in within a week after a brain injury.³
Multiple sclerosis damages the nerves in your brain and spinal cord. Up to 80% of people with multiple sclerosis experience spasticity symptoms, including muscle tightness and stiffness, that affect their ability to do daily activities, such as preparing meals.⁴
Cerebral palsy happens when your developing brain is damaged (commonly before you are even born), affecting your ability to control your muscles. More than 80% of people with cerebral palsy experience muscle spasticity.⁵
Spinal cord injuries are when your spinal cord or nearby nerves, tissues, and bones become damaged, according to the U.S. National Library of Medicine. Spinal cord injuries can happen due to physical trauma or an illness.
Hereditary spastic paraplegia is a group of disorders caused by a genetic abnormality that deteriorates the nerves in your spine. Symptoms get worse with time, so you may eventually need to use a cane to walk, according to the National Institute of Neurological Disorders and Stroke (NINDS).

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Spasticity diagnosis

It’s important to talk to your doctor about your symptoms if you think you have spasticity. You can start by scheduling an appointment with your primary care physician if you have one. They can then refer you to a neurologist if necessary. Generally, your appointment will involve a physical exam, so that your doctor can see how you move, as well as diagnostic tests. The exact tests your doctor recommends will depend on the medical condition they suspect you may have based on your symptoms. That said, the NINDS says the following tests can help diagnose spasticity:

Blood tests can look for markers of muscle diseases and muscle damage.
Magnetic resonance imaging (MRI) shows detailed two- and three-dimensional images of tissue to highlight abnormalities in your brain and spinal cord. MRIs require sitting really still in a tube-like machine for long periods of time, so if you are claustrophobic, you may want to talk to their doctors about other options.

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Spasticity treatment

Depending on your particular symptoms (and what’s causing them), you may work with a team of health care professionals from different medical specialties, including neurologists, orthopedic surgeons, physical therapists, occupational therapists, and speech language pathologists, to develop a treatment plan. Treatment could include medication, physical therapy, surgery, and lifestyle modifications to help you feel your best.

“Spasticity is first treated with stretching activities, bracing, and modalities like heat,” Dr. Haffey tells SELF. “Depending on the severity, we then use oral medications, progress to botulinum toxin injections, surgical intervention, or even the implantation of a pump that sends muscle relaxant medication into the spinal fluid.”

Here’s a bit more information about different spasticity treatments.

Lifestyle modifications

“Spasticity can sometimes affect one's ability to perform activities of daily living, which can be an adjustment for people. They may need to develop strategies to modify their way of doing these activities,” Dr. Haffey says. Some things that may help include:

Going to physical therapy for treatment and to learn stretches and strengthening exercise that can help you improve your range of motion and mobility.
Working with an occupational therapist to practice everyday movements (i.e., lifting a drinking glass or using eating utensils) and improve coordination.
Wearing a splint or brace to help with spasms and tightness if your doctor thinks it can help.
Taking warm baths to help your muscles relax.
Maintaining regular appointments with your physician in order to best manage your condition.

Medication

If spasticity interferes with your daily life and you need additional support outside of lifestyle modifications, then your doctor might prescribe medication. Some common medications include:

Oral muscle relaxants: There are numerous kinds of muscle relaxants, and the exact mechanism for each can differ. Ultimately, they all help to relax tight muscles and decrease muscle spasms.
Botulinum toxin injections: In some cases botulinum toxin can be injected into your muscles to paralyze them so that they don’t contract. This is generally used with other therapies and is usually most effective when trying to relieve spasticity in a small number of muscle groups, according to the Cleveland Clinic.

Surgery

Sometimes surgery is recommended if other treatments haven’t worked. According to the Cleveland Clinic, the most common options include:

Intrathecal baclofen pump: This procedure involves surgically putting a pump in your abdomen that delivers medication directly to your spinal fluid. This is generally best for people with severe spasticity or when oral medications haven’t helped enough.
Selective dorsal rhizotomy: In this procedure your surgeon cuts the nerve roots that contribute to your increased muscle tone to help alleviate muscle stiffness. This surgery is typically performed on children with spasticity as a result of cerebral palsy.

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Living with spasticity

Spasticity can feel slightly different for every person who has it depending on their affected muscles and the severity of their condition. Some people may have spasticity that affects their arms, making their limbs feel so heavy that it’s hard to lift items. Other individuals may have really painful muscle spasms and notice that, during an episode, their muscles feel harder or look a little different than they typically do, according to the Cleveland Clinic. Spasticity tends to be a chronic condition that requires long-term management and care. That said, some people with mild spasticity may improve enough that they’re only dealing with minor symptoms that come on from time to time and only cause mild discomfort, according to Dr. Diaz.

If you have spasticity, it’s really important to see a neurologist. Without proper treatment your pain can make it hard for you to sleep and shower, inhibit mobility, and even increase your risk of falling. Working with your care team to come up with an individualized plan can help you figure out the best course of action so you can live as fully as possible.

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