If your child was born with or develops a condition that causes spasticity, certain treatments can improve their comfort and mobility. This is especially true if their treatments are coordinated by a team of specialists with spasticity expertise.
University of Iowa Health Care is home to the state’s only multispecialty spasticity clinic for children. It gives our patients access to top pediatric providers, including:
- Physiatrists (physical medicine and rehabilitation doctors) who provide or oversee nonsurgical spasticity treatments
- Neurosurgeons who can treat some of the nerves responsible for spasticity
- Orthopedic surgeons who specialize in treating bone, joint, and muscle problems caused by spasticity
These specialists work together—and with your referring provider—to make sure your child receives a customized, comprehensive care plan with a goal of helping your child reach their full potential.
In fact, we offer a monthly service where patients can see all these specialists on the same day, under one roof.
What is spasticity?
Spasticity refers to chronically tight, stiff muscles—typically in the legs and arms.
If you have spasticity, you’re unable to relax these muscles. Instead, your muscles are constantly “tensed,” or rigid. This makes walking and other movements difficult.
With spasticity, certain nerves in your brain and spinal cord don’t send the right signals to your muscles. This nerve problem may be present at birth. It can also occur if you have an injury or medical condition that causes nerve damage.
The most common conditions and injuries that cause spasticity include:
- Cerebral palsy, especially a type called spastic cerebral palsy, one of the most common causes of spasticity in children
- Spinal cord injury
- Traumatic brain injury (TBI)
Although spasticity affects each person differently, the most common symptoms and complications include:
- Muscle stiffness
- Muscle contractures (shortened, inflexible muscles), which can slow bone growth and cause bones to bend
- Muscle spasms (cramps)
- Bouncing of the ankles or wrists
- Overactive reflexes
Spasticity treatment options
UI Health Care offers every nonsurgical and surgical treatment your child may need, including options you won’t find anywhere else in Iowa.
Our areas of expertise include:
Certain oral medicines (by mouth or by a gastrostomy tube) help reduce muscle spasms and stiffness or relieve nerve pain
We use stretching and strengthening exercises to improve your child’s balance, flexibility, and mobility.
We teach you and your child easier ways to perform everyday activities such as bathing, grooming, and dressing.
Foot and ankle braces, fiberglass casts, and other devices help stabilize joints and improve range of motion.
Injecting botulinum toxin (Botox) into the affected muscles can help your child relax. We typically repeat these injections every three months.
Baclofen is a medicine that relaxes the muscles. If your child’s symptoms are severe and baclofen by mouth isn’t providing enough relief, we can implant a special pump that delivers liquid baclofen directly into their spinal fluid to achieve greater effects.
This is a type of spine surgery that treats spasticity in the legs. During the procedure, we find the faulty nerves responsible for your child’s muscle stiffness and reduce their ability to overpower the good nerves. With intensive physical therapy, this allows the good nerves to grow stronger and can improve your child’s pain, mobility, and independent function. We’re one of the few medical centers in the country that offers SDR.
We’re skilled at treating bone, joint, and muscle problems caused by spasticity. For example, our orthopedic surgeons can lengthen muscles and tendons, fuse bones, and realign joints.
When we evaluate your child for spasticity, we will also look for other muscle tone disorders. If your child has dystonia, DBS might be considered. DBS involves implanting small electrodes into the brain areas that control movement.
An extra level of care and support for spasticity
As our patient, your child has access to the University of Iowa Stead Family Children’s Hospital Center for Disabilities and Development (CDD). Located in Iowa City, the center offers a wide range of medical and support services to help children with developmental challenges.
These services include:
- A disability resource library
- Patient and family education
- Physical therapy
- Occupational therapy
- Social services
Our goal is to help children with mental or physical challenges—including spasticity—lead healthy, productive, and independent lives.
Iowa’s only pediatric spasticity clinic
UI Health Care’s spasticity clinic provides convenient, one-stop access to children who could benefit from team-based care. Our clinic can help patients for whom previous spasticity treatments haven’t helped or have stopped working.
What to expect when you are referred to our spasticity clinic
Your child will need a physician referral to be seen at our spasticity clinic. Here’s what you can expect your child receives a referral:
First, we will determine if your child needs a specialized physical therapy evaluation at our Center for Disabilities and Development.
Next, we may order additional imaging (X-rays or MRI, for example), which can be scheduled prior to your child’s first session at our spasticity clinic.
Lastly, your child will be seen in our spasticity clinic.
Patient benefits of our spasticity clinic
Our physician-led clinic includes a pediatric physiatrist, neurosurgeon, and orthopedic surgeon. Although they routinely treat children with spasticity in their individual practices, they also come together to perform multispecialty assessments and treatment planning.
Comprehensive sessions at our spasticity clinic take place once a month. Here’s what they include:
- Your child will see all three specialists at the same time.
- The team will conduct a thorough evaluation, including a physical exam and medical history review.
- Together, your team will create a care plan that incorporates one or more spasticity treatments. Their recommendations will be based on several factors, including the severity of your child’s symptoms and the effectiveness of their current or previous treatments.
It’s important to note that spasticity is one type of increased muscle tone. In the spasticity clinic, we will look to see if your child has spasticity as well as another type of muscle tone called dystonia. If spasticity is not the predominant muscle tone type, or if there is a significant amount of dystonia, other treatment options will be considered.
Your child’s treatment plan is designed to be portable. If you don’t live locally, you can get certain treatments—such as physical or occupational therapy—in your own community.
But if your child needs advanced treatment such as surgery, we can promptly schedule them here at UI Health Care.