Upper Limb Spasticity

What is upper limb spasticity?

Upper limb spasticity occurs when your arm muscles are constantly shortened and stiff. The contracted muscles trigger abrupt and uncontrollable movements (spasms) in your arm(s). You also can have trouble with arm function and coordination.

Symptoms of upper limb spasticity

Upper limb spasticity often is painful. Symptoms vary based on your degree of spasticity and include:

  • repeated muscle contractions
  • muscle spasms that can force your arm(s) into uncomfortable positions
  • increased muscle tone (hypertonicity)
  • deep tendon reflexes
  • hardened or fixed joints that impair mobility.

What causes upper limb spasticity?

Upper limb spasticity is caused by damage to the nervous system. The job of the nervous system is to send messages back and forth from your brain to your body. These signals travel through your spinal cord. Damage or an injury to your nervous system affects these messages. They become disrupted, blocked, or overpowered. In this instance, it can make your arm muscles stiffen and contract.

You get upper limb spasticity as a result of a health condition. The most common causes of upper limb spasticity in adults are:

  • Stroke. Most strokes occur when a blocked artery prevents oxygen from reaching your brain. This can cause brain damage. You may lose control of certain functions, like moving your arms or being able to speak. The damage can be partial or complete. It may be temporary or permanent.
  • Multiple sclerosis (MS). MS is an autoimmune disease that affects your nervous system. It triggers your immune system to destroy myelin. This is the substance that surrounds and protects your nerve cells. When myelin gets damaged or destroyed, your nerves can’t function properly. They no longer deliver and receive signals in the right way.
  • Spinal cord injury (SCI). Your spinal cord is made up of nerves and nerve cells that carry messages from your brain to other parts of your body. It is protected by bony rings in your back that make up the spinal column. Sometimes this is called the vertebral column or the backbone. The effects of SCI depend on where the damage happens. Upper limb spasticity can occur from damage to the bones (vertebra) in your neck. This is known as a cervical injury.
  • Traumatic brain injury (TBI). TBI can occur from a severe, violent strike to your head. This causes your brain to bump against the inside of the skull. TBI also can occur when an object, such as a bullet or a piece of the skull, enters your brain. TBIs cause bleeding or swelling of the brain and damage to the nerve cells. It disrupts the way your brain sends messages to the rest of your body.
  • Cerebral palsy (CP). CP is a group of neurological disabilities. It occurs in the area of your brain that controls your muscles. Damage to the cerebral cortex affects your muscles’ ability to move and work together.

How is upper limb spasticity diagnosed?

There are no tests to detect upper limb spasticity. Your doctor can perform a physical exam and review your symptoms. They also will want to know about any health problems or disorders.

Can upper limb spasticity be prevented or avoided?

Upper limb spasticity is a possible result of another health condition. Therefore, you cannot prevent it.

Upper limb spasticity treatment

The treatment options for upper limb spasticity vary. Your plan depends on the severity of symptoms, the related disorder, and your overall state of health. Your doctor may recommend one or more of the following:

  • Therapy. Physical therapy comes in different forms. Exercises can improve your range of motion and retrain your muscles. It also can relieve your symptoms and reduce muscle shrinkage. Stretching can release tightened, contracted muscles. Therapy helps with your flexibility, coordination, and strength.
  • Medicine. Antispastic medicines can relax your muscles so that you have fewer spasms. Injections also can help with this.
  • Braces. Braces or splints keep your limb in place. They can prevent muscles from contracting too much.
  • Surgery. Surgery in this instance is rare. It can be used to try and repair nerve paths to improve movement or relieve pain.

Living with upper limb spasticity

Upper limb spasticity affects your normal arm function. The range of impairment depends on your symptoms and state of health. You might need help with routine activities, such as bathing, dressing, and eating. Things like writing and driving also may not be possible. It can be hard to ask for and need help in your daily life. You might consider counseling for mental and emotional support.

Questions to ask your doctor

  • How do I know if I’m at risk for upper limb spasticity?
  • Can physical therapy actually improve my condition?
  • What are the side effects of antispastic medicines?
  • Will I always have upper limb spasticity or will it go away?