Spasticity: What It Is and What You Can Do About It

Stiff, tight muscles that don’t relax on their own—sound familiar? That’s spasticity. It happens when the nervous system that controls muscle movement is damaged, so muscles fire too much or at the wrong times. Spasticity can make walking, dressing, or even sleeping hard, but there are real steps that help reduce symptoms and improve daily life.

Common causes include stroke, spinal cord injury, multiple sclerosis, cerebral palsy, and traumatic brain injury. Onset can be sudden or gradual. You might notice increased muscle tone, painful spasms, a limb that’s hard to move, or joints that get stuck in one position.

How clinicians assess spasticity

Doctors don’t guess. They look at how muscles respond to movement, check reflexes, and ask how symptoms affect activities. Simple scales (like the Modified Ashworth Scale) rate stiffness, while gait analysis or electromyography can give more detail. Expect questions about when stiffness started, what makes it worse, and which daily tasks are affected.

Treatment options that actually help

Treatment mixes therapy, medicine, and devices. Which mix works best depends on how severe the spasticity is and what goals you have—less pain, easier dressing, better walking, or fewer spasms at night.

Physical and occupational therapy should be first. Regular stretching, active exercises, range-of-motion routines, and positioning help keep joints flexible and reduce reflex overactivity. Therapists may add serial casting, splints, or orthotics to hold a limb in a better position while tissues adapt.

Medications can reduce overall muscle tone. Oral options include baclofen, tizanidine, dantrolene, and benzodiazepines. Each works differently and has side effects—drowsiness, weakness, or liver effects—so doctors balance benefits and risks. For localized spasticity, botulinum toxin injections target overactive muscles and often give months of relief with minimal systemic side effects.

For severe, widespread spasticity that doesn’t respond to other treatments, an intrathecal baclofen pump may be considered. It delivers medicine directly near the spinal cord and uses much lower doses than oral drugs. Surgery or tendon lengthening is another step when contractures limit function and conservative treatments fail.

Complementary approaches—like cooling wraps, electrical stimulation, and targeted massage—can help with comfort and short-term relief. Some people find cannabinoids ease spasm frequency, but evidence varies and legal status differs by region.

Practical tips: keep a daily stretching routine, track what triggers spasms (cold, pain, tight clothing), time medication to match activity needs, and ask your team about home exercises you can do safely. Caregivers should learn safe transfer and positioning techniques to prevent pain and skin issues.

When to call a doctor: sudden increase in spasms, fever, new weakness, or skin changes under splints. These can be signs of infection, medication problems, or evolving neurologic issues.

Spasticity can feel overwhelming, but small, consistent steps add up. Talk with your rehab team about a plan that fits your goals—whether that’s less pain, better walking, or easier daily care.