What happens if I stop treating spasticity? Will my condition worsen quickly?

As a rule, spasticity will worsen when you stop treatment. Muscles and tendons shorten, the joints become stiffer and incorrect posture persists permanently without therapeutic intervention. This leads to an ever-increasing restriction of movement. The declining mobility makes coping with everyday life more difficult, reduces quality of life in general and will increase pain. . According to the International Classification of Function, Disability and Health (ICF) of the World Health Organisation (WHO), most people with spasticity are likely to experience a relevant reduction in their participation in social and professional life if spasticity is not treated. 6

6 CF is the WHO framework for measuring health and disability at both individual and population levels. ICF was officially endorsed by all 191 WHO Member States in the Fifty-fourth World Health Assembly on 22 May 2001(resolution WHA 54.21) as the international standard to describe and measure health and disability.

I’ve been clenching my hand for years. Is there hope for recovery?

It depends. Therapeutic methods such as physiotherapeutic mobilisation, hand orthoses or injections with botulinum toxin and ultimately surgery can be options to reduce spasticity. However, this requires a careful anamnesis and detailed examination. Talk to a physician about treatment options to decide on the right therapy concept for you.

Will spasticity keep me from walking?

Depending on brain and spinal cord damage, spasticity can cause limited mobility of the lower extremities and difficulties in walking. Since each individual is unique, this can only be answered by a doctor on the base of symptoms and findings.

What is the future for post stroke spasticity management?

Botulinum toxin injection is one of the most important treatment options in the future to reduce spastic muscle tone. The physiotherapeutic treatment and the drug therapy will continue to be the two main pillars in spastic therapy.

Alternative researchers are attempting to find ways to eliminate spasticity through neurosurgical procedures or other anti-spastic drugs.

Which type of toxins would suit better for post stroke spasticity?

There are 8 different sub-types (A, B, C1/C2, D, E, F, G and H) of the botulinum toxin which have been isolated, two of them (A and B) have been used therapeutically. Botulinum toxin type A injection represents the gold standard treatment for focal spasticity with efficacy, reversibility, and low prevalence of complications.

What are the health implications of using botulinum toxin frequently?

Botulinum toxin has been used for almost 30 years to treat spasticity. Out of these experiences it shows that botulinum does not cause long-term side effects. Microscopic examinations showed that no permanent changes have occurred in the nerves or muscles after absorbing Botulinum. After the effect ends, neither the active substance nor its effects on the nerves can be detected. As a calm muscle is usually weaker (think of a leg in a cast), with time a smaller dose of Botulinum toxin is going to be needed, to get the same muscle relaxing effect than before.

How long can I be treated with botulinum toxin?

The treatment with Botulinum toxin can be repeated for an indefinite period of time, if the active substance is well tolerated. Due to the degradation of Botulinum toxin after each injection, the paralysing effect is always reversible.

Who do I see about getting a splint?

Orthoses / splints are usually recommended by the treating neurologist, rehabilitation specialist or physiotherapist in case of very strong or very low muscle tone. There are many different models with different functions.