The muscles of the body maintain a normal muscle tone, a level of muscle tension that allows us to maintain posture. However, when muscle tension increases, they become rigid and are described as spastic. When muscles become spastic, their range of motion decreases and this can cause pain.
Therefore, muscle spasticity has been defined as a disorder of sensorimotor control resulting from an upper motor neuron (UMN) lesion, which presents as intermittent or sustained involuntary muscle activation.
What are the characteristics of spasticity?
After an acute episode of brain or spinal cord damage, weakness may appear. The affected limb may have a reduced ability to move both voluntarily and reflexively.
Initially, the arm falls parallel to the body when the person is sitting or standing, and the leg becomes weak, bends, and cannot support body weight, making standing and walking difficult. Gradually, manifestations of spasticity will appear, posture will change into extension or flaccid flexion, and tension, pain, and resistance to stretching will develop.
- Clonus: involuntary rhythmic contractions triggered by stretching; these can interfere with walking, transfers, sitting, and personal care
- Spasms: sudden involuntary movements that often involve multiple muscle groups and joints in response to somatic or visceral stimuli
- Spastic dystonia: it is a form of muscle hypertonia without triggering factors due to the inability of motor units to stop the stimulus after voluntary or reflex activity; it causes characteristic limb postures and contractures
- Spastic contracture: inappropriate activation of antagonist muscles during voluntary activity due to lack of reciprocal inhibition causes loss of dexterity and slowness of movement
What are the causes of muscle spasticity?
Structural lesions of the central nervous system at the level of the brain, brainstem, and spinal cord are very common. Throughout birth and life, there are pathological circumstances that can cause these alterations. Some processes originate during the gestational period or at the time of birth, whether hereditary, genetic, or acquired, and in other cases, acquired damage occurs throughout life, whether in childhood, adolescence, adulthood, or old age.
The causes are as numerous as the conditions capable of damaging the central nervous system. Among the most notable causes in children is cerebral palsy (CP), and in adults, acquired brain or spinal cord injury (stroke, multiple sclerosis, traumatic brain injury, spinal cord injuries, tumors, etc.), as well as neurodegenerative disorders.
It may appear early or be a late manifestation of the process. It remains stable or with slight changes over months and years. Over time, the associated consequences or problems tend to worsen.
Is muscle spasticity common?
Muscle spasticity is relatively common and affects many groups of people with different underlying conditions equally. It is often overlooked. Neither the person with muscle spasticity nor their family usually complain.
The examiner often does not ask about it or does not perceive it, and consequently appropriate corrective or preventive measures are not established. It is important to emphasize the need to detect muscle spasticity as early as possible, assess its consequences, and act with treatment strategies that allow the affected person to improve functionality, relieve pain, facilitate care, and enhance quality of life.
Can muscle spasticity be prevented?
Muscle spasticity appears and cannot be prevented. If it is detected early, treatment strategies can be initiated to reduce its severity and prevent the development of complications.
Can muscle spasticity disappear?
If the cause is curable, if the lesion is minimal or reversible, muscle spasticity may become undetectable or disappear. It is important to detect and treat as early as possible all those conditions that can damage the central nervous system.
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