Managing Spasticity in the Community

Spasticity is a symptom that affects many people with neurological conditions such as stroke, multiple sclerosis, spinal cord injury or cerebral palsy.

It involves involuntary muscle tightness or stiffness caused by disrupted messages between the brain and the muscles. This leads to an exaggerated response when a muscle is stretched.

Symptoms can range from mild to severe and often fluctuate throughout the day.

Understanding the condition and knowing what you can do day‑to‑day can help manage symptoms effectively.

What does spasticity look like?

Spasticity can affect the muscles of the arms, legs, head or trunk.

You may notice:

Fingers pulling into the palm
The elbow bending when walking
Legs pulling together
Shaking in the leg
Sudden leg spasms

These patterns vary from person to person and may affect movement, walking and daily function.

How can spasticity be identified?

You can screen for possible spasticity at home by considering:

1. Is there weakness in any limb?

2. Is the limb held in an abnormal posture?

Examples include:

Closed fist
Bent wrist
Flexed elbow
Internally rotated shoulder
Knees pressed together
Foot or ankle turned inward
Walking on the ball of the foot

3. Do you feel resistance when you gently move the affected limb?

If the answer is yes, a referral to a Spasticity Specialist (Tone Management Clinic, NRT) may be appropriate.

If none of the above apply, a specialist referral may not be required.

Why is it important to manage spasticity?

Spasticity may worsen over time. Good management can:

Improve comfort
Support mobility
Maintain independence
Reduce risk of muscle shortening
Help prevent pain
Support daily activities such as walking, dressing and washing

Spasticity can also contribute to sleep problems, posture changes, skin issues and hygiene challenges.

What can make spasticity worse?

Spasticity can worsen due to increased tension or discomfort in the body. Triggers include:

Pain
Temperature changes (too hot or too cold)
Infections (e.g., bladder or chest)
Skin irritation or pressure areas
Bladder or bowel problems
Poorly fitting clothing, shoes or splints
Poor posture or balance in sitting, lying or walking
Emotional stress, anxiety or fatigue

These triggers can act as warning signs that something needs attention.

How can spasticity be managed?

Therapies and assessments

Physiotherapy or occupational therapy can assess your movement and identify triggers.
Posture support: sitting and sleeping positions may be adjusted to reduce muscle tightness.