Authors: Margaret Means, MD; Sonika Agarwal, MBBS, MD  
Children’s Hospital of Philadelphia 

Reviewed: September 2021 

SUMMARY

Spasticity is a term used to describe a muscle and joint condition in children. In this condition, a child’s joints are more difficult to move and bend due to tightness in the muscles. Examples of affected joints are knees, elbows, and ankles. 

Spasticity can have many different causes. They are usually related to a spinal cord or brain problem.  

Spasticity can be diagnosed by a physical exam. Usually, specialists make the diagnosis. The specialists might be: 

• Pediatric neurologists: These are children’s brain doctors. 
• Rehabilitation or therapy specialists: Therapies may include physical therapy, speech therapy, occupational therapies, and other types. These specialists treat issues related to muscle tone, movements, or postures.  

After diagnosis, a doctor may order imaging studies of the brain or spinal cord to look for a cause. Depending on the cause, children may have other signs and symptoms in addition to spasticity. 

Disorder Overview

DESCRIPTION 

Any number of different issues in the brain or spinal cord can cause spasticity. This is because our muscles are controlled by nerves. Nerves connect muscles to the spinal cord and brain. A problem at any point along a nerve pathway can lead to spasticity. Spasticity is a sign of an underlying problem in the nervous system. 

Children with spasticity may have: 

• Arms or legs that are difficult to move due to muscle tightness 
• More muscle resistance to stretching and movement 

SIGNS AND SYMPTOMS

Signs 

There are several signs of spasticity: 

Spasticity can appear: 

• Shortly after birth 
• Later in life, if a child has an injury to the nervous system  

Symptoms 

Possible symptoms include: 

CAUSES

INVESTIGATIONS 

Clinical Exams 

A diagnosis involves examining the child’s joints and muscles. A child with suspected spasticity will be referred to a child neurologist and a rehabilitation specialist. 

The neurologist will: 

• Take a complete health history, including family history, birth history, and medical/surgical history 
• Perform a physical exam 
• Recommend any further testing needed: neuroimaging, laboratory studies, genetic studies, etc. 
• Refer to other specialists as necessary 

The rehabilitation specialist will: 

• Perform an exam: assess tone, range of movement, posture and recommend therapies 
• Recommend medications for tone management 

Imaging Studies 

Doctors may order pictures of the brain and spinal cord. The pictures can show if there has been damage to these areas, causing the spasticity. The most likely type of imaging they order is magnetic resonance imaging (MRI).    

 Blood tests 

Depending on your child’s health history and their other symptoms, the doctor may order blood tests to look for possible causes. They may ask for tests to look for: 

• Infection 
• Metabolic abnormalities 
• Genetic abnormalities 

TREATMENT AND THERAPIES  

OUTLOOK

Spasticity may get progressively worse, stay the same, or get better with therapies and treatment. This will depend on its cause. 

Some children with mild spasticity do not have any issues with normal function. Others with more severe spasticity may not be able to walk on their own. They may not be able to perform daily tasks without help. Usually, the more severely affected the brain or spinal cord is by the underlying cause, the more severe the symptoms of spasticity. 

RELATED DISORDERS

Spasticity is often mentioned as a symptom of other disorders. However, just because a child has spasticity does not mean they have these disorders. Two disorders commonly associated with spasticity are: 

• Cerebral palsy. A condition related to brain development. It can have many different possible causes. Because the brain is affected, children usually have some degree of spasticity.   

• Multiple sclerosis. An autoimmune disorder affecting the nerves. It is caused by the immune system attacking parts of the brain and spinal cord. Because of this, patients often have some spasticity.  

Research 

ClinicalTrials.gov for Spasticity are clinical trials that are recruiting or will be recruiting. Updates are made daily, so you are encouraged to check back frequently.  

ClinicalTrials.gov is a database of privately and publicly funded clinical studies conducted around the world. This is a resource provided by the U.S. National Library of Medicine (NLM), which is an institute within the National Institutes of Health (NIH). Listing a study does not mean it has been evaluated by the U.S. Federal Government. Please read the NLM disclaimer for details.   

Before participating in a study, you are encouraged to talk to your health care provider and learn about the risks and potential benefits.  

The information in the CNF Child Neurology Disorder Directory is not intended to provide diagnosis, treatment, or medical advice and should not be considered a substitute for advice from a healthcare professional. Content provided is for informational purposes only.  CNF is not responsible for actions taken based on the information included on this webpage. Please consult with a physician or other healthcare professional regarding any medical or health related diagnosis or treatment options. 

Spasticity Information Page. National Institute of Neurological Disorders and Stroke. Updated March 27, 2019. https://www.ninds.nih.gov/Disorders/All-Disorders/Spasticity-Information-Page 

Spasticity. The Cleveland Clinic. Published January 28, 2019. https://my.clevelandclinic.org/health/diseases/14346-spasticity  

Swaiman KF. Swaiman’s pediatric neurology: Principles and practice. Edinburgh: Elsevier; 2018. Ch 5: Muscular tone and gait disturbances. p. 27–31. https://www.worldcat.org/title/swaimans-pediatric-neurology-principles-and-practice/oclc/993643240  

Pina-Garza JE. Fenichel’s clinical pediatric neurology. London: Elsevier Saunders; 2013. Ch 12: Paraplegia and quadriplegia. p. 253-269. https://www.worldcat.org/title/fenichels-clinical-pediatric-neurology/oclc/1036254009