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- My name is Bill Monroe
and I had an ischemic stroke in 2017 at the age of 46.
About a month after my stroke I noticed that
my limbs on my left side were having muscle spasms
and that made everyday activities difficult.
During a doctor visit I learned that
these muscle spasms were called spasticity
and it's a common condition after a stroke.
- After a stroke the signals from the brain
that allow muscles to relax can be blocked,
causing the muscle on the stroke side
to tighten and spasm.
This is spasticity.
It can range in severity from mild stiffness
to severe, painful spasms,
like a Charlie horse that won't go away.
Spasticity can set in weeks, months,
or even at a year after a stroke.
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Spasticity can cause painful muscle spasms,
difficulty stretching the muscle,
stiffness in the arm, hand, leg, and ankle,
or an arm to be folded against the chest
with a curled wrist and fingers.
Spasticity can also lead to joints
in the arm and leg to become stuck
or frozen in an abnormal
and possibly painful position.
This is called contracture.
Spasticity and contracture can cause
significant difficulty with daily living tasks,
such as bathing, eating, and dressing.
It can cause problems with body positioning,
making it difficult to sit in a chair
or even sleep comfortably.
In the long run lack of comfortable rest
can lead to fatigue and impaired cognition.
- I have spasticity on my left side.
My fingers curl into a fist
and sometimes it can be difficult to release them.
The fist can be so tight it can be
hard to get a shirt with a cuff on.
I also have to make sure that I keep
my fingernails trimmed
because they can actually dig into my hand.
My left arm is often bent at a 75 degree angle,
you know, sort of right at the elbow.
And sometimes I can force it straight
but sometimes I can't.
It can prevent me from rotating my wrist
which can also make it difficult
to turn a door knob
or reach for the handle of a car door.
On my foot, my second toe curls
which makes it difficult to put on shoes or walk.
My spasticity varies during the day.
It can be worse first thing in the morning
or when I'm tired.
- Working with your healthcare team
and having honest and open dialogue is critical
to addressing your needs as a patient
and your recovery.
Your situation is unique
and every case is different.
There are a number of treatment
options for spasticity which can include
regular stretching with a wide range of motion,
working with an occupational and physical therapist
who have expertise with spasticity management,
braces and splints which can help
to hold the muscle in place
and stop it from contracting,
oral medications that promote relaxation of the muscles,
targeted injections with botulinum toxin
into the most effected muscles
which can help reduce tone and tightness in those muscles.
In some patients with very severe spasticity
a surgically implanted pump called
an Intrathecal Baclofen Pump,
can be used to deliver medication
directly into the spinal fluid.
Ask your healthcare provider for recommendations
for devices or modifications in the home
that can help ensure your safety
and reduce your risk of falls.
Your healthcare provider will prescribe
the best approach to your treatment
depending on the severity of your spasticity.
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- My spasticity has lessened over time.
I'm always telling the muscles
that they need to do something
so that over time they can learn
how to do it as I recover.
I have a goal of running one day.
There are ways to treat and manage spasticity.
Like me, talk to your healthcare team
about the most effective options for you.
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