Treating spasticity

Treating spasticity

Contact your family doctor

If you are worried about your symptoms, do not hesitate to contact your family doctor or general practitioner. He or she will refer you to a neurologist or another specialist if necessary.


Initial examination by a neurologist

In order to help you as best as possible, you should describe exactly how the spasticity affects your life. You should describe exactly which everyday activities hinder you and in what way.


The specialist assesses the symptoms and spasticity (impairment of muscle function). A physical examination is carried out, neurological tests are performed and CT, MRI or other imaging procedures are usually used.


What needs to be done to get meaningful results?

    the degree of everyday restrictionthe strength of the affected musclesmeasure the intensity of the painmuscle tone (measurement: degree of muscle tension)the mobility of the joints – how large is the range of motion?


After the extensive examination, the specialist uses the results for the diagnosis and subsequent therapy measures. Collaboration with the patient plays a major role here. In order for the specialist to create the therapy measures in a patient-oriented manner, the patient should clearly communicate his wishes and goals. On the one hand, the doctors can put aside unrealistic goals and describe the situation to the patient in detail. The treatment method is also discussed.


The physiotherapist

Spasticity is also known as spasticity or spastic paralysis. The affected muscles are treated by a physiotherapist to eliminate or reduce further impairments. The aim is to improve functionality using various exercises. Therefore, the affected person is also recommended to do exercises at home every day, as positive results can only be achieved through continuity.


The therapy is coordinated jointly by the supervising physiotherapist and the attending physician. The patient's wishes are always taken into account and if they cooperate with the selected treatment program, they are combined. However, treatment without medication is rarely possible. Those affected often require painkillers.


Which information/topic areas are important?

Doctors can try to fix things that they know about. Patients should make an effort to open up to their doctors. The medical staff are aware of how uncomfortable certain questions can be.


The following topics should be considered:

    Movement defects, have you had the spasticity treated by another doctor? Where, when, how intensely, and with which movements do the pains occur? Stiffness, how limited are you? What medications, nutritional supplements or products have you already been prescribed and which ones are you taking?


To avoid overwhelming yourself and your loved ones, grab a pen and paper and write down all of the topics mentioned above. If questions or other topics related to your illness come to mind while you are creating your own guide, write them down.


Tip: Document questions and symptoms on two different sheets of paper. You should also leave a space under each question in case you want to write down the answers. This will make your visit to the doctor easier and lead to a faster diagnosis.

Preparation: What questions should I ask my doctor?

In order to be able to help the patient as best as possible, the patient should describe exactly how the spasticity affects his or her life. This should include a precise description of which everyday activities hinder the patient and in what way.

What therapeutic options are available to me?

Various measures are available to improve mobility. Your specialist will inform you about which treatment options are suitable for you. He or she can also explain the different therapy approaches to you.

Do I have realistic therapy goals?

First of all, you must understand that the treatment goals differ from patient to patient, meaning that an individual result can be expected depending on the degree of spasticity. However, this statement should not demotivate you, but only make you realize that your expectations should be discussed precisely with your attending physician.

What side effects can occur?

Find out about the possible risks and side effects, both in terms of medication and treatment options.

Does spasticity get worse as it progresses?

This possibility always exists, but rarely during ongoing treatment. Ask your doctor, as he or she can assess your individual course of illness.

Treatment period – How long does the treatment take?

The mobility of muscles and joints can only be improved through regular exercises and treatments. However, this is individual, as the treatment of spasticity is based on a long-term therapy plan.


What is most important?

Your well-being! You should always express all your worries, thoughts and considerations to the doctor. Because the success of a therapy program is not only in the hands of the doctor, but also in yours. Your willingness is the most important thing. Doctors can perceive the patient, but if important information is not shared with the doctor out of shame, this will hinder success.

Possible therapy goals

First of all, you must understand that therapy goals differ from patient to patient. In order for the specialist to create a patient-oriented therapy plan, he or she should clearly communicate his or her wishes and goals. On the one hand, doctors can put unrealistic goals aside. Otherwise, the results would be disappointing for you, despite medical progress and success.

Can I be cured? Spastic paralysis cannot currently be cured. Through medical and physiotherapeutic treatments, symptoms can be alleviated and controlled to such an extent that the patient can manage his or her life. (Restrictions excluded).

The general goals of therapy are: 1. Improvement of quality of life (e.g. independent eating, dressing, hygiene, etc.). 2. Improvement of mobility (e.g. walking, jumping, lying, sitting, carrying, grasping, feeling). 3. Improvement of appearance through improved posture. 4. Pain reduction. 5. The psyche of the affected person can recover. The positive effects of therapy cannot be determined in advance. Spasticity is individual and is influenced by a variety of factors!

Therapy options

How are spasticities resolved?

There are various treatment options, which also depend on the location and severity of the spasticity and accompanying symptoms. The basis of treatment is usually physiotherapy, which stretches the affected muscles and joints. Accompanying medical measures can be carried out on this basis. Treatment with botulinum toxin, among other things, plays an important role here. The simultaneous administration of botulinum toxin is often recommended, particularly in the case of focal and multifocal spasticity.


The different treatment options:


Therapy with botulinum toxin 💉The botulinum toxin is injected into the affected muscles; this procedure is called "intramuscular injection". The muscles relax. The active ingredient is crucial for this. The dosage is individual. After a thorough examination of the affected muscle, the doctor can give an exact indication of the dosage intensity. Botulinum toxin is injected into the patient with a thin syringe. It takes effect after just a few days.


There is a temporary relaxation of the pathologically tense muscle. Spastic cramps and involuntary movements are reduced. The effect of an injection is long-lasting. Up to several months before the patient should make the next appointment. You can find more information on our page "What is Botolinum Toxin"


Physiotherapy

This therapy serves to maintain the mobility of the affected muscles and joints. It usually forms the basis for any spasticity treatment. The therapy plan is individually tailored to the patient's needs.


Die Constraint Induced Movement Therapy (CIMT)

CIMT therapy has been established for several years to treat motor dysfunction after a stroke or other neurological diseases.

The founder of the therapy was the American psychologist Edward Taub. He believed that stroke patients often no longer use the affected limbs and that this leads to a further worsening of the paralysis.

In order to actively counteract this process, CIMT therapy forces the patient to intensively move the arm affected by paralysis, for example, by immobilizing the healthy arm during therapy.

By training with the affected arm, neural pathways in the brain are stimulated and the patient learns to use the paralyzed side again.


Orthoses and plaster treatment

Orthoses are orthopedic devices that serve to support, fixate and relieve the affected muscles and joints. Plaster treatment could help to stretch and extend the muscles.


Occupational therapy

In occupational therapy, those affected learn techniques that support them in their everyday lives. This also includes advice on possible aids. Occupational therapists are trained to provide individual support to people in carrying out their daily activities. In doing so, they want to help them to become active, to participate and to gain more appreciation in social and private life.


Treatment with medication

Antispasmodic medications can be used for more severe functions and pain. Various drug treatment options are available to the specialist staff.

Consult a specialist or family doctor. Taking the medication is only recommended in conjunction with parallel treatment. Ask your doctor about risks or side effects.


Die Intrathekale Baclofentherapie (ITB)

This is a drug therapy with an additional surgical access. It allows the drug "baclofen" to be administered directly into the patient's spinal cord. It is transported to its destination by a pump under the abdominal skin. (ITB therapy for severe disabilities).


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