Muscle spasticity, or spasms, causes your muscles to become stiff or rigid. It can also cause exaggerated, deep tendon reflexes, like a knee-jerk reaction when your reflexes are checked. Muscle spasms are typically brief whereas spasticity lasts longer. Muscle spasticity is usually due to a neurologic condition but muscle spasms often occur in people with no known neurologic condition.

High muscle tone - care; Increased muscle tension - care; Upper motor neuron syndrome - care; Muscle stiffness - care

These things may make your spasticity worse:

• Being too hot or too cold
• The time of day
• Stress
• Tight clothing
• Bladder infections and spasms
• Your menstrual cycle (for women)
• Certain body positions
• New skin wounds or ulcers
• Hemorrhoids
• Being very tired or not getting enough sleep
• Use of diuretics
• Blood and electrolyte imbalances

Your physical therapist can teach you and your caregiver stretching exercises you can do. These stretches will help keep your muscles from getting shorter or tighter.

Being active also helps keep your muscles loose. Aerobic exercise, such as swimming, and strength-building exercises are helpful as are playing sports and doing daily tasks. Talk with your health care provider or physical therapist first before starting any exercise program.

Your provider or physical/occupational therapist may place splints or casts on some of your joints to keep them from becoming so tight that you cannot move them easily. Make sure to wear the splints or casts as your provider tells you to.

Be careful about getting pressure sores from exercise or being in the same position in a bed or wheelchair for too long.

Muscle spasticity can increase your chances of falling and hurting yourself. Be sure to take precautions so you do not fall.

Your provider may prescribe medicines for you to take to help with muscle spasticity. Some common ones are:

• Baclofen (Lioresal)
• Botulinum toxin (Botox) injection
• Dantrolene (Dantrium)
• Diazepam (Valium)
• Gabapentin (Neurontin)
• Tizanidine (Zanaflex)

These medicines have side effects. Contact your provider if you have any of the following side effects:

• Being tired during the day
• Confusion
• Feeling "hung over" in the morning
• Nausea
• Problems passing urine

Do not just stop taking these medicines, especially Zanaflex. It can be dangerous if you stop abruptly.

Pay attention to changes in your muscle spasticity. Changes may mean that your other medical problems are getting worse.

Always contact your provider if you have any of the following:

• Problems with the medicines you are taking for muscle spasms
• Can't move your joints as much (joint contracture)
• Harder time moving around or getting out of your bed or chair
• Skin sores or skin redness
• Your pain is getting worse

American Association of Neurological Surgeons website. Spasticity. www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spasticity. Accessed April 18, 2024.

Francisco GE, Li S. Spasticity. In: Cifu DX, ed. Braddom's Physical Medicine & Rehabilitation. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 23.