Spasticity and Contractures

Also known as: joint contractures, flexion contractures, muscle tightness and stiffness, muscle contractions.

What are spasticity and contractures?

Spasticity and contractures are conditions in which muscle imbalance across a joint leads to abnormal positioning and tightness. Spasticity refers to involuntary tightening or stiffening of muscles. The term contracture refers to abnormal positioning of a joint.

What causes spasticity and contractures?

A number of neurologic conditions can lead to spasticity of the upper extremity, including cerebral palsy, stroke, multiple sclerosis, and injuries or tumors of the brain and spinal cord.

What are the symptoms of spasticity and contractures?

Affected limbs typically demonstrate abnormal posture that affects function and sometimes hygeine.  In a growing child, spasticity and contractures can lead to abnormal development of bones and joints.

What are spasticity and contractures care options?

The care of patients with spasticity requires a team effort, with input from the patient, caregivers, and therapists. Generally, treatment is aimed at improving hygiene, activities of daily living (function), pain, and appearance.

The initial treatment of spasticity includes conservative management, therapy and splinting, oral medications (e.g., baclofen and dantrolene), and injectable neurolytic medications (e.g., Botulinum toxin and phenol). These techniques are usually attempted prior to surgical intervention.

Surgical goals vary based on current and expected functionality and severity of the deformity.  Children with spasticity present a unique challenge, as surgical intervention may be required to allow more normal bone, joint and muscle development.

Reviewed by: Aaron J Berger, MD

This page was last updated on: September 21, 2020 02:05 PM