New Hope for the Treatment of Upper Limb Spasticity

Treating stroke as soon as possible can greatly decrease the effect it has on a person, but the detrimental health effects of a stroke can occur long after the actual event. One of these effects, upper limb spasticity, can occur weeks, months or even years after a stroke and greatly affect a stroke survivor’s quality of life. Patients no long have to suffer; there are now treatment options to help them live better and more active lives.

What Is Upper Limb Spasticity?

People with upper limb spasticity may have rotated shoulders, flexed elbows and wrists and clenched fists. Arms are forced up against the body and uncontrollable muscle movements or spasms occur at inopportune moments. The muscles in the elbow, wrist and fingers are uncomfortably tight and stiff.

While not life threatening, upper limb spasticity greatly diminishes a person’s quality of life and makes the simplest of tasks, such as getting dressed or putting on deodorant, nearly impossible. Trying to straighten the muscles in the elbow, wrist and fingers can be very difficult.

Actor Henry Winkler co-presented at an upper limb spasticity educational and awareness event at Wake Forest Baptist Health in September 2011. Winkler’s mother suffered from upper limb spasticity for many years after her stroke in 1989. He is now the spokesperson for Open Arms, an outreach and education organization for sufferers of upper limb spasticity and their caregivers.

“I watched [my mother’s] life come to a grinding halt,” said Winkler, “not only because she had a stroke, but because all of the work she was doing [to treat her symptoms] didn’t seem to bring her any further forward.”

We Can Treat Upper Limb Spasticity

An estimated 1 million Americans suffer from upper limb spasticity. The condition most commonly occurs after a stroke, but also occurs after spinal cord or traumatic brain injury or in adults with multiple sclerosis (MS) or cerebral palsy. Because of this lengthy period of time between a stroke and the start of upper limb spasticity symptoms, many people don’t realize they have the condition and don’t seek treatment that could help.

Today, there is not much public awareness of this debilitating condition or its treatments, but people with upper limb spasticity don’t need to suffer anymore. Treatment options are available.

“There is now extraordinary work that is done [and] extraordinary knowledge now about what it is to have a stroke,” said Winkler. “I know for a fact that if my mother knew [the current treatment] existed …, it would have changed her life.”

Clinicians and researchers at Wake Forest Baptist Health and other hospitals now have a range of new clinical and therapeutic options to treat and manage upper limb spasticity. One of the key, and most successful, treatment options is the use of Botox® to treat muscle stiffness in patients’ wrist, elbow and finger muscles. Other treatment options include physical and occupational therapy, oral medications, medications delivered by a catheter and, in some cases, surgery.

 “We try to design things to be very patient oriented and outcomes oriented,” said Dr. Allison Brashear, professor and chair of Wake Forest Baptist’s department of neurology, and co-presenter of the educational event. Doctors at Wake Forest Baptist Health use individualized therapies and evaluate patients to come up with the best possible single or combination therapy, including the use of Botox®.”

• Watch a video from the upper limb spasticity educational event at Wake Forest Baptist Health.
• Learn more about the symptoms of and treatment for spasticity (link to Health Encyclopedia).
• Read about the comprehensive stroke services available at Wake Forest Baptist Health. 
• Dr. Allison Brashear and other doctors at Wake Forest Baptist Health’s Department of Neurology are leading the way in the treatment of stroke and other neurological conditions in western North Carolina. Visit the Department of Neurology’s website.
• Visit the website of Open Arms, an organization dedicated to raising awareness about upper limb spasticity.