Neurological conditions and spasticity.

Spasticity symptoms include continuous muscle stiffness, spasms and involuntary contractions, which can be painful. In addition, spasticity can impact a person’s walking, use of their arm – mainly opening the hand – and many other activities.

Neurological conditions such as multiple sclerosis, cerebral palsy, stroke, brain and spinal cord injury frequently present people with problems with spasticity. This is due to spasticity being a symptom of damage to the brain, spinal cord or motor nerves.

Spasticity management and intramuscular injections.

Spasticity management is a team approach with doctors and therapists working together to decide on the best treatment and achieve the best outcome of the treatment. There is no one gold standard, and treatment decisions are based on careful multidisciplinary assessments and clear goals.

For people with spasticity, intra-muscular injections directly into the muscle can be an effective treatment. However, it is essential that a person who has had these injections also has follow-up physiotherapy or occupational therapy to maximise the outcomes after the injections. Here at ARC, a team approach to the treatment of spasticity is used; the client may be seen by an occupational therapist, a physiotherapist, an orthotist or a combination of the three both before and after injections. Communication with the injecting doctor is vital, as measuring the effects of the injections will guide the future management plan.

Therapy after intramuscular injections.

One of the essential outcomes after intra-muscular injections is to stretch the muscle out as much as possible to gain additional length. This can be achieved in therapy by combining a specific stretching program, functional electrical stimulation (FES), functional retraining and use of a splint or orthoses to wear at rest or during activities.

Sometimes, a splint is required to help the limb achieve the optimal position. Often, splints can be obtained “off the shelf”; however, generic options are sometimes not adequate, and a splint has to be made specifically for a person. At ARC, we can make these custom splints either with a physiotherapist or an orthotist to gain further muscle range over a more extended period.

These custom made splints can be put on and taken off at home to gain a maximum stretch over a joint. However, the skin needs to be frequently and carefully monitored to ensure no pressure areas are developing. These can be a considerable concern in people who particularly have impaired sensation or numbness in their limbs.

Planning your therapy.

It’s important to know that the toxin takes 7-14 days to kick in and relax the muscle. This is, therefore, the ideal ‘therapy window’, so planning your physiotherapy or occupational therapy treatment for them is a must. At ARC, we like to assess people before the injections take place so we can take some careful measurements and set up the treatment plan in the therapeutic window after your injections.

The take-home point is that the management of spasticity is very complex and individual. Outcomes can structure future treatment, and involving physiotherapy or occupational therapy early in the process is vital. Talk to your Rehab Specialist or Neurologist if you don’t have a therapist already involved. If you feel intra-muscular injections might help you and you don’t know where to start, contact us on (02) 9906 7777 or referrals@archealth.com.au