Before you and your medical team can decide the best way to manage your spasticity, the team will need to know how the condition affects you. Doctors often turn to treatment when spasticity causes pain, gets in the way of daily activities or sleep, or keeps you from other typically normal functions.

Your doctor will talk to you about the goals of treatment before deciding how to move forward. Several treatment options are available:

Non-Drug Treatments

Doctors usually try non-drug treatment before medication or surgery. Your doctor might suggest:

  • Physical therapy. During regular sessions, you’ll learn ways to position yourself to avoid triggering your spasticity. You’ll also learn stretches and exercises to help prevent your muscles from contracting.
  • Occupational therapy. An occupational therapist can help you make changes around your house and change certain daily activities at home and at work to help you function better. They can also work with you on your speech and hand movements.
  • Massage. A licensed massage therapist can help relax your muscles and improve your range of motion.
  • Casts or braces. These can help keep your muscles from spasming and tightening involuntarily.
  • Temperature therapy. Applying cold (ice, cold water, or chemical sprays) to your muscles, especially before physical therapy, may help calm spasticity. Heat, on the other hand, relaxes muscles temporarily to ease spasms.
  • Electric stimulation. Electric pulses can help strengthen weak muscles to counteract the spastic ones.
  • Biofeedback. An electric monitor signals you every time your muscle spasms. The process should train you to relax your muscles consciously as they spasm.

Medication

If non-medication options don’t bring relief, your doctor may suggest you add medication to your treatment. These are some of your options:

Oral medications

Your doctor may prescribe a medicine that relaxes your muscles, such as:

  • Baclofen (Lioresal)
  • Dantrolene sodium (Dantrium)
  • Tizanidine (Zanaflex)

Or a sedative, such as:

  • Clonazepam (Klonopin)
  • Diazepam (Valium)

Your doctor could also suggest anticonvulsant/nerve pain medication, such as gabapentin (Neurontin).

Any of these medications can help relax entire large muscle groups at once. But they can also cause some side effects such as dizziness, weakness, and drowsiness.

Botulinum toxin (Botox) shots are another way to relax muscles. Doctors inject Botox into the specific muscle that needs to relax. It takes about 7 to 10 days to feel the effects, which can last for up to 6 months. 

Surgery

If pills or Botox don’t work well enough, your doctor may want to try surgery. Here are some options:

Intrathecal baclofen therapy (ITB). A surgeon implants a pump in your belly, and it sends liquid baclofen, a muscle-relaxing medication, to your spinal fluid. The pump gets more of the medicine to your spinal cord than pills can. This means you don't have to take as much, and you’ll have fewer side effects. The pump can stay in for about 7 years.

Orthopedic surgery. You may need surgery on muscles, bones, or connective tissue to help with movement. Orthopedic surgery can lengthen and release contracted muscles and tendons that are too short.

Neurosurgery. In some cases, your doctor may want to operate on your brain, spinal cord, or nerves to help relieve spasticity. In a procedure called rhizotomy, a neurosurgeon separates out certain nerves along your spine that tell muscles to contract. The surgeon cuts them to ease spasticity in those muscles. 

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Show Sources

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SOURCES:

Cleveland Clinic: “Spasticity.”

American Association of Neurological Surgeons: “Spasticity.”

National Multiple Sclerosis Society: “Massage and Bodywork,” “Controlling Spasticity.”

Journal of Advanced Research: “Efficacy of cold therapy on spasticity and hand function in children with cerebral palsy.”

Saudi Journal of Anaesthesia: “Spasticity – Pathogenesis, prevention and treatment strategies.”

Johns Hopkins Medicine: “Spasticity.”

Medscape: “What is the role of biofeedback in the treatment of spasticity?” “What is the role of electrical stimulation in the treatment of spasticity?”

Boston Children’s Hospital: “Cerebral Palsy and Spasticity Center: Orthopedic Surgery.”

U.S. Department of Veterans Affairs: “Managing Spasticity With an Intrathecal Baclofen Pump.”