Effective Muscle/Joint Spasm Management

Spasticity refers to increased, involuntary, velocity-dependent muscle tone that causes resistance to movement. It is commonly seen in conditions such as spinal cord injury, brain trauma, and various inflammatory conditions. Characteristics of spasticity include hypertonicity, hyperactive stretch reflexes, and clonus. This condition typically occurs below the level of neurological lesions in individuals with upper motor neuron lesions.
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Causes of Spasticity

Spasticity arises from an imbalance of signals between the central nervous system (brain and spinal cord) and the muscles. It can be triggered by various internal and external stimuli, including:

Techniques include, but are not limited to:

  • Changes in Position
  • Cutaneous Stimulation
  • Tight Clothing
  • Bladder or Kidney Stones
  • Urinary Tract Infection
  • Catheter Blockage
  • Fecal Impaction
  • Pressure Sores
  • Anal Fissures
  • Fractures
  • Burns/Infections
  • Emotional Stress
Treatment for Spasticity
  • Oral Medications or Injections
  • Direct Intrathecal Injections
  • For leg spasticity, intrathecal Baclofen pumps may be implanted in the spinal cord.
  • Dosage and duration of medications will be determined by a healthcare professional, who will assess muscle tone and develop a management plan.
Benefits of Spasticity
  • Maintains Muscle Bulk
  • Decreases Risk of Osteoporosis
  • Improves Venous Return

Therapeutic Management

  • Weight-Bearing Activities: Engaging in weight-bearing activities, such as standing, serves as a form of static stretching. This practice can help reverse early contractures and diminish stretch reflex excitability.
  • Biofeedback: Utilizing biofeedback through electromyography or joint position sensors can assist in reducing spasticity. Auditory and visual feedback can also contribute positively to this process.
  • Static Stretching: Prolonged static stretching of the muscles can be achieved with the use of splints and serial castings.
  • Icing: The application of ice can effectively reduce phasic stretch, reflex activity, and clonus.

Anti-Spasticity Positioning

  • Skin Cooling Effects: The initial effect of skin cooling often leads to increased hypertonicity; however, this cooling is temporary, and its benefits typically last only a few hours. Cooling can be utilized alongside static stretches to counter hyperactive stretch reflexes, which may lead to contractures. Additionally, it can help manage painful spasms.
  • Massage and Movements: Deep, rhythmical massage combined with both active and passive movements can significantly alleviate spasticity.
  • Vestibular Stimulation: Engaging in vestibular stimulation using a rocking chair or hammock has been reported to effectively relax hypertonic muscles.