Did you know the reason you experience spasticity after TBI has nothing to do with your muscles?
It’s true! The brain is the real culprit behind spasticity. Which means the key to reversing spasticity lies in retraining your brain.
In this article, we’ll help you understand the root cause of your spasticity, and then show you what the best treatments for spasticity after TBI look like.
We’ll also show you what you can do when your spasticity is so severe that your muscles become effectively paralyzed.
What Causes Spasticity After TBI?
Spasticity (a common side effect of TBI) happens when there’s a problem the central nervous system (CNS).
The CNS is made up of the brain, spinal cord and neurons, all of which work together to control your muscle movements.
The neurons act as messengers for the brain, and use your spinal cord as a highway to travel back and forth between the brain and muscles.
Normally, your brain can send messages through the central nervous system to tell your muscles when to contract or relax, which helps your body maintain a comfortable muscle tone.
But sometimes after a brain injury, this message flow is interrupted, and your muscles no longer know whether they are supposed to tighten or relax.
As a result, the muscles stay in a constant state of flexion, which we call spasticity.
The longer the muscle stays flexed, the shorter the muscle becomes, until eventually a contracture (the stiffening of the muscle fibers) sets in.
Alright then. That’s what is happening in your body to cause spasticity, but is there anything you can do to treat it?
How to Treat Spasticity After TBI
Sometimes spasticity will resolve on its own, but it is better not to wait for this to happen.
The longer the spasticity lasts, the more likely contractures will develop. Contractures limit the movements of your joints and make treating your spasticity a lot more difficult.
So what can you do to treat spasticity after TBI effectively?
1. Stretching and Passive Range-of-Motion
Therapists often use passive range of motion exercises and stretching to treat spasticity, which can be helpful.
Stretching is important for preventing contractures from developing, so you should definitely incorporate it into your spasticity treatment.
You can also use orthotic braces like a cast or splint on your arms or legs to prevent contractures. These keep the limb in a stretched position and slowly lengthen the muscle.
These methods don’t help the muscle relax though, which means they don’t really treat spasticity; they just stop it from getting worse.
2. Botox Injections
Botox is a nerve blocking agent that prevents the release of acetylcholine, a neurotransmitter that causes your muscles to contract.
It can help your muscles relax and stop painful spasms, which makes it a popular treatment option for spasticity.
The problem with Botox though is its effects are only temporary. Once it wears off, the spasticity returns.
This is because Botox does not treat the underlying cause of spasticity, which is a problem in the brain’s ability to send messages to the muscles.
In fact, both of the treatment options we’ve looked at so far only focus on treating the symptoms of spasticity, not the cause.
To improve spasticity, your brain needs to send messages to your muscles again.
But is there a way you can help your brain do this?
Yes there is!
To help your brain regain control over the signals it sends to your muscles, you’ll need to engage neuroplasticity.
3. Engaging Neuroplasticity to Treat Spasticity After TBI
Neuroplasticity refers to your brain’s ability to rewire itself and create new neural pathways.
Your brain forms these new pathways through repetitive, therapeutic exercise. This means the best way to treat your spasticity is to exercise your affected muscles.
Think of it like paving a road through snow with a shovel. You have to keep digging in order to clear a path. The more you dig, the clearer the path will become, and the easier it will be to walk through it.
So the more you practice and exercise, the more you reinforce those new neural pathways, which means easier communication between your brain and muscles and less spasticity!
This is just one more reason why physical therapy exercises are so important for brain injury patients.
But what if your spasticity is so severe you cannot even move your muscles at all?
Treating Severe Spasticity After TBI
Sometimes spasticity makes your muscles effectively paralyzed.
That’s where the passive stretching exercises and Botox treatments covered above come in.
Even though they are only temporary solutions, they are very effective at loosening up muscles, and can relax them enough to allow you to exercise.
Another option you can use to treat severe spasticity is an intrathecal baclofen pump.
A baclofen pump is a surgically implanted device that delivers baclofen – a medicine that relaxes muscles – directly into your spinal fluid.
It is helpful for people whose spasticity is widespread and severe.
Again, these are only temporary solutions and won’t address the root cause of spasticity.
This is why the best treatment for spasticity is a combination of passive range-of-motion exercises, medication, and active physical therapy exercises that engage neuroplasticity.
As communication between your brain and muscles improves, your spasticity will eventually decrease, and you will be able to finally relax your muscles again!