Sign Up for a Free Account
  • Updated 10.26.2023
  • Released 08.14.1998
  • Expires For CME 10.26.2026




Spasticity is a common debilitating factor in central nervous system disorders characterized by velocity-dependent resistance to movement. There are many established treatments, such as oral medications (ie, baclofen, valium), toxin injections, nerve blocks, intrathecal baclofen pumps, and selective dorsal rhizotomy. When carefully selected based on a patient's condition and goals, these treatments can greatly improve function and quality of life and prevent secondary complications. A combination of the above treatments is usually needed for optimal results. In addition to well-established treatments, new and promising treatments include stem cell treatments, hyaluronidase, vibration, extracorporeal shock wave therapy, and cryo-neurolysis.

Key points

• Early diagnosis and treatment of spasticity is critical for best outcomes, including preventing soft-tissue contractures and bony subluxation, dislocation, and deformities.

• Treatment of spasticity is generally multimodal, including a combination of treatments, must be personalized to the individual, and may change over time.

• Clear functional and quality-of-life goals are necessary to ensure optimal outcomes.

Historical note and terminology

Spasticity, derived from the Greek word “spastikos” or Latin “spasticus,” which means to pull (16), is a condition that can result from any central nervous system insult.

The most widely accepted definition of spasticity is a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon reflexes, resulting from hyperexcitability of the stretch reflex (38). Despite wide acceptance, those who diagnose and manage spasticity can attest that Lance’s definition is not exhaustive of the array of spasticity presentations. These vary broadly and may be influenced by several factors, including the mechanism and severity of the insult, age of onset, and other factors. Young further added characteristics of positive and negative symptoms. Positive symptoms include exaggerated cutaneous reflexes, including nociceptive and flexor withdrawal reflexes, autonomic hyperreflexia, dystonia, and contractures. Negative symptoms include paresis, lack of dexterity, and fatigability (76).

Treatment for spasticity was documented as early as the late 19th century when surgeons Abbe and Bennet discussed decreasing tone in a spastic limb through sensory rhizotomies. Later, in 1898, scientist Sherrington published experiments in which the sensory roots of spastic cats were severed to relieve spasticity (01). The technique of sensory rhizotomies has been improved and continues to be used today as a treatment for patients with spasticity, as does neuromuscular blockage, a longstanding treatment that has been used for over 30 years (36).

Today, there are comprehensive pharmacologic and nonpharmacologic spasticity treatments widely available, including stretching and therapeutic modalities, oral therapy, chemodenervation with neurotoxin, chemoneurolysis with phenol or ethyl alcohol, intrathecal baclofen, and additional surgeries, such as tendon lengthening or transfers and functional neurotomy. There are also new and emerging therapies, including cryoneurolysis and injection of hyaluronidase. These are discussed in more detail in the treatment section.

This is an article preview.
Start a Free Account
to access the full version.

  • Nearly 3,000 illustrations, including video clips of neurologic disorders.

  • Every article is reviewed by our esteemed Editorial Board for accuracy and currency.

  • Full spectrum of neurology in 1,200 comprehensive articles.

  • Listen to MedLink on the go with Audio versions of each article.

Questions or Comment?

MedLink®, LLC

3525 Del Mar Heights Rd, Ste 304
San Diego, CA 92130-2122

Toll Free (U.S. + Canada): 800-452-2400

US Number: +1-619-640-4660



ISSN: 2831-9125