Spasticity
PAIN CONDITION
Spasticity: Causes, Treatment & Pain Relief
Spasticity is a debilitating condition that occurs when your muscles tighten abnormally, causing pain and making movement challenging. Severe spasticity can make basic self-care, like bathing or getting dressed, almost impossible without help. It’s sometimes called muscle hypertonia or muscle stiffness, and can be painful and directly impact your quality of life. Spasticity is often linked to nerve or brain conditions like cerebral palsy (CP) or traumatic brain injury (TBI).[1]
About Spasticity
This motor disorder is a neurological condition caused by damage to the central nervous system — the part of your body that controls voluntary movement. [2] Spasticity directly affects your comfort, mobility, and daily function. About 500,000 Americans and nearly 12 million people worldwide are impacted by this condition.[1]
Johns Hopkins Medicine defines spasticity as abnormal muscle tightness due to prolonged muscle contraction. [3] But what does that really mean? It means your muscles are contracting on their own — involuntarily — whether you’re resting or trying to move, like when you walk.[4] Instead of relaxing when they should, your muscles stay tight and resist stretching. This makes everyday movements like walking, talking, or even basic tasks much harder.[4]
Along with a limited range of motion — like being unable to move your wrist fully — spasticity can also cause contracture, meaning your joint becomes frozen or stuck in an abnormal, often painful position.[5]
While muscle spasms (those sudden, brief muscle jerks) can be a symptom of spasticity, they’re not the same thing. Spasticity is more about constant muscle tightness than random muscle movements.
Common causes of spasticity include conditions like stroke, multiple sclerosis (MS), cerebral palsy, traumatic brain injuries, and spinal cord injuries.[1] Unfortunately, spasticity doesn’t just make movement hard — it can also cause serious complications like fractures, infections, chronic constipation, and bedsores.[4]
Spasticity Symptoms
Spasticity is a motor disorder that makes your muscles unusually tight or stiff. It can appear mild and barely noticeable, or so severe that it locks up your joints and makes everyday activities impossible. If it’s not managed, spasticity can cause more significant health problems like joint contractures, pressure sores, and even infections.
Signs and symptoms of spasticity can include:
- Muscles feel stiff, heavy & difficult to move [6]
- Movement is slow (feels like pulling, tugging, or wading through mud) [6]
- Increased muscle tone (hypertonia) [4]
- Muscle spasms (involuntary muscle contractions) [4]
- Clonus (fast, involuntary muscle contractions that feel like a tremor) [4]
- Abnormal posture [4]
- Pain or discomfort [4]
- Contracture (permanent muscle and tendon contraction – ‘frozen’) [4]
- Muscle, joint, or bone deformities [4]
- Sleep disruption [4]
- Difficulty or inability to perform daily activities [4]
- Overactive reflexes [4]
- Involuntary movement [4]
Spasticity Causes & Risk Factors
Spasticity typically occurs due to damage to nerve pathways that regulate muscle movement. When those pathways are injured, the normal flow of signals between the brain and muscles is disrupted, causing the muscles to stay in a constant state of contraction.[4]
Some of the main conditions linked to spasticity include:
Stroke (cerebrovascular accident) [1]
Multiple sclerosis (MS) [2]
Cerebral palsy (CP) [2]
Traumatic brain injury (TBI) [2]
Spinal cord injury (SCI) [2]
Amyotrophic Lateral
Sclerosis (ALS) or Lou
Gehrig’s disease [7]
Nerve pathway damage [4]
Infections like encephalitis or meningitis [8]
Hereditary Spastic
Paraplegia (HSP) [9]
Krabbe disease [4]
Spastic Pain Management Treatments
Managing spasticity usually takes a mix of different treatments and a team of healthcare professionals who each bring their own expertise to the table. Medications, like muscle relaxers, are often part of the plan, but the goal isn’t to completely wipe out spasticity — you actually need a little bit of muscle tone for your muscles to work properly.[10]
Some patients, especially those with MS, have found that cannabis can help ease their muscle stiffness, and researchers are working to understand how cannabinoids improve spasticity.[11]
Your treatment plan should include lifestyle changes and self-care measures such as:
- Get enough sleep
- Manage triggers (i.e., fatigue, stress, tight clothing, extreme temperatures, other health conditions) [10]
- Dietary changes
- Exercise & stretching
- Address mental health needs
- Stay social, don’t isolate
Occupational and physical therapy can help strengthen your muscles and increase flexibility while preventing them from shrinking permanently and worsening symptoms.[12] Assistive devices and home modifications like braces, supports, grab bars, and walkers can help maintain your mobility and independence.[12]
Spasticity can make your muscles feel tight, stiff, and difficult to move, but comprehensive pain management can make a real difference. Treating the underlying neurological causes with targeted, minimally invasive therapies can help reduce muscle tightness, ease discomfort, and improve movement. When combined with complementary treatments like physical therapy and lifestyle changes, pain management for spasticity can lead to greater flexibility, better control, and a better quality of life without major surgery.
Non-surgical, interventional pain control procedures for spastic pain may include:
- Trigger point injections
- Corticosteroid injections
- Joint injections
- Nerve blocks
- Hyaluronic acid (HA) injections
- Peripheral nerve blocks
- Stellate ganglion block
- Peripheral nerve stimulation (PNS)
- Spinal cord stimulation (SCS)
- Intrathecal pain pumps
- Intrathecal baclofen therapy
- Botox injections
- Motor point phenol block
- Dorsal Longitudinal T-Myelotomy
When to Consult a Spastic Pain Care Specialist
Managing your spasticity and its underlying cause takes a whole-body approach—and that’s exactly what pain specialists are here to offer. If you’re living with constant muscle stiffness, spasms, or struggling with daily activities because of tightness or contracture, it’s essential to reach out to a pain care specialist.
A personalized care plan focused on targeted treatments, alternative therapies, and simple lifestyle adjustments can help you move more effectively, stay active, and manage your spastic pain more effectively. Taking action early can make a big difference in easing symptoms, preventing complications, and protecting your joints and muscles for the long run.
You don’t have to tough it out—getting the right support can make living with spasticity a lot easier and help you get back to doing the things you love.
Disclaimer: This resource provides general information about spastic pain, associated medical conditions and injuries and is not a substitute for professional medical advice, diagnosis, or treatment. Spasticity red flags needing immediate care include worsening muscle stiffness, severe pain, loss of movement, contractures, intense swelling, signs of infection, or complete immobility. Always consult a doctor for proper evaluation and treatment.
Resources:
- Shilt JS, Seibert PS, Kadyan V. Optimal management for people with severe spasticity. Degener Neurol Neuromuscul Dis [Internet]. 2012;2:133-140. Published 2012 Oct 3. doi:10.2147/DNND.S16630. Accessed April 27, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6065570/
- Pilitsis JG, Khazen O. Spasticity. American Association of Neurological Surgeons (AANS) [Internet]. Published April 30, 2024. Accessed April 27, 2025. Available from: https://www.aans.org/patients/conditions-treatments/spasticity/
- Spasticity. Johns Hopkins Medicine [Internet]. Accessed April 27, 2025. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/spasticity
- Spasticity. Cleveland Clinic [Internet]. Accessed April 27, 2025. Available from: https://my.clevelandclinic.org/health/symptoms/14346-spasticity
- Spasticity. American Stroke Association [Internet]. Accessed April 27, 2025. Available from: https://www.stroke.org/en/about-stroke/effects-of-stroke/physical-effects/spasticity
- Spasticity and spasms. Multiple Sclerosis Trust [Internet]. Updated March 22, 2025. Accessed April 27, 2025. Available from: https://mstrust.org.uk/a-z/spasticity-and-spasms
- Cartwright MS, Gillis ZS. Amyotrophic Lateral Sclerosis. Practical Neurology [Internet]. JUL-AUG 2020. Accessed April 27, 2025. Available from: https://practicalneurology.com/diseases-diagnoses/neuromuscular/amyotrophic-lateral-sclerosis-1/31691/
- Sissons B. Encephalitis vs. meningitis: What is the difference?. Medical News Today [Internet]. Updated September 19, 2023. Accessed April 27, 2025. Available from: https://www.medicalnewstoday.com/articles/encephalitis-vs-meningitis
- Hereditary Spastic Paraplegia. National Institute of Neurological Disorders and Stroke [Internet]. Accessed April 27, 2025. Available from: https://www.ninds.nih.gov/health-information/disorders/hereditary-spastic-paraplegia
- MS Symptom: Spasticity & Spasms. MS Australia [Internet]. Accessed April 27, 2025. Available from: https://www.msaustralia.org.au/symptom/spasticity-spasms/
- Spasticity Management: A Comprehensive Review of Pharmacological and Interventional Treatment. Edogun E, Bandla M, Herman S. Article 1011 A Comprehensive Review of Pharmacological and Interventional Treatment. Annals of Physical Medicine and Rehabilitation. 2024;2(1):1011. Accessed April 27, 2025. Available from: https://www.medtextpublications.com/open-access/spasticity-management-a-comprehensive-review-of-pharmacological-and-interventional-treatment-1625.pdf
- Cherney K. 10 Ways to Improve Your Quality of Life with Spasticity. Healthline [Internet]. Published March 09, 2022. Accessed April 27, 2025. Available from: https://www.healthline.com/health/improve-quality-of-life-with-spasticity