Every year, according to the Centers for Disease Control and Prevention (CDC), nearly 800,000 people in the US suffer a stroke. Of those, an estimated 1 in 4 will experience post-stroke muscle tightness, contraction or rigidity (also called spasticity).
“After a stroke, the brain and the muscles may no longer communicate the way they should,” says Eric Goldstein, M.D., FAHA, a vascular neurologist at Henry Ford Health. “And that miscommunication can affect your ability to move and control your muscles.”
What Happens During a Stroke?
A stroke occurs when blood flow to the brain is interrupted. This can happen because of a blocked blood vessel (ischemic stroke) or because a blood vessel breaks (hemorrhagic stroke). In either case, the brain is deprived of the blood and the oxygen it needs to function. Without oxygen, brain cells quickly die, resulting in permanent damage.
A transient ischemic attack (TIA) is a temporary blockage of blood flow to the brain. TIAs are typically seen as warning signs of a future stroke.
What Causes Spasticity After a Stroke?
Damage in the brain after a stroke can change how the brain communicates with muscles. “When the brain is functioning properly, it’s constantly sending signals to the muscles to tell them what to do or what not to do” explains Dr. Goldstein.
“When the brain stops signaling to the muscles on how to move, the spinal cord takes over,” says Dr. Goldstein. “That can lead to spasms, tight muscles and rigidity.”
Rehabilitation Services At Henry Ford
Symptoms of Post-Stroke Spasticity
Not everyone experiences spasticity after a stroke. In those who do, symptoms typically show weeks to months after the stroke. “People who haven’t made full movement recovery after stroke may be more prone to spasticity,” says Dr. Goldstein.
Spasticity and rigidity usually affect the arms, legs, hands and feet. The location affected depends on which area of the brain was damaged by the stroke. Some common symptoms may include:
- Curled-in toes, wrist or fist
- Difficulty stretching or fully extending the affected muscle
- Folded-in elbow, with arm pressed against the chest
- Painful muscle contractions or spasms
- Stiffness in affected limbs
Muscle Spasticity Treatment
While there is no cure for post-stroke spasticity, there are therapies that can relieve symptoms and help improve muscle control. “Intensive physical and occupational therapy is the best way to regain movement and control,” says Dr. Goldstein. “The sooner you start rehab after a stroke, and the harder you hit it, the better the outcome will be.”
In addition to physical and occupational therapy, your neurologist may suggest other treatments to improve spasticity. These can include:
- Botulinum toxin injections into an affected muscle group weaken it so that it can no longer spasm.
- Braces or splints help keep muscles in the proper position.
- Muscle relaxant medications calm nerve impulses that cause unwanted muscle contractions.
- Spinal cord stimulators (also called a baclofen pump) are a small device implanted in the body to deliver medication directly into the spinal fluid.
- Surgery is sometimes used to release muscles and relieve associated pain.
These treatments can’t redo any circuitry in the brain that was damaged by the stroke, but they can help manage symptoms. With the right combination of therapies, people with post-stroke spasticity can find pain relief and better muscle control and movement.
Reviewed Eric Goldstein, M.D., a neurologist who sees patients at Henry Ford Hospital, Henry Ford West Bloomfield Hospital, Henry Ford Macomb Hospital and Henry Ford Wyandotte Hospital. He is the Neurology Medical Director for the Henry Ford Macomb Hospital Stroke Center.
