Overcoming Muscle Spasticity

Spasticity is one of the common complications of a stroke. Usually, spasticity develops months or even a year after a stroke—and often may become more noticeable during recovery. Spasticity is a challenging, unpleasant problem for stroke survivors, but there are solutions and ways to control it.

Older woman in hand physiotherapy
KatarzynaBialasiewicz / Getty Images

What Is Spasticity?

Muscle stiffness, tightness, rigidity, and inflexibility are often referred to as spasticity. After a stroke, the arms, legs, or face can become weak or paralyzed. That weakness means that a stroke survivor cannot control muscle movement. But, often, after a stroke, weak muscles become "stuck" in a rigid or tight position and cannot comfortably relax when you want them to.

Sometimes, with milder spasticity, you might be able to move your muscles, but they may jerk unevenly as you move, instead of moving smoothly. Some people with spasticity notice that the muscles fall into an unusual position or twisted position while at rest.

How Spasticity Feels

Often, the stiffness and weakness of spasticity make you feel that you are moving slowly or overcoming a tight band around your muscles. Sometimes, your muscles are painful at rest or with movement.

For example, if you have spasticity in your arm, you might feel a tense muscle pain in your arm or even in the surrounding area, including your neck or back. Sometimes, after a severe stroke, you might not be able to feel the discomfort or pain from the spasticity right away, but nearby muscles can become painful after months and months of painless spasticity.

What You Can Do

Often, making sure to regularly exercise your weak muscles can help prevent spasticity. Sometimes, you may need someone else to assist you by moving your weakened muscles for you. Physical therapy regimens and scheduled home exercise routines help to prevent or lessen spasticity.

Many people with spasticity notice that physical therapy is especially challenging and uncomfortable in the beginning, but over time, therapy has been proven to be beneficial for the rigid muscles.

When therapy and exercise don't adequately alleviate spasticity, prescription-strength muscle relaxant medication can help. However, some people can’t tolerate muscle relaxants due to side effects such as fatigue or dizziness.

Another treatment option for spasticity includes powerful and targeted injections of muscle relaxants or botulinum toxin (botox). Injections work for some people, but not all, and they often need to be repeated at regular intervals because the beneficial effects wear off after some time.

In its stroke treatment guidelines, the American Heart Association notes that while botox is not a cost-effective option for every patient with stroke-related spasticity, the treatment can help improve active or passive limb positioning for activities such as dressing and hygiene. This can help reduce overall caregiver burden, which is an important consideration when weighing the cost versus benefits of botox.


Scientific research studies have shown that spasticity can, in fact, improve. Overall, it appears that as spasticity resolves, there is evidence that brain activity in the area damaged by the stroke begins to recover. So, exercising muscles affected by spasticity is probably one of the many ways that brain tissue can be directed to heal after a stroke.

Living With Spasticity

Spasticity can be uncomfortable and painful. If you experience symptoms that sound like they might be early or even late spasticity, you need to know that there are solutions and that you don't have to continue to suffer.

Even more importantly, if you live with untreated spasticity for too long, your muscles can stiffen even further. Over time, this can make it more difficult to move, exacerbating your handicap and resulting in a worsening cycle that makes your stroke recovery more of an uphill battle.

If you think you might have spasticity, talk to your healthcare provider or your physical therapist so that you can get the right treatment to relieve your symptoms of spasticity. Usually, medical treatment or exercise therapy for spasticity is not a complete cure, so ongoing therapy may be necessary.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Thibaut A, Chatelle C, Ziegler E, Bruno MA, Laureys S, Gosseries O. Spasticity after stroke: Physiology, assessment and treatment. Brain Inj.

  2. Winstein CJ, Stein J, et al.; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for adult stroke rehabilitation and recovery: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2016 Jun;47(6):e98-e169. doi: 10.1161/STR.0000000000000098.

  3. Li S. Spasticity, motor recovery, and neural plasticity after strokeFront Neurol. 2017;8:120. Published 2017 Apr 3. doi:10.3389/fneur.2017.00120

  4. Bhimani R, Anderson L. Clinical understanding of spasticity: Implications for practiceRehabil Res Pract. 2014;2014:279175. doi:10.1155/2014/279175

Additional Reading

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.