Spasticity Treatment and Pain Management: Easing Stiff Muscles and Nerve Pain

Doctors sort spasticity by how much of the body it reaches. Focal spasticity is one or two muscle groups, like a bent elbow or a foot that points down. Multifocal means a few areas, often the arm and leg on the same side. Generalised spasticity covers large parts of the body, often after a spinal cord injury. People also mix up two other words. A spasm is a sudden, short tightening that comes and goes. Rigidity feels equally stiff at any speed. It's typical of Parkinson's disease, and it's treated quite differently.

Pain after a brain or spinal cord problem rarely has just one cause. Some of it is mechanical. Tight muscles pull joints into odd positions, and a weak arm hanging by the side strains the shoulder. Then there's neuropathic pain, meaning pain from the nerves themselves. People describe burning, tingling or little electric shocks. Some can't bear a bedsheet resting on the leg. When the damage sits inside the brain or spinal cord, doctors call it central pain, or central pain syndrome. It can turn up weeks or even months after the stroke or injury. Ordinary painkillers from the chemist often barely touch it.

Spasticity and nerve pain are usually managed over months and years. A few sessions won't fix them, and we'd rather say so now. Still, most people find it all gets easier to live with. Stretching becomes a daily habit. If injections help, they're often repeated every few months, and the weeks after one are the time to push the stretching, while the muscle is looser. Stiffness also flares. An infection, constipation, a pressure sore, tight clothes, cold, tiredness or stress can set it off, so learn your own triggers. Most of it happens as an outpatient and at home. Early on, inpatient rehabilitation can make sense.

A sudden change in stiffness or pain usually has a cause. Call the doctor soon if spasms suddenly get much worse, since a urine infection, constipation or a pressure sore is often behind it. Same for red or broken skin under a splint, or medicines that make someone very drowsy. Some things can't wait. Trouble swallowing or breathing after a botulinum toxin injection needs emergency care. So do signs of a new stroke, like a drooping face or slurred speech. Call 112. And if someone has a spinal cord injury at mid-chest level or higher, a pounding headache with a flushed face may be autonomic dysreflexia. That's a dangerous jump in blood pressure and needs urgent help.