Is there treatment for post-stroke spasicity?

1 answer | Last updated: Sep 14, 2017
Jeromes asked...

I still smoke cigarettes and occasionally drink whiskey, although something happened to my body 5 1/2 years ago. MRI's did not reveal the cause of my left-side body numbness. Doctors told me it was probably a pin head sized blood clot that disappeared. The tightness in my left side, from my neck to my foot, has never left and seems to have intensified recently. Will any oral medication, Botox, ITB Therapy, Phenol or surgery stop this post-stroke spasticity-like condition? And yes, I know smoking and drinking are bad habits.

Expert Answers

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

Post-stroke spasms are generally treated with some combination of physical therapy, injections, or oral medications. Probably the easiest and most benign of these options is physical therapy. I would include under this "umbrella" such things as massage therapy and accupuncture. I have had good success with all of those for my patients.

If physical manipulations are not enough, the next step would be injections. Botox is typically the mainstay of therapy, and is best used if only a few muscles are involved. It can compliment the physical therapy quite well. It also avoids the systemic side effects that come with oral medication.

Finally, if all else fails, oral medications can be used. These are sometimes needed if there are too many muscles involved for injections to be practical. Examples of medications that I commonly use would be Baclofen or Xanaflex. They can have sedating side effects if given at too high a dose.

I would ask your doctor to refer you to a "Physiatrist", or rehab specialist, to get things started. From there, after evaluation, the above can be used in different combinations to help your symptoms.

Good luck.