About spasticity
After a stroke, brain injury, spinal cord injury, or conditions such as multiple sclerosis or cerebral palsy, the signals that normally keep muscles relaxed can be disrupted. Some muscles then contract too easily or stay tight, especially with quick movement. This is called spasticity.
Spasticity can make it hard to open the hand, bend the elbow, walk, or get dressed, and it can cause pain and skin problems. It is not always harmful, since some stiffness can help with standing, so treatment is guided by specific goals such as easier hygiene, better walking, or less pain.
Common symptoms
- Stiff or tight muscles that resist stretching
- A fist, bent elbow, or pointed foot that is hard to straighten
- Muscle spasms or jerking movements
- Pain or discomfort in tight muscles
- Difficulty with walking, dressing, or hand use
Common causes and risk factors
- Stroke
- Traumatic brain injury
- Spinal cord injury
- Multiple sclerosis, cerebral palsy, or other neurologic conditions
How we diagnose it
Dr. Chen examines each affected muscle group to measure stiffness, range of motion, and strength, and observes how you walk and use your hands. Together with you, your family, and your therapists, we set specific goals for treatment. Ultrasound, and sometimes electrical stimulation, is used to identify the exact muscles or nerves to target, so injections go where they will help most.
How Propel treats spasticity
Rehab is the foundation: regular stretching, strengthening of the muscles that oppose the tight ones, positioning, and bracing or splinting when helpful. Staying active supports overall health and makes other treatments more effective. We also review medications, since some oral medicines for spasticity can cause drowsiness.
For stiffness in specific muscles, Dr. Chen may recommend botulinum toxin injections, which relax targeted muscles for a period of months, or chemoneurolysis, in which medication placed at a nerve calms the muscles it controls. These are guided by ultrasound for accuracy and timed with therapy so that gains in stretch and strength can be built on. When spasticity is widespread or severe, we can help coordinate a referral for other treatments.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about spasticity
- How long do botulinum toxin injections last for spasticity?
- The effect typically builds over one to two weeks and lasts a few months. Injections can be repeated, and therapy during that window helps make the most of the relaxed muscles.
- Is it too late to treat spasticity years after a stroke?
- Not necessarily. Many people benefit from treatment long after a stroke or injury, particularly when goals are specific, such as easier hand hygiene or less foot pulling while walking.
- What is the difference between botulinum toxin and chemoneurolysis?
- Botulinum toxin is injected into the muscle itself to relax it. Chemoneurolysis places medication at the nerve that controls the muscle, which can be useful for larger muscle groups. Dr. Chen may use one or both depending on your goals.