Spasticity management in the department of Physical Medicine and Rehabilitation (PM&R) offers focused specialty care for people with spasticity at Mayo Clinic's campus in Rochester, Minnesota. Our highly specialized physicians can help with spasticity caused by an illness or injury to the central nervous system in both children and adults.
Spasticity may cause discomfort, difficulty with movement, and bone and joint deformity.
- Spasticity in the arms — it usually happens in the muscles that pull the arm toward the body and bend the elbow, wrist and fingers.
- Spasticity in the legs — it usually happens in the muscles that turn the hip in, extend the knee, and pull the foot down and inward.
In some people, spasticity is hardly noticeable. In others, it is severely limiting.
Why you should see a PM&R physician for your muscle spasms
Each of our spasticity physicians completed real-life training, including post-graduate hands-on experience, one-on-one mentorship, and shadowing time with providers and their patients with complex diagnoses. Along with the unique integrated, coordinated care model that Mayo Clinic is known for, our specialists also have robust procedural training in botulinum toxin and phenol injections using electrical stimulation or ultrasound guidance.
Our physicians can help in separating spasticity from other issues and constructing a plan of care for you. You'll receive an evaluation followed by a one-on-one consultation with our spasticity specialists to fully understand what you're experiencing.
We'll ask you about your history and about how spasticity affects your daily activities. Typical questions we may ask are about how your spasticity affects the way you walk, drink from a cup or move from one position to another.
Your spasticity evaluation
During your evaluation, your PM&R specialist:
- Checks your strength, reflexes and sensation. Muscle weakness and increased reflexes may show where communication between the brain or spinal cord and the muscles has been interrupted.
- Measures your joint range of motion and flexibility by moving your arms and legs at different speeds.
- Assesses your ability to complete daily activities, such as walking, engaging with stairs, changing positions or picking up objects from the floor.
- Evaluates the fluidity of your movements during tasks, such as while you pick up a cup.
- Watches for difficulties with vision, sensation, or balance that you may report or show.
Your specialist also may recommend that you complete additional testing. Mayo Clinic features highly sensitive and state-of-the-art testing machines to provide the best results, including:
- MRI (Magnetic resonance imaging) scans the brain and spinal cord to look for a cause.
- X-rays may show hip development problems, spinal curvature, weakened bones or bony deformities.
Gait lab testing is a detailed thorough evaluation of the way you walk. Sensors are attached to your body. These sensors record movement by capturing electrical activity from muscles and recording this information into a computer. The computer builds an image of your movement to help your team decide on what treatment may work best for you.
A rehabilitation treatment plan just for you, designed with you
Following your consultation, we'll work with you to create your best plan of care. It is important to treat spasticity that is causing problems, but spasticity may only be part of the concerns you're experiencing. Our experts can help you identify both your needs and your best therapy options.
With your goals in mind, your multidisciplinary team can discuss both surgical and nonsurgical options. These may include any of the following:
- Therapies — This can include many approaches such as decreasing triggers that may aggravate your spasms, including infections, positional movement or environmental changes. Therapies also may include physical and occupational therapy, orthotic use, and serial casting.
- Medications — Prescription oral medications (given by mouth) can be helpful at reducing spasticity.
- Injections — Botulinum toxin (Botox), phenol or alcohol injections can be injected into specific spastic muscles to block the signals that cause a muscle to contract. These injections provide temporary relief, allowing you to move and strengthen your muscles.
- Intrathecal drug pump — With the help of a device placed directly into the spinal fluid, medication (such as baclofen) can help to relax certain muscles in the body, which may relieve spasms, cramping and tightness. Intrathecal baclofen does not cure these problems, but it may allow other treatment, such as physical therapy, to be more helpful in improving your condition.
- Surgeries — Options may be to cut sensory or motor nerves to spastic muscles or to cut muscles, tendons or ligaments to improve movement.
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Minnesota