United States Department of Veterans Affairs
 Resources & Education for Stroke Caregivers' Understanding & Empowerment

RESCUE Lifepreserver Fact Sheet Masthead Logo

RESCUE HOME  |   RESCUE Fact Sheet Library


A person has their hands together and clenched

CARING FOR SOMEONE WITH PHYSICAL NEEDS

Spasticity

(Stiff Muscles & Limited Movement)

Spasticity is a condition in which muscles become stiff or rigid. The muscles resist being stretched, which limits movement. Spasticity can develop in any muscle in the body. It is most common in the arms, fingers and legs.



Small image of a life saver

Why Is It Important to Get Help?

Small image of a life saver

Helpful Tips

Small image of a life saver

What Do You Need to Know?

Small image of a life saver

Remember

Small image of a life saver

What Treatments Should You Discuss with Your Healthcare Team?

Small image of a life saver

More Resources



Why Is It Important to Get Help?

Spasticity develops slowly over weeks or months. It ranges from slight muscle stiffness to muscle shortening. When the muscles shorten, the joints can “freeze” into position. This is a painful condition called a contracture. Contractures prevent normal movement and interfere with doing daily tasks. Properly positioning spastic limbs helps prevent contractures.

Symptoms of spasticity include:

  • Stiffness or tightness of muscles and joints
  • Painful muscle spasms or cramping of muscles
  • Involuntary (uncontrollable) jerking motions
  • Exaggerated deep-tendon reflexes (knee-jerk reflex)
  • Abnormal position of the arm; tight fist, bent elbow and arm pressed against the chest
  • Abnormal position of the legs; crossing the legs as the tips of scissors would close (scissoring) 


What Do You Need to Know?

Spasticity is out of your loved one’s control. Things that trigger spasticity or make it worse are:

  • Pain (pressure sores)
  • Infections (bladder, toenail, ear)
  • Cold temperatures
  • Constipation
  • Fatigue or stress


What Treatments Should You Discuss with Your Healthcare Team?

A man is stretching while being helped by a physical therapist

Your loved one’s needs determine the type of treatment. Often, treatment involves a mix of therapy and medicine. The goals are to relieve symptoms, reduce pain and improve movement.

Physical exercise and stretching – This will help loosen stiff muscles. A physical therapist works with your loved one. Often, this includes full range of motion exercises several times a week. Gentle stretching of tight muscles may be needed. The physical therapist may suggest constraint-induced movement therapy (CIMT). CIMT involves restricting movement in the unaffected arm to force the use of the affected arm. The American Stroke Association Web site has more information on CIMT. You can find the link in the More Resources section.

Braces and splints – These assistive devices hold the muscles in a more normal position. This helps to prevent contractures and improve comfort.

Oral medicines – There are medicines to treat the effects of spasticity. Some work to temporarily block nerve impulses. Others work to relax the muscles. Talk to your healthcare team about medicines for your loved one.

Injections of a medicine – Medicines, such as Botox®** help to block nerve activity. This loosens the muscles. Intrathecal baclofen therapy (ITB) is used to treat severe spasticity. A surgically placed pump delivers baclofen** into the spinal fluid. Baclofen is a medicine that relaxes the muscles.

Surgery – This is often the last choice for treating severe, chronic spasticity. It involves operating on the bones, muscles or nerves. Surgery works to block pain and restore some movement.



Helpful Tips

Encourage your loved one to remain active – Exercise and stretching can help ease symptoms and maintain movement. Reinforce using the affected arm as much as possible for daily tasks.

Properly position spastic limbs to prevent contractures – Proper positioning can keep affected limbs from becoming fixed into a set position. The physical therapist can teach you proper positioning.

Watch for skin breakdown – Spasticity in the fingers can cause the nails to tear into the skin. Spastic limbs may rub against each other. Check the skin regularly for any redness or sores. A good time to do this is during bath time. Talk to your healthcare team about any concerns.

Listen and be supportive – Spasticity can be mentally and physically stressful. Allow your loved one to express his or her feelings.



Remember

  • Spasticity develops slowly over weeks or months. Tell your healthcare team if your loved one shows signs of spasticity.
  • Check the skin regularly for skin breakdown. Talk to your healthcare team about any concerns.
  • Talk to the physical therapist about how to properly position spastic limbs to prevent contractures.


More Resources

The following resources are related to this fact sheet only. View a full list of the resources from all RESCUE fact sheets.

Logo for the American Stroke Association

American Stroke Association
Web: www.strokeassociation.org*
Phone: 1-888-478-7653

The American Stroke Association has information about stroke-related physical problems. Read about the following topics:


Photo collage of images representing computers and the Internet
Logo for My HealtheVet

My HealtheVet
Web: www.myhealth.va.gov

My HealtheVet (MHV) provides trusted information on stroke and other health conditions. It also provides resources for stroke caregivers and tools to track your loved one's health.

Visit the My HealtheVet Caregiver Assistance Center for more information on caregiving.


Release Your Potential
Web: www.releaseyourpotential.com*

Release Your Potential is an on-line community for people affected by spasticity. It provides information on spasticity along with various treatments and resources.



*Link Disclaimer: Links to information and Web sites outside of the Department of Veterans Affairs do not indicate an endorsement of products or services offered by the sites. In addition, these sites may have privacy and security policies that are inconsistent with those of VA.

**Brand Name and Medicine Disclaimer: Brand names and types of medicines are provided as examples only. Their inclusion does not mean that these products are endorsed by VA or any other Government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory.

Download a free version of Adobe Reader* to view PDF files.



References: American Stroke Association. (2008). Spasticity. Retrieved February 13, 2009, from: http://www.strokeassociation.org/print_presenter.jhtml?identifier=3004666*; National Stroke Association. (2009). Mobility: Regaining Independence. Retrieved February 13, 2009, from: http://www.stroke.org/site/PageServer?pagename=mobility*; National Stroke Association. (n.d.). Hope: The Stroke Recovery Guide. Retrieved February 17, 2009, from: http://www.stroke.org/site/PageServer?pagename=HOPE*; We Move. (2009). Overview of Spasticity. Retrieved February 13, 2009, from: http://www.wemove.org/spa/spa_overview.html*


Alternate lifepreserver logo for the RESCUE Project
Logo for the Rehabilitation Outcomes Research Center - White head on a blue background with a blue brain containing 5 white and one red star

These materials were created for the project:

Web-Based Informational Materials for Caregivers of Veterans Post-Stroke

Project Number SDP 06-327 funded by VA HSR&D Quality Enhancement Research Initiative (QUERI); Supported by the
Stroke QUERI

Visit the Stroke QUERI Website