Spasticity Quiz
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Muscle tension
Knee does not move
My arm and leg on one side is harder to move than the other
Uncontrolled movements
My hands and feet are clumsy
Hands have fine tremors
Tingling
Not seeing your symptoms? No worries!
What is Spasticity?
Spasticity is abnormal muscle tightness due to extended muscle contraction. It is typically linked to damage to the spinal cord, brain, or nerves.
Typical Symptoms of Spasticity
- Stiff, rigid muscles causing difficulty bending joints
- Difficulty with fine motor control or coordination in hands and feet
- History of stroke
- Fine tremors of the hands or fingers
- Difficulty walking normally
- Numbness anywhere from the elbow to the wrist
- Weakness that affects one side more than the other
- Difficulty moving the joint(s)
Diagnostic Questions for Spasticity
Your doctor may ask these questions to check for this disease:
- Do you have stiff muscles and/or inflexible joints even with assistance?
- Do you have difficulty with fine motor control or coordination in your hands and feet?
- Have you ever had a stroke?
- Do you experience fine tremors in your hands or fingers?
- Do you have difficulty walking normally?
Treatment of Spasticity
Treatment relies on the cause. Physical therapy, occupational therapy, and prolonged stretching can help reduce spasticity. Splinting, casting, and bracing can maintain range of motion and flexibility.
Reviewed By:
Benjamin Kummer, MD (Neurology)
Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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- Muscle spasms
- Unsteady gait
- Body shaking for no reason
- Shaking hands
- Stiffness
- Walking difficulties
- Limbs falling asleep easily and frequently
- Balance issues
- Hand twitching
- Tremors
- Can't walk
- Losing grip in hands and dropping things
- Sudden inability to walk
- Hands shaking after workout
- Abnormal gait
See full list
Symptoms Related to Spasticity
Diseases Related to Spasticity
FAQs
Q.
Trapped? Why Your Body is Locked: Locked In Syndrome & Medical Next Steps
A.
Locked-in syndrome is a rare but critical condition where a person is fully conscious yet cannot move or speak, usually from a brainstem stroke; preserved blinking or vertical eye movement may allow communication, and any sudden onset of these symptoms is a medical emergency requiring 911, immediate CT or MRI, and stroke therapy. There are several factors to consider that can affect your next steps, including look-alike conditions, diagnostic tests, ICU support, rehabilitation, spasticity management, communication devices, prognosis, and emotional care; see the complete details below.
References:
* Leon-Ruiz M, et al. Locked-in Syndrome: Diagnosis, Prognosis, and Medical Management. Neurohospitalist. 2019 Jul;9(3):144-150. doi: 10.1177/1941874419853922. Epub 2019 Jul 16. PMID: 31333792; PMCID: PMC6651147.
* Laureys S, et al. Locked-in syndrome: a review of current knowledge and future directions. Brain Inj. 2017;31(9):1173-1182. doi: 10.1080/02699052.2016.1245030. Epub 2016 Nov 16. PMID: 27854483.
* Chatelle C, et al. Locked-in syndrome: State of the art of current and future communication strategies. Brain Inj. 2017;31(9):1183-1191. doi: 10.1080/02699052.2016.1245031. Epub 2016 Nov 16. PMID: 27854484.
* Sarà M, et al. Quality of Life in Patients with Locked-in Syndrome: A Systematic Review. J Clin Med. 2021 Sep 7;10(18):4030. doi: 10.3390/jcm10184030. PMID: 34522771; PMCID: PMC8465954.
* Arumugham A, et al. Locked-in Syndrome: A Systematic Review of Etiologies. J Clin Med. 2021 Jun 22;10(13):2757. doi: 10.3390/jcm10132757. PMID: 34167098; PMCID: PMC8295982.
Q.
Big Toe Fanning Up? Why Your Babinski Reflex Matters & Medical Next Steps
A.
Big toe moving up with toe fanning after stroking the sole is a positive Babinski reflex, which is normal in infants but in adults can signal a brain or spinal cord issue that needs prompt medical evaluation. There are several factors to consider, including accompanying symptoms like weakness, stiffness, balance changes, or sudden stroke signs that require emergency care. For what to do next, including when to seek urgent help, what tests doctors use, and conditions that can cause this finding, see the complete guidance below, as there are important details that can change your next steps.
References:
* Schilham L, van der Geest JN, van der Hoeven B, van der Eb A, Visser-Meily A. The Babinski Sign: A Comprehensive Review. J Neurophysiol. 2021 Jul 1;126(1):153-162. doi: 10.1152/jn.00557.2020. Epub 2021 May 26. PMID: 34038165.
* Singla V, Vashisht S. The Babinski reflex: a historical and clinical perspective. J Coll Physicians Surg Pak. 2011 Dec;21(12):803-5. PMID: 22217743.
* van Gijn J. The Babinski sign. Pract Neurol. 2002 Oct;2(5):252-8. doi: 10.1046/j.1474-7766.2002.02036.x. PMID: 15729792.
* Miller R, Toth C. Babinski's sign: Its many meanings. Can J Neurol Sci. 2004 Feb;31(1):1-12. doi: 10.1017/s0317167100003004. PMID: 15035544.
* Askenasy JJ, Askenasy E. Babinski's sign in a historical and neurological context. Front Neurol. 2012;3:101. doi: 10.3389/fneur.2012.00101. Epub 2012 Jun 18. PMID: 22719702. PMCID: PMC3376742.
Q.
Always Tense? Why Your Body Is Stuck & Somatic Yoga Medical Next Steps
A.
There are several factors to consider. See below to understand more. Chronic tightness often reflects a nervous system stuck in a protective stress response, where somatic yoga with slow, mindful contraction then release can reset muscle tone more reliably than stretching, yet progressive stiffness, spasms, weakness, one sided changes, or trouble walking may signal spasticity or other medical issues, so use the spasticity symptom check and see a clinician, with step by step guidance below.
References:
* Gupta N, Khera S, Vempati R, et al. Yoga for anxiety and stress management: a systematic review and meta-analysis of randomized controlled trials. J Psychiatr Res. 2017 Aug;91:105-117. doi: 10.1016/j.jpsychires.2017.03.006. Epub 2017 Mar 15. PMID: 28363717.
* Desai R, Telles S, Kumar A. The physiological effects of Yoga: a review of the literature. J Ayurveda Integr Med. 2021 Jul-Sep;12(3):477-483. doi: 10.1016/j.jaim.2021.05.006. Epub 2021 Jun 10. PMID: 34119335; PMCID: PMC8486016.
* Mehling WE, Gopisetty V, Daubenmier V, Price RK, Hecht FM. Yoga practice and its effects on interoception and body awareness: a systematic review. J Complement Integr Med. 2020 Jul 1;17(3):/j/jcim.2020.17.issue-3/jcim-2018-0196/jcim-2018-0196.xml. doi: 10.1515/jcim-2018-0196. PMID: 30978250; PMCID: PMC7402377.
* Telles S, Gaurav V, Gupta R, Balkrishna A. Effects of Yoga Interventions on the Autonomic Nervous System: A Systematic Review. Front Neurosci. 2023 Feb 15;17:1115598. doi: 10.3389/fnins.2023.1115598. PMID: 36873539; PMCID: PMC9975764.
* Park CL, Riley KE, Bedford G, et al. Mind-Body Practices for Stress-Related Conditions: A Systematic Review of Reviews. J Behav Med. 2021 Aug;44(4):421-434. doi: 10.1007/s10865-021-00216-0. Epub 2021 Feb 20. PMID: 33611684; PMCID: PMC8290263.
Q.
Feeling Stiff? Why Your Muscles Are Hypertonic + Medical Next Steps
A.
Persistent stiffness that resists stretching may be hypertonicity, meaning increased resting muscle tone. Common, reversible triggers include stress, poor posture, and overuse, while serious causes can involve the nervous system such as stroke, multiple sclerosis, or spinal cord or brain injury. There are several factors to consider, including urgent warning signs, how doctors diagnose it, and treatments from physical therapy to medications. See below for the complete details and the next steps that could impact your healthcare decisions.
References:
* Opoku, M., Sadowsky, C., & McDonald, J. W. (2018). Muscle hypertonicity: A systematic review of mechanisms, evaluation, and treatment. *PM&R*, *10*(10), 1084-1094.
* Milanov, I. (2018). Spasticity, rigidity, and dystonia: from pathophysiology to differential diagnosis and treatment. *International Review of Neurobiology*, *139*, 423-455.
* Mottram, C., Bawa, P., & Stein, R. B. (2017). Motor unit behavior in persons with chronic stroke: Mechanisms of muscle hypertonia. *Journal of Neurophysiology*, *118*(4), 1891-1906.
* Gracies, J. M. (2021). Assessment and management of spasticity and rigidity. *Hand Clinics*, *37*(3), 395-408.
* Nalamasu, N., & Biller, J. (2021). Pharmacological Management of Spasticity: A Narrative Review. *Current Treatment Options in Neurology*, *23*(12), 1-13.
Q.
Is Your Body "Jumping"? Why Your Reflexes Misfire & How to Find Relief
A.
Sudden body jumps are usually reflex related and often harmless from hypnic jerks, stress, caffeine, fatigue, electrolyte shifts, or medications, but persistent stiffness, exaggerated reflexes, weakness, numbness, or other neurologic changes can point to spasticity or brain and spinal cord conditions that need prompt evaluation. Relief can come from lowering caffeine, staying hydrated and correcting electrolytes, improving sleep and stress control, stretching and physical therapy, and when needed targeted medicines or procedures. There are several factors to consider, and important red flags and evaluation steps are outlined below to guide your next steps.
References:
* Nardone R, et al. Spasticity: Current Treatment and Future Perspectives. J Clin Med. 2020 Jul 15;9(7):2227. PubMed PMID: 32679808.
* Trenkwalder C, et al. Restless legs syndrome: an update on treatment and diagnosis. Lancet Neurol. 2021 Jul;20(7):582-595. PubMed PMID: 34147043.
* Taricco M, et al. Spasticity management: An update. J Clin Neurosci. 2022 Dec;106:17-23. PubMed PMID: 36384232.
* Zhou L, et al. Hyperekplexia: clinical features, diagnosis, and treatment. Front Neurol. 2023 Jun 13;14:1169680. PubMed PMID: 37397746.
* Truong DD. Myoclonus: Current Concepts and Future Directions. Mov Disord Clin Pract. 2017 Mar-Apr;4(2):170-179. PubMed PMID: 30364808.
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Smania N, Picelli A, Munari D, Geroin C, Ianes P, Waldner A, Gandolfi M. Rehabilitation procedures in the management of spasticity. Eur J Phys Rehabil Med. 2010 Sep;46(3):423-38. PMID: 20927008.
https://www.minervamedica.it/en/journals/europa-medicophysica/article.php?cod=R33Y2010N03A0423Dietz V, Sinkjaer T. Spasticity. Handb Clin Neurol. 2012;109:197-211. doi: 10.1016/B978-0-444-52137-8.00012-7. PMID: 23098714.
https://www.sciencedirect.com/science/article/abs/pii/B9780444521378000127?via%3DihubSheean G. The pathophysiology of spasticity. Eur J Neurol. 2002 May;9 Suppl 1:3-9; dicussion 53-61. doi: 10.1046/j.1468-1331.2002.0090s1003.x. PMID: 11918643.
https://onlinelibrary.wiley.com/resolve/doi?DOI=10.1046/j.1468-1331.2002.0090s1003.xBarnes MP Johnson GR. Upper Motor Neurone Syndrome and Spasticity : Clinical Management and Neurophysiology. New York N.Y: Cambridge University Press; 2001.
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