Helping your patients with spasticity reach maximal function

Familiarity with spasticity and its treatment options and a rational approach to care are necessary to achieve an optimal outcome in patients with this disorder. Not all spasticity needs to be treated. Functional problems experienced by the patient and feedback from caretakers should guide decisions of whether and how to treat. Primary care physicians may benefit from maintaining close working relationships with physical medicine and rehabilitation physicians (physiatrists), who are experienced in assessment of spasticity, especially in relation to function, and can help differentiate true spasticity from rigidity and contracture. After underlying exacerbating factors are ruled out, a treatment plan starting with conservative methods and advancing to more aggressive measures should be followed. Consultation with physiatrists may be useful in regard to antispasticity medications, nerve blocks, intrathecal pumps, and postrhizotomy care.