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Spasticity & Dystonia

Spasticity & Dystonia

Spasticity

Spasticity is an involuntary contraction of your muscles that produces stiffness and loss of control, leading to difficulty with movement and speech. Other symptoms of spasticity include pain, jerking movements, hyperactive reflexes, muscle spasms, bone and joint deformity, and abnormal posture. It is caused by injury to the region of the brain that controls movement or damage to the nerves that carry impulses between the brain and the muscles due to trauma. Spasticity may also be associated with diseases such as multiple sclerosis, stroke and cerebral palsy.

To diagnose spasticity your doctor reviews your family and medical history, and performs a thorough physical examination to identify associated muscular or neurologic disorders. Your doctor may order tests to assess muscular activity, range of motion, and movement of your arms and legs.

It is necessary to seek treatment early as spasticity can lead to contractures (hardening of the muscles), joint stiffness, and pressure ulcers from immobility. Spasticity treatment includes medication, Botulinum toxin injections, occupational and physical therapy, use of braces, or surgery. In rare cases, your doctor inserts a pump into the spinal fluid to directly administer medications to the nervous system.

Dystonia

Dystonia defines a group of movement disorders characterized by slow repetitive involuntary movements or spasms and contractions. It is a neurological condition that can affect different parts of the body (eyelids, face, neck, vocal cords and hands) causing tremors, foot dragging, worsening of handwriting, difficulty speaking and can sometimes result in painful abnormal postures. Symptoms are usually mild, but may become more noticeable with prolonged stress, fatigue or exertion. Dystonia may affect one part of your body (focal dystonia), two or more adjacent parts of the body (segmental dystonia) or most of the body (generalized dystonia).

The cause for dystonia is not clear. It may be inherited, associated with other conditions such as stroke, Parkinson’s disease, multiple sclerosis, brain tumors and brain infections, or may be caused by injury, poisoning, certain medications or abnormalities in parts of the brain controlling movement.

Your doctor diagnosis dystonia by reviewing your medical history and performing a thorough physical examination. Various blood tests and imaging tests may be ordered to identify the underlying cause. Treatment is aimed at providing symptomatic relief. Botulinum (Botox) toxin injections may be prescribed in specific areas to reduce contractions which may help with abnormal posturing. Medications and muscle relaxants may be helpful with early-onset dystonia. When conservative treatment does not relieve symptoms, your doctor may suggest surgical procedures such as deep brain stimulation (electrodes are implanted in the brain to control muscle contractions) or selective peripheral denervation (nerve endings are severed to prevent painful spasms).