For me, spasticity has always been one of the most exhausting and distressing symptoms of MS. But this week, it has reached a new height, flaring up at the most inconvenient times and catching me off guard, reminding me that living with MS is not for the faint of heart. It’s an ongoing negotiation with my own body.
In this post, I want to share with you some insights into what spasticity is, why it strikes so unpredictably, and most importantly, how I’ve learned to manage it—sometimes with success, and sometimes with the humbling recognition that relief is a process.
What Is Spasticity?
Spasticity, in simple terms, is a disruption in the natural rhythm of muscle movement. Normally, our nervous system directs certain muscles to contract while others relax. But when the central nervous system is damaged, as it is in MS, this delicate dance of contraction and relaxation is thrown off. As a result, muscles may contract uncontrollably, stay tight, and become resistant to releasing. These spasms can affect just one part of the body, or, in some cases, multiple muscle groups.
When a muscle doesn’t fully release, it doesn’t just stay tight; it can deprive the muscle of much-needed oxygen and reduce blood flow, which in turn can lead to a build-up of lactic acid. Imagine running a marathon with no way to hydrate—your muscles seize, scream for relief, and yet, they remain clenched.
In severe cases, this prolonged tension can cause bone deformities and long-term pain, while in other instances, spasticity simply feels like the aftermath of a vigorous workout, except it’s your whole body that’s affected—not just a select group of muscles. For me, spasticity is a constant reminder that, despite my best efforts, my body doesn’t always follow the script I’d like to write.
Symptoms of Spasticity
Spasticity is more than just muscle stiffness. It’s the unwelcome unpredictability of your body going rogue. For me, it’s often in my feet or lower back—especially after tasks like washing dishes. The other day, I experienced a spasm in my shoulder that nearly made me lose consciousness. The pain was so intense, I thought I might pass out, and when the muscle finally released, it still clung to tension for what felt like an eternity.
Some of the symptoms of spasticity include:
- Increased muscle tone (some might call it “extra firmness,” though I wouldn’t necessarily recommend it!)
- Involuntary muscle movements
- Spasms, which can be brief or last for what feels like forever
- Clonus, which is a rapid, rhythmic contraction of muscles
- Contracture, where muscles and tendons become permanently tight due to prolonged spasms
- Deformities in bones and joints
- Stiffness, which can leave your body feeling like it’s encased in a cast
How to Relieve Spasticity: My Tips
I want to be clear: managing spasticity is not a one-size-fits-all solution. What works one day might not work the next. But over the years, I’ve come to rely on certain practices to help calm my muscles, ease the pain, and restore some semblance of comfort to my body. These are the tools I’ve gathered, though I encourage you to consult your healthcare provider before trying anything new. Together, you and your doctor can craft a plan that’s right for you.
Magnesium Magnesium can help relax muscles and may reduce spasticity, especially when used as a supplement or through topical applications.
Electrolytes Proper electrolyte balance is crucial for muscle function. Ensuring adequate intake of potassium, calcium, and sodium can support muscle relaxation.
Increase Water Intake Staying well-hydrated can help flush toxins and lactic acid from the muscles, potentially reducing the intensity of muscle spasms.
Breath Work Practicing deep breathing exercises helps to increase oxygen supply to the muscles and reduce muscle tension.
Stretching Regular stretching helps maintain flexibility and reduce muscle stiffness. It’s particularly helpful for managing spasticity in the legs, back, and arms.
Massage Using Foam Rollers Self-massage with tools like foam rollers can help release tight muscles and ease spasticity, especially in larger muscle groups like the back and thighs.
Trigger Point Therapy This technique focuses on releasing tight knots in the muscles that can contribute to spasticity.
CBD (Orally and as a Cream) Cannabidiol (CBD) may help reduce spasticity and inflammation. A combination of oral and topical CBD, particularly when combined with capsaicin, can provide relief.
Essential Oils Certain essential oils, like Deep Blue by DoTerra, have anti-inflammatory properties and can help relax tight muscles.
Baclofen Baclofen is a muscle relaxant that can be prescribed to reduce spasticity. It’s often used twice a day to manage symptoms.
Chemodenervation (Botulinum Toxin or Phenol) Chemodenervation involves the injection of botulinum toxin (Botox) or phenol into affected muscles to temporarily block the nerve signals that cause spasticity. This treatment can provide relief by reducing muscle stiffness and improving movement, and is particularly helpful for localized areas of spasticity.
Aquatic Therapy Aquatic therapy takes advantage of buoyancy to ease pressure on joints and muscles while allowing for controlled movement, helping reduce spasticity and increase flexibility.
Electrical Stimulation (TENS Unit) A Transcutaneous Electrical Nerve Stimulation (TENS) unit can help alleviate muscle spasms and reduce spasticity by sending electrical pulses through the skin to the muscles.
Cold and Warm Compresses Applying cold compresses can reduce inflammation, while warm compresses can help relax tight muscles and improve circulation.
Compression Stockings Wearing compression garments or stockings helps improve circulation and can reduce muscle tension, especially in the legs.
Relaxation Techniques Techniques like meditation, progressive muscle relaxation, and mindfulness can help reduce overall stress and muscle tension, contributing to relief from spasticity.
Conditions That Trigger Spasticity: Understanding the Underlying Causes
Spasticity is a condition that can be caused by a number of diseases and conditions that affect the nervous system. When the brain and spinal cord are damaged, they can disrupt the signals that control muscle movement, leading to spasticity. Here are some of the most common diseases and conditions that can cause spasticity:
1. Multiple Sclerosis (MS)
Multiple sclerosis is a chronic autoimmune disease where the immune system attacks the protective covering of nerve fibers, leading to communication breakdowns between the brain and the body. This damage can result in spasticity, often affecting the legs, arms, and other parts of the body. Spasticity in MS can be mild or severe and often leads to muscle stiffness, pain, and difficulty with movement.
2. Cerebral Palsy (CP)
Cerebral palsy is a group of neurological disorders that affect muscle tone, movement, and motor skills. It is caused by damage to the developing brain, typically before or during birth. Spasticity is one of the most common symptoms of cerebral palsy, and it can affect various parts of the body, leading to tight, stiff muscles that restrict normal movement and flexibility. The severity of spasticity in CP can vary, with some individuals experiencing mild stiffness, while others may face more severe muscle contractions and deformities.
3. Stroke
A stroke occurs when there is a disruption of blood flow to the brain, leading to brain cell damage. Depending on the area of the brain affected, a stroke can result in spasticity in various muscle groups. This is most often seen in the arms and legs on one side of the body (hemiplegia), but it can affect other areas as well. Spasticity after a stroke can develop in the months or even years following the event, and it can hinder rehabilitation efforts and the recovery of movement.
4. Traumatic Brain Injury (TBI)
Traumatic brain injury is caused by a blow or jolt to the head that damages the brain. Spasticity can develop as a result of damage to the areas of the brain responsible for motor control. Individuals with TBI may experience spasticity in their limbs, particularly if the injury has affected the motor cortex or the pathways that communicate with the spinal cord. This can cause difficulty with coordination, movement, and muscle control.
5. Spinal Cord Injury (SCI)
A spinal cord injury occurs when there is damage to the spinal cord, often from a traumatic event such as an accident or fall. Depending on the location and severity of the injury, individuals with SCI can develop spasticity, especially in the limbs below the injury site. Spasticity in spinal cord injuries can be a result of disruption to the normal communication between the brain and the muscles, leading to uncontrolled muscle contractions and stiffness.
6. Parkinson’s Disease
Parkinson’s disease is a neurodegenerative disorder that primarily affects movement. It occurs when the brain’s dopamine-producing cells become damaged. Spasticity in Parkinson’s disease is often associated with rigidity, which is a type of muscle stiffness that can limit the ability to move. While rigidity and spasticity are separate conditions, they often occur together, making movement challenging and painful for those with Parkinson’s disease.
7. Amyotrophic Lateral Sclerosis (ALS)
Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurodegenerative disease that affects the motor neurons responsible for controlling muscle movement. As the motor neurons degenerate, spasticity can develop in various muscles, leading to stiffness and tightness. ALS typically causes both spasticity and weakness, making movement difficult and contributing to the loss of coordination and control over voluntary muscles.
8. Huntington’s Disease
Huntington’s disease is a genetic neurodegenerative disorder that causes the progressive breakdown of nerve cells in the brain. As the disease advances, spasticity can develop, alongside other motor symptoms such as chorea (involuntary movements), dystonia, and muscle rigidity. Spasticity in Huntington’s disease is often due to the disruption of the brain’s control over movement and muscle function.
9. Hereditary Spastic Paraplegia (HSP)
Hereditary spastic paraplegia is a group of rare genetic disorders that primarily affect the spinal cord and cause progressive stiffness and weakness in the legs. The condition is caused by mutations in genes responsible for maintaining the health and function of nerve cells, leading to damage to the spinal cord’s motor pathways. The hallmark of HSP is spasticity in the lower limbs, and as the condition progresses, individuals may experience difficulty walking, muscle spasms, and loss of coordination.
10. Metabolic and Mitochondrial Diseases
Certain metabolic and mitochondrial disorders can also lead to spasticity. These conditions, which affect the body’s ability to produce energy at a cellular level, can lead to damage to the nervous system. As a result, spasticity may develop, often as part of a broader range of symptoms. Examples of metabolic and mitochondrial diseases that can cause spasticity include mitochondrial myopathies, Tay-Sachs disease, and various forms of leukodystrophy.
11. Infections of the Brain or Spinal Cord
Infections that affect the brain or spinal cord, such as meningitis or encephalitis, can also lead to spasticity. These infections cause inflammation in the nervous system, which can disrupt the normal functioning of motor pathways and lead to muscle spasms, stiffness, and difficulty with movement. Spasticity in these cases is often accompanied by other neurological symptoms, such as weakness, sensory disturbances, or cognitive changes.
12. Demyelinating Diseases
Diseases that cause the loss of the myelin sheath (the protective covering around nerves) can also result in spasticity. This includes diseases like Guillain-Barré syndrome and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). The loss of myelin disrupts the transmission of signals between the brain and muscles, leading to spasticity, muscle weakness, and coordination problems.
13. Post-Polio Syndrome (PPS)
Post-polio syndrome is a condition that affects polio survivors, often years after their initial recovery. It can cause new muscle weakness, fatigue, and spasticity. The exact cause is unclear, but it is believed to result from the long-term strain placed on muscles that were previously affected by the polio virus, causing progressive deterioration.
Conclusion
Spasticity is a complex and often challenging symptom, but it can be managed with the right interventions, therapies, and treatments. Understanding its underlying causes—whether they are from MS, stroke, cerebral palsy, or any of the other conditions listed above—is the first step in effectively addressing it. For those of us living with spasticity, learning how to navigate its effects, seeking support, and incorporating strategies for relief can help improve quality of life. Each journey is unique, but we are not alone in facing this condition.
Spasticity and MS: Management Strategies
Frequently Asked Questions About Spasticity
Are there other diseases that cause spasticity?
Yes. Strokes, spinal cord injuries cerebral palsy, amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease), hereditary spastic paraplegias, and adrenoleukodystrophy (ALD).
What causes spasticity?
Spasticity is caused by damage to the nerve pathways that send messages from the brain to the spinal cord. These messages tell muscles to relax. When that signal is disrupted, because of damage to the nerves, spasticity sets in.
How many people typically deal with spasticity?
Approximately 12 million people worldwide, are affected by spasticity. Approximately 80 percent of people with cerebral palsy and 80 percent of those with multiple sclerosis live with spasticity.
How does spasticity occur?
The intensity and frequency of spasticity can vary, but it often becomes worse with activity, stress, fatigue, or temperature changes. In some cases, the continuous muscle contractions can cause pain, discomfort, and even permanent changes in muscle tone or joint position if left untreated.
What does spasticity what does it feel like?
In some cases, spasticity feels like a cramp or a charley horse, where the muscle suddenly tightens and causes sharp, painful spasms. These spasms can be fleeting or they can last for several minutes, and in some situations, they can be so severe that they interfere with movement or cause pain that radiates through the affected area.
At its mildest, spasticity might feel like tightness or stiffness in one part of the body, such as the legs or back. In more intense cases, it can feel like a prolonged, unrelenting contraction of the muscles, causing discomfort, pain, and a loss of mobility. The feeling can spread throughout a limb or body part, and may lead to abnormal postures, difficulty walking, or even problems with hygiene or daily tasks.
Ultimately, spasticity can feel like your muscles are constantly pulling in the opposite direction of relaxation, leaving you feeling sore, stiff, and sometimes even frustrated by your body’s inability to move as you want it to.
How does one pronounce spasticity?
The word “spasticity” is pronounced as spas-TIS-ih-tee.
Here’s a breakdown:
- “Spas” sounds like the beginning of “spasm”
- “TIS” rhymes with “kiss”
- “ih” sounds like the “i” in “sit”
- “tee” sounds like the “t” in “tree”
How is spasticity diagnosed?
Spasticity is typically diagnosed through a combination of medical history, physical exams, and sometimes specialized tests. Here’s how the process generally works:
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Medical History: The doctor will ask about your symptoms, including when they began, how they have progressed, and any factors that make them better or worse. They may also inquire about any underlying conditions, such as multiple sclerosis, cerebral palsy, or a previous stroke, that could contribute to spasticity.
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Physical Examination: During a physical exam, the doctor will assess your muscle tone by gently moving your limbs and observing how your muscles respond. They will check for signs of stiffness, resistance, or jerky movements, and may perform specific tests to evaluate the extent and location of the spasticity.
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Neurological Examination: The doctor will check your nervous system to assess muscle function and reflexes, as well as the coordination between the brain, spinal cord, and muscles. Abnormal reflexes, such as hyperactive reflexes or a clonus (rapid muscle jerks), may indicate spasticity.
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Imaging Tests: In some cases, your doctor may order imaging tests, such as MRI (Magnetic Resonance Imaging), to look for damage to the brain or spinal cord that might be causing the spasticity. These tests help identify underlying neurological conditions.
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Electromyography (EMG): An EMG measures electrical activity in the muscles and nerves. This test can help determine if the muscles are responding abnormally to nerve signals, which may indicate spasticity.
By combining these evaluations, doctors can diagnose spasticity and determine its severity, which is key to developing an effective treatment plan.
What is the difference between spasticity and rigidity?
The main difference between spasticity and rigidity lies in the cause, nature, and characteristics of muscle stiffness.
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Spasticity:
- Cause: Spasticity results from damage to the brain or spinal cord, typically affecting the upper motor neurons. This disrupts the communication between the brain and muscles, leading to an abnormal increase in muscle tone.
- Nature: It is characterized by involuntary muscle contractions and stiffness that can fluctuate. Spasticity is usually velocity-dependent, meaning it becomes worse with faster movements or when a muscle is moved quickly. The muscle tone may increase in response to specific movements or stimuli (like a stretch), but it can relax once the stimulus is removed.
- Symptoms: It often presents as jerky or sudden muscle contractions, sometimes causing spasms or clonus (repetitive jerks of the muscle).
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Rigidity:
- Cause: Rigidity is typically seen in disorders affecting the basal ganglia, such as Parkinson’s disease. It is a result of problems in the brain’s ability to regulate muscle tone, leading to sustained, uniform stiffness.
- Nature: Unlike spasticity, rigidity is not dependent on the speed of movement. The stiffness remains constant regardless of how quickly or slowly the affected muscles are moved. It often involves a continuous resistance to movement in both directions of joint movement, even when the muscle is not actively contracting.
- Symptoms: It can feel like “lead-pipe” stiffness, where there is constant resistance to movement. There is no sudden jerking or spasming, just a steady, uniform tightness.
In summary:
- Spasticity involves intermittent, jerky contractions that are more pronounced with faster movement and are often seen in conditions like MS or stroke.
- Rigidity involves constant muscle stiffness and resistance to movement, more commonly seen in conditions like Parkinson’s disease.
The information provided on this page is for general informational purposes only and is largely based on my own personal experiences with spasticity. It is not intended as medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition, including spasticity. Never disregard professional medical advice or delay seeking it because of something you have read on this page. The content provided here is based on personal experience and should not be used as a substitute for professional care. If you are experiencing symptoms of spasticity or any other medical condition, please consult with your healthcare provider for appropriate evaluation and treatment.
Sources
Multiple Sclerosis Association of America. “Spasticity.” MSAA, https://mymsaa.org/ms-information/symptoms/spasticity. Accessed 21 March 2021.
John Hopkins Medicine, “Spasticity.” John Hopkins Medicine, https://www.hopkinsmedicine.org/health/conditions-and-diseases/spasticity. Accessed19 March 2021.
The Cleveland Clinic “Spasticity.” The Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/14346-spasticity. Accessed19 March 2021.
What Causes Muscle Spasticity?. Healthline. https://www.healthline.com/health/spasticity. Accessed 19 March 2021.
