Editor’s Note: This story is Part 1 of a 2-part series on spasticity. Part 1 focuses on treatments.

One result of injuries and diseases that impact the central nervous system is a condition called spasticity, in which muscles tighten abnormally, causing pain and impacting movement.

Through issues such as stroke, multiple sclerosis, cerebral palsy and brain and spinal cord injuries, communication from the brain or spinal cord to muscles can be disrupted.

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“With a chronic disorder affecting the central nervous system, the muscle isn’t getting the right information and the muscle tightens, resulting in spasticity,” said Dr. Tracy Vargas, a neurologist with UCHealth Neurology Clinic in Steamboat Springs. “Patients will talk about feeling tight, having muscle spasms and experiencing a reduced range of motion.”

These overactive muscles can have a broad impact on motion. Spasticity in hand muscles can result in a clenched fist that’s difficult to open, while spasticity in leg muscles can make it difficult to walk.

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Various factors can cause symptoms of spasticity to worsen, such as stress, illness and lack of sleep.

While patients can reduce stroke risk factors through diet, lifestyle and regular follow-up with a primary care provider, most conditions that cause spasticity, such as multiple sclerosis, cannot be prevented.

Vargas encourages patients to seek treatment early on. Untreated spasticity can result in contractures, in which muscles, joints, tendons and other tissues tighten so much, movement is no longer possible.

“You can surgically release it, but you’ll never get more function,” Vargas said.

Various treatments can help prevent contractures and improve spasticity.

“We’re using these therapies not only to reduce the risk of joint contractures, but also to help improve function of the limb and improve overall quality of lifestyle,” Vargas said.

One option is medication. While medications can help relax muscles and reduce spasticity, patients can’t always tolerate side effects.

“There is the potential to have adverse side effects like sedation or cognitive changes,” Vargas said. “People will sometimes say they don’t like how they feel on these specific medications, which sometimes limits dosing and overall use.”

Targeted therapies, such as injecting Botox into affected muscles, have seen good success. Botox is a neurotoxin that paralyzes muscles for a limited time. Treating overactive muscles with the toxin can decrease spasticity and allow patients to experience more typical movement patterns.

For instance, Botox injections in spastic hand muscles may allow the hand to relax and open, making daily activities easier and allowing for improved hygiene. Injections in spastic leg muscle may result in more stability when walking and may help normalize someone’s gait.

Botox injections often work in conjunction with muscle relaxers — once Botox takes effect, patients may find a much lower dose of a muscle relaxer helps them reduce spasticity without the side effects.

While spasticity is a chronic condition, treatment can make a big difference in a patient’s life.

“The more we can treat it, the less progressive and debilitating it can become,” Vargas said. “A lot of patients have less discomfort. They often have an improved range of motion. We’re not going to cure it, but we can treat it and help manage it to improve people’s quality of life.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.