I recently found an article about the effectiveness of botulinum toxin injections for the treatment of spasticity. This article is really encouraging and shows that with the correct treatment stroke survivors can overcome spasticity. Please see below for more details.
Jonathan suffered a serious brain injury six years ago, leaving him quadriplegic. With support of people like his mother, and hard-working healthcare professionals, the now 33-year-old made progress, but still suffered from muscle tightness and rigidity. His hands would clench so tightly, his nails would dig into the palms, the was difficult for nurses and painful for Jonathan. Physiotherapy was a key part of his care and recovery.
Spasticity can be caused by strokes, as well as spinal cord injury, multiple sclerosis and a variety of other neurological illnesses. Those who have strokes may suffer weakness, but also stiffness that results in paralysis, such as when hands become clinched and cannot move, or knees become locked in place and interfere with walking. The condition may make it difficult for patients to tend to their personal hygiene, or for nursing home staff to change their dressing.
Jonathan suffered a serious brain injury six years ago, leaving him quadriplegic. With support of people like his mother, and hard-working healthcare professionals, the now 33-year-old made progress, but still suffered from muscle tightness and rigidity. His hands would clench so tightly, his nails would dig into the palms, the was difficult for nurses and painful for Jonathan. Physiotherapy was a key part of his care and recovery.
Spasticity can be caused by strokes, as well as spinal cord injury, multiple sclerosis and a variety of other neurological illnesses. Those who have strokes may suffer weakness, but also stiffness that results in paralysis, such as when hands become clinched and cannot move, or knees become locked in place and interfere with walking. The condition may make it difficult for patients to tend to their personal hygiene, or for nursing home staff to change their dressing.
Jonathan is one of several patients to receive relief, however, through injections of botulinum toxin, an effective treatment for limb spasticity, a painful and debilitating condition affecting the muscles and joints.
“What we try to do is loosen the joints so they have greater range of motion and it's less painful” said Mirsattari, a physical medicine and rehabilitation specialist. “Spasticity is traditionally treated with medications or with surgery. The medications tend to have a lot of side effects and are not well tolerated and with surgeries, you have to cut the muscle to release them from the tension they have.” Botulinum toxin is an alternative where, instead of cutting the muscle or instead of taking a pill by mouth, you are injecting the muscle at the site of the problem, so you isolate the muscles that are the source of the problem and determine which ones are contributing to the abnormal posture and treat them locally, with a local injection into those muscles.
This is part of the spasticity treatment; by itself, it won't accomplish all the objectives. You still need physiotherapy, occupational therapy, range-of-motion exercises, nursing care, or medications if they are partially working, but not fully effective.
“There's always a functional gain. Either there’s pain relief or they have a reduction in a tremor or the hand that was tightly fisted that's putting fingernails into the palm print, there's relief, so now you can give good care and a good stretch. Even tight shoulders, tight arms can affect getting a shirt on effectively, tight legs make it impossible to do good hygiene and to be able to dress properly, ankle issues can impact gait - we always have a functional goal. It's not just for good looks and it's not just to relax - there's always a purpose in mind.”
“What we try to do is loosen the joints so they have greater range of motion and it's less painful” said Mirsattari, a physical medicine and rehabilitation specialist. “Spasticity is traditionally treated with medications or with surgery. The medications tend to have a lot of side effects and are not well tolerated and with surgeries, you have to cut the muscle to release them from the tension they have.” Botulinum toxin is an alternative where, instead of cutting the muscle or instead of taking a pill by mouth, you are injecting the muscle at the site of the problem, so you isolate the muscles that are the source of the problem and determine which ones are contributing to the abnormal posture and treat them locally, with a local injection into those muscles.
This is part of the spasticity treatment; by itself, it won't accomplish all the objectives. You still need physiotherapy, occupational therapy, range-of-motion exercises, nursing care, or medications if they are partially working, but not fully effective.
“There's always a functional gain. Either there’s pain relief or they have a reduction in a tremor or the hand that was tightly fisted that's putting fingernails into the palm print, there's relief, so now you can give good care and a good stretch. Even tight shoulders, tight arms can affect getting a shirt on effectively, tight legs make it impossible to do good hygiene and to be able to dress properly, ankle issues can impact gait - we always have a functional goal. It's not just for good looks and it's not just to relax - there's always a purpose in mind.”
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