Spasticity is the condition in which overactivity in certain muscles causes their rigidness, stiffness, or spasm. It arises from damage to the brain or spinal cord that conditions such as injury, cerebral palsy, stroke, or multiple sclerosis may have caused. Spasticity can affect most of the body (common spasticity) or only a small area (focal spasticity), such as the hands and feet. The effects of spasticity range from mild stiffness to painful, uncontrollable spasms.
Botulinum toxin causes temporary paralysis by blocking the nerve endings, and by using this feature, it is aimed to reduce excessive muscle contraction in spasticity. Botulinum toxin is injected into specific muscles only. Which muscles to choose for injection depends on the patient. The amount of botulinum toxin injected into each muscle is also determined according to the individual needs of the patient. Small muscles can be injected at one or two sites, while three or four injections may be required for large muscles. Botulinum toxin does not spread very far from the injection site, so normally it does not affect the surrounding muscles.
Botulinum toxin starts to take effect in small muscles within 24 hours, and its full effects are seen after three to four days. It may take up to two weeks to get the full benefit on larger muscles or muscles that are very stiff. The effects of the treatment last for about three to four months. After that, the muscle begins to return to its former state, but with an intense physical therapy program that includes stretching exercises and the use of a splint, the benefit from the injection may last longer (6 to 12 months).
The effect of the injection lasts for different durations in each patient, and there is no way to predict how long the effect will last. The patient’s experience after the first injection will give a good idea regarding the benefits, and how and how often the next injection will be given will be re-evaluated.
What is Spasticity?
Spasticity, which is a pathological health problem, occurs as a result of severe contraction in the human body. Spasticity, which can arise from damage to the brain, can manifest itself in the muscles of a certain part of the body, as well as in the whole body.
The problem of spasticity is defined by the person suffering from the disease as “constant contraction of the muscles”. Since these involuntary contractions cause the muscles to become rigid and tense, they greatly limit the daily activities of the person such as walking, talking, eating, and moving, consequently reducing the quality of life.
Spasticity is not considered a stand-alone disease. Any disease occurring on the brain and spinal cord that may cause deformation in these two vital organs can lead to spasticity in that person.
In general, spasticity problems are experienced as a result of cerebral palsy, multiple sclerosis, brain trauma, stroke, and serious injuries. Spasticity can also be seen in children and may be caused by a lack of oxygen in the brain due to various conditions.
Spasticity is seen in varying degrees of severity in each person. Spasticity, caused by various reasons, may begin to progress and be seen in different parts of the body over time. In order to prevent its progress, the person and the people who take care of the patient should be careful.
Ingrown nail, urinary tract infection, extreme cold or extreme heat, constipation, vascular occlusion, fracture-dislocation, gallbladder problems, gum problems, hemorrhoids, menstrual bleeding, pressure sores, and any infection can trigger spasticity and cause it to progress.
Does Spasticity Go Away?
As with any disease, the condition of spasticity is usually personal. Especially since it is seen differently in a different region in each case, experts emphasize that the most accurate approach for the treatment of spasticity will be possible with a personalized evaluation.
There are several treatment methods applied in the medical world for spasticity lately. Physical therapy, drug therapy, surgical intervention are among the methods applied in the treatment of spasticity. Unfortunately, it is not possible to give a definitive answer to whether spasticity goes away. Because how patients will respond to this 3-stage treatment varies.
As the treatment process progresses as expected and the patients with spasticity begin to respond to the treatment, they experience less fatigue and regain their mobility abilities such as eating and dressing on their own.
Is There a Treatment for Spasticity?
This problem, which can occur congenitally or later in children, is also seen in adults. People who encounter the problem of spasticity search for treatment options because it adversely affects the person’s quality of life and causes discomfort.
The physical therapy method is regarded as the first step in the treatment of spasticity. It is important for the treatment to follow the physical therapy sessions regularly, to do the homework, and for the person who takes care of the patient to help in the movements of this exercise program.
After the physical therapy phase, drug therapy starts. The drug treatment is started by adjusting the individual doses following the doctor’s general condition evaluations. For this reason, no drug should be used based on hearsay information without expert advice.
Depending on the condition of some patients, surgical interventions are also one of the preferred methods among various techniques applied in the treatment of spasticity. Surgical interventions aim to fix the person surgically by applying plaster and splint in positions antagonistic to the spastic muscles. In general, the exercise programs applied regularly and correctly helps to alleviate the complaints of the person.
How is Spasticity Evaluation Performed?
Spasticity is a neuromuscular disorder. That is, the muscles are in a constant state of contraction. This leads to many consequences. For example, an individual with spasticity cannot perform basic activities such as walking, moving, and speaking.
Spasticity can have many causes. However, spasticity in children mostly results from brain damage due to a lack of oxygen. At the same time, brain trauma, stroke, spinal cord damage also lead to this situation. All of these events cause damage to the nervous system.
Spasticity, which arises in many different forms, occurs due to overactive tendon reflexes. While bent joints are frequently encountered, spasticity may also manifest itself with conditions such as speech problems and the crossing of arms and legs. In the long run, the muscles stay in a single position, contracting the joints. In this way, a fixed structure becomes permanent in the body.
If the presence of spasticity is revealed and its degree is to be determined, the whole body goes under a thorough physical examination during the evaluation. Besides, neurological assessment is the cornerstone of this practice. An assessment should be made by physical and professional therapists to determine which muscles of the individual show spasticity.