Spasticity

An injury to the brain can cause an abnormal increase in muscle tone causing stiffness or tightness. This is called spasticity. A spastic muscle does not easily relax the way a normal muscle does.

This effect of TBI is most common with a severe and/or penetrating brain injury.

Regular stretching, splints to keep limbs in proper position, and medications are common treatments to help manage spasticity.

Severe spasticity can be painful so pain management may be a treatment recommended by the healthcare provider.

What might you see?

• Involuntary muscle tightness and stiffness
• Decreased range of movement and abnormal positioning of the arms, legs, or body (the hands and upper limbs are most commonly affected, but the legs, head and neck, or trunk can have spasticity as well)

How can you help?

• The physical or occupational therapist will develop a stretching program for the service member or veteran. Ask the therapist to teach you this program so that you can assist.
• Post diagrams of the stretches where the service member or veteran can refer to them regularly. Help them do the recommended stretches daily. This will ensure the range of motion of joints is maintained and avoid joint stiffness and immobility.
• If splints are used to help control spasticity, learn how to apply them. Find out how long they are to be worn each day (some splints are worn continuously, and others are worn only periodically).
• Monitor the service member or veteran’s skin for any pressure points from the splints. These can occur when a splint rubs against a bony area and irritates the skin or results in an abrasion or open wound. Alert nurses to any areas of redness or any area that starts to look like a sore.
• Tell the healthcare team if the spasticity gets worse. This could be a sign of an underlying problem.
• If spasticity is so severe that it interferes with the person’s overall comfort, positioning, and general functioning, ask the healthcare provider about different treatment options. Treatment options may include medications, injections of botulinum toxin type A, implanting a muscle relaxant pump, and other approaches.