In brain injury, Day Neuro Program, Stroke

Managing Your Spasticity 

After a brain injury occurs, you may experience many new symptoms. Significant muscle tightness, known as spasticity of hypertonicity,  may be one of these symptoms. This muscle tightness can vary from mild stiffness to severe spasms, and it can impact one to multiple muscle groups. If left untreated, this tightness may limit your movement, cause contractures or joint deformities, and elicit pain.

Why Does Spasticity Occur?

Your brain controls the tone of your muscles.  A brain injury, such as a stroke, can cause damage in the ability of your brain to send normal signals to your muscles. When your brain sends abnormal signals to your muscles, your muscles may begin to over-react and experience tightness. This tightness can cause muscles to shorten or shrink.

Why is it important to address spasticity early in your recovery process?

Leaving spasticity untreated can lead to contractures of your muscles. This means that the muscles could tighten and freeze permanently in a specific position, which can cause significant pain and prevent movement.

How can you manage your spasticity?

There are several ways that you can manage your spasticity. Most individuals respond best by using a combination of treatments to manage their spasticity. Below are some of the most common forms of tone management.


Moving your muscles frequently is extremely important to keep your muscles and joints mobile and decrease the risk of getting contractures. Even if you are not able to actively move your muscles on one side, there are specific stretches you can do with help from the other side of your body or from others. Your occupational and physical therapists can provide you with an individualized plan to safely stretch your muscles.


Orthotics, splints, and/or other positioning agents may help to keep the muscles in an optimal position to reduce muscle spasms, relieve pressure, and prevent the tightness from causing contractures. Your occupational and physical therapists can create or choose orthotics and customize them to ensure comfort and proper fit. Positioning is very important to prevent contractures.

Oral medications:

Oral medications may be used to help the muscles that are impacted by spasticity. Talk to your doctor about your tone to determine if you are a good candidate for oral medications.


Medication can be injected into specific muscles or muscle groups by a doctor to relax the muscles. This muscle relaxation occurs because the medication that is injected blocks the signals that cause the muscles to contract. Talk to your doctor to determine if you are a candidate for injections.


When tone has increased, a pump can be surgically inserted into the body to distribute medication into the spinal canal. The pump can be programmed to deliver certain amounts of medications at different times of the day. When getting a pump, it is vital that you keep close contact with your doctor and consistently attend appointments with your doctor to ensure that you get the appropriate amount of medication. Talk to your doctor to determine if you are a candidate for a pump.


When tone becomes severe, surgical interventions can become an option. Surgery is not the typical beginning treatment for tone management, but it is an option that can be used to lengthen or release the muscles that have become too tight or contracted. To determine the severity of your tone and discuss if surgery is an option for you, talk to your doctor.

Always consult your doctor about the risks and benefits of all treatment, especially oral medications, injections, pumps, and surgery.

Spasticity can be challenging to manage, but your doctors, occupational therapists, and physical therapists can work together with you to help create an individualized plan to manage your spasticity and improve your quality of life.

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