Have you ever felt your hand or arm stiff and tight, difficult to move, or had tightening you could not control? These symptoms may not be something ordinary to overlook, because they can be a sign of muscle spasticity, which is often related to a problem in the brain or the spinal cord. Understanding the symptoms and the causes will help you get the right treatment in good time. In this article we will take you through spasticity, its various causes, and the full range of approaches to treatment.
Understanding spasticity and what it looks like
Spasticity is a symptom arising from a disorder of the central nervous system, which leaves the muscle abnormally tight and unable to relax normally. It differs from ordinary muscle pain, because it involves abnormal signalling from the brain, which keeps the muscle contracted and stiff continuously.
What does spasticity feel like, and is it different from cramp?
Spasticity is clearly different from an ordinary cramp. A cramp usually happens at a particular moment and disappears by itself within a few minutes, whereas spasticity is continuous: the muscle stays highly toned, stiff, and difficult to move all the time. A patient may feel that an arm or a leg is stiff like a piece of wood, unable to bend or straighten freely. Spasticity may also produce abnormal postures, such as a hand clenched into a fist, or a foot pointing downward all the time.
Where it is commonly found
Spasticity is often found in several areas of the body, particularly the arms, legs, hands, and feet, which are the parts used for everyday movement. Each site has its own pattern of symptoms and effects:
Spasticity in the hand and fingers
- Fingers curled tightly into the palm, unable to straighten
- Difficulty gripping or holding objects
- An effect on daily activities such as eating, dressing, or using a phone
Spasticity in the arm
- The arm held bent against the body, stiff, with limited movement
- Difficulty lifting the arm or straightening it
- An effect on activities that need the arm, such as bathing and dressing
Spasticity in the leg and foot
- The leg stiff, the foot pointing down or turned up
- Difficulty walking, with an abnormal walking pattern
- A ready risk of falling and injury
- An effect on balance and on getting about in daily life
Levels of severity in spasticity
The severity of spasticity can be divided into several levels, from mild symptoms that do not affect daily life to severe symptoms that leave a person unable to move at all. The doctor will assess the level of severity in order to plan appropriate treatment.
Mild spasticity
- The muscle is slightly tight, noticeable on movement
- Movement is still normal
- Little effect on daily life
Moderate spasticity
- The tightening is greater and muscle tone is clearly increased
- Movement begins to be difficult and takes more effort
- Assistive equipment may be needed for some activities
- An effect on work and daily routine
Severe spasticity
- The muscle is very stiff, with very little movement or none at all
- The joint becomes fixed (contracture) and cannot bend or straighten
- Most activities depend on other people
- A risk of long-term complications such as pressure sores and bone deformity
A closer look at the 7 main causes of spasticity in the arm, leg, and hand
Understanding the cause of spasticity is important in planning appropriate treatment. Spasticity usually arises from a problem in the central nervous system, which includes the brain and the spinal cord. When these are damaged, muscle control becomes abnormal and spasticity follows.
1. Stroke
Stroke is the most common cause of spasticity. When a blood vessel in the brain narrows or bursts, the part of the brain that controls movement is damaged, causing paralysis, which is often followed by spasticity on the paralysed side. Patients who have had a stroke often have a spastic hand, an arm held bent against the body, or a stiff leg after the acute phase of the illness has passed.
2. Traumatic brain injury
Brain injury from an accident, a concussion, or a blow to the head can damage brain tissue, leaving muscle control abnormal and causing spasticity. The severity depends on the area and the degree of the injury.
3. Spinal cord injury
When the spinal cord is injured by accident or disease, signalling between the brain and the muscle is interrupted, causing spasticity in the part of the body below the level of the injury. Patients with a spinal cord injury often have severe spasticity and need continuous rehabilitation.
4. Multiple sclerosis (MS)
This disease arises when the immune system attacks the sheath around the nerves, so that nerve signalling becomes abnormal. Spasticity is one of the common symptoms in patients with MS, and it often affects quality of life a great deal.
5. Cerebral palsy (CP)
Cerebral palsy is a condition arising at birth or in early childhood, because the brain has not developed fully, leaving problems with muscle control and movement. Spasticity is a prominent feature of one type of cerebral palsy, and needs care and rehabilitation from childhood.
6. Hypoxic-ischaemic brain injury
When the brain does not get enough oxygen — from drowning, cardiac arrest, or a pause in breathing — the brain cells are damaged, which may lead to spasticity later.
7. Other hereditary neurological disorders
Some hereditary diseases affecting the nervous system, such as Huntington's disease or inherited conditions that cause nerve degeneration, can also produce spasticity.
What can cause a spastic hand or a locking finger?
A spastic hand and a locking finger affect daily life a great deal. Understanding the cause helps in choosing a suitable treatment.
Spasticity from a brain disease
A spastic hand arising from a disease of the brain or spinal cord usually comes with other symptoms such as weakness, numbness, or difficulty moving. The hand curls and bends tightly into the palm, the fingers cannot be straightened, and there may be pain with it.
Trigger finger
Unlike spasticity from a brain disease, trigger finger arises from inflammation of a tendon in the finger, so the finger catches when bending or straightening. The patient feels the finger lock in one position and has to use force or the other hand to straighten it. This is often found in people who use their hands for heavy work or repeated work regularly.
Overusing the hand
Using the hand in the same position repeatedly — craft work, typing, using a mouse for long periods — may cause wrist pain, or may inflame the muscles and tendons of the hand, leaving tightness and pain. Without care, this can develop into a chronic problem.
How doctors diagnose and assess the symptoms
Correct diagnosis of spasticity is an important step in planning treatment. The doctor will use several methods to assess the cause and the severity.
History taking and physical examination — the doctor begins with a detailed history of the symptoms.
Muscle tone assessment — the doctor uses a standard scale, such as the Modified Ashworth Scale, to measure the level of muscle tone, assessed from the resistance felt when the joint is moved.
Advanced diagnostic imaging — in some cases where the exact cause needs to be known, the doctor may order an MRI or CT scan of the brain or spinal cord, to see whether there is a lesion or abnormality and where.
Treatment and rehabilitation for spasticity in the arm, leg, and hand
There are several ways to treat spasticity, depending on the cause and the severity. The main aims of treatment are to reduce muscle tone, increase the range of movement, and improve the patient's quality of life.
Physiotherapy and occupational therapy
Physiotherapy is the most important main treatment for patients with spasticity. The physiotherapist designs a programme of muscle stretching, joint exercise, and movement training to reduce tightness and increase muscle strength. Regular physiotherapy helps prevent the condition from worsening and helps the patient manage daily life better.
Medication, both oral and injected locally (botulinum toxin)
Some oral medicines, such as muscle relaxants, can help reduce muscle tone. In addition, injecting botulinum toxin (Botox) into the spastic muscle is a highly effective method: the medicine works by blocking the nerve signal to the muscle, allowing the muscle to relax. It takes effect about 1-2 weeks after injection, the effect lasts about 3-4 months, and repeat injection may be needed when the symptoms return.
Using a support or splint
Using a support — a hand splint, an ankle splint, or another splint — helps keep the joint in a suitable position, prevents the joint from becoming fixed, and gradually stretches the spastic muscle.
Surgery (in severe cases)
Where spasticity is very severe and does not respond to other treatment, the doctor may consider surgery to lengthen or release a tendon, or nerve surgery to reduce the abnormal signalling. Surgery is considered a last option when other methods have not worked.
Treatment for spasticity at PYONG Rehabilitation Clinic
If you or someone you love has a spastic hand, arm, or leg, PYONG Rehabilitation Clinic has a team of specialist rehabilitation medicine physicians with expertise in diagnosing and treating spasticity. We also have specialist neurologists who can diagnose and care comprehensively for the neurological diseases that cause spasticity.
The approach to treating spasticity at PYONG Rehabilitation Clinic
We have modern equipment and a range of treatment approaches, so that patients receive care that is targeted and as effective as possible:
- Diagnostic ultrasound — we use ultrasound technology to diagnose and assess the condition of muscle, tendon, and joint, so that treatment is as precise and targeted as possible
- Transcranial Magnetic Stimulation (TMS) — TMS is the latest innovation in treating spasticity arising from brain disease. It uses electromagnetic waves to stimulate the area of the brain that controls movement, helping to rebalance the working of the nervous system, reduce muscle tone, and effectively promote recovery of brain function, particularly in patients with stroke and brain injury
- Peripheral Magnetic Stimulation (PMS) — PMS technology stimulates nerve and muscle at depth, improving nerve function, increasing muscle strength, and effectively reducing spasticity, without pain or irritation of the skin
- High Power Laser Therapy — high-power laser technology can penetrate 5-6 centimetres into the muscle layer, stimulating tissue repair, reducing inflammation, and relieving the pain that comes with spasticity. Patients can feel the improvement immediately after treatment
- Targeted botulinum toxin (Botox) injection — our specialists can inject Botox precisely into the spastic muscle, using ultrasound to identify the location. The medicine helps release the tightness of the muscle, and its effect lasts about 3-4 months
- Multidisciplinary care — at PYONG Rehabilitation Clinic you will be cared for by a team from several specialties: rehabilitation medicine physicians, neurologists, physiotherapists, occupational therapists, and orthotists, working together to plan the most comprehensive and suitable treatment for you
We believe that close care and a treatment plan adapted to each individual will help you return to a better quality of life. Treating spasticity takes continuity and cooperation between doctor and patient.
5 basic physiotherapy exercises to reduce spasticity
1. Finger and wrist stretch — stretching the fingers and wrist gently helps reduce muscle tightness. You can use the other hand to help straighten the spastic fingers gradually, holding for about 10-15 seconds and repeating several times, to increase flexibility and reduce stiffness in the hand.
2. Arm and elbow stretch — exercising the elbow by bending and straightening slowly helps increase flexibility in the arm. This can be done by stretching the arm out in front and then gradually bending it back towards the body, repeating 10-15 times on each side, to release tightness and increase the range of movement.
3. Calf and ankle stretch — sitting on the floor and stretching the leg out in front, then using the hand to pull the toes towards the body, helps stretch the calf muscle and the ankle. Hold for 15-20 seconds, then release gradually, and repeat several times to reduce tightness and prevent spasticity at the ankle.
4. Thigh stretch — the thigh muscle can be stretched by standing and holding one foot, pulling it up towards the buttock, holding for about 15-20 seconds, then releasing and changing sides. Doing this exercise regularly helps reduce spasticity and prevent the joint from becoming fixed.
5. Advice for doing physiotherapy at home — physiotherapy at home should be done regularly, at least 2-3 times a day, using gentle force, without forcing to the point of pain, and in a period when the muscle is still warm, such as after a warm bath. In addition, a hot or cold pack over the spastic area before the exercises may help reduce tightness.
Frequently asked questions (FAQ)
Can spasticity be cured completely?
Spasticity from a disease of the brain or spinal cord mostly cannot be cured completely, but it can be controlled and its severity reduced with continuous treatment and rehabilitation. The aim of treatment is to improve quality of life and help the patient do more.
What happens if it is not treated?
If spasticity is left untreated, it will steadily worsen: the muscle becomes tighter and stiffer, until finally the joint may become fixed (contracture) and unable to move at all. There may also be chronic pain and skin breakdown, with a great effect on daily life.
With what symptoms should you see a doctor?
You should see a doctor at once if a hand or arm becomes spastic suddenly, especially if it comes with other symptoms such as one-sided weakness, slurred speech, or confusion, because these may be signs of a stroke. In addition, if spasticity is gradually worsening, affecting daily life, or not improving even with rest, you should consult a doctor to find the cause and receive appropriate treatment.
Summary
If you or someone you love has a spastic hand, arm, or leg, PYONG Rehabilitation Clinic has a team of specialist physicians in rehabilitation medicine with expertise in diagnosing and treating spasticity. We have modern equipment and a range of treatment approaches, from physiotherapy and targeted injection to new technologies, to help reduce spasticity and restore muscle function as far as possible.
We believe that close care and a treatment plan adapted to each individual will help you return to a better quality of life. If you are interested, you can contact us with any question or to make an appointment.