Overview

After a stroke, the injury to the brain can cause muscles to contract or flex on their own when you try to use an arm or leg. This is called spasticity. It can be painful. It has been described as a "wicked charley horse." Because the muscle can't move in its full range of motion, the tendons and soft tissue surrounding the muscle can tighten or become shorter.

• Spasticity in an arm can cause a balled-up fist, a bent elbow, or an arm pressed to the chest.
• Spasticity in a leg can cause a pointed foot, a curling toe, or a stiff knee.

Spasticity can have a profound effect on the quality of life, making it hard to walk or do daily activities. If it's not treated, spasticity can cause the muscle to "freeze" into an abnormal position. This can be very painful.

How are spasticity problems treated?

Treatments for spasticity after a stroke include muscle therapies, medicines, and surgery. Your doctor can help you understand your options.

Muscle therapies

Exercise and stretching are important treatments for spasticity. If the joints of your affected limb are not moved through their full range of motion, they can become stiff to the point that they can no longer be straightened. Therapists will work with you to increase your range of motion and help prevent permanent muscle shortening. You need to move the affected limb over and over again, either on your own or with the help of a caregiver, therapist, or a special machine.

In some cases electrical stimulation is used on muscles. Casts or splints may be used to hold muscles in their normal position. This helps to prevent the muscles from shortening so they can work normally.

Medicines

Muscle relaxants may be used to relax tight muscles and stop muscle spasms.

Botulinum toxin or phenol injections directly into the spastic muscle block messages that cause the muscle to contract.

A muscle relaxant called baclofen may be delivered directly to the spinal cord through a small tube. The tube is implanted into the spinal cord by a surgeon, who also implants a small pump under the skin of the person's abdomen to deliver the medicine.

Surgery

Some people may have surgery to treat spasticity. For example, surgery may be needed to lengthen or release muscles that are too tight in the arm or leg.