Care and Treatment Options for Upper Limb Spasticity
If you suspect that you or a loved one is affected by upper limb spasticity, speak to a doctor right away. You may be referred to a neurologist or physiatrist specialized in this condition to have your symptoms assessed.
To determine if someone has upper limb spasticity, the doctor will identify the cause of the symptoms and muscles that are involved. Specifically, the doctor will evaluate motor function, muscle control, and how muscle stiffness and tightness may affect functional abilities. A doctor may also make a clinical evaluation of the nervous system and deep tendon reflexes.
Once diagnosed, there are several ways neurologists and physiatrists treat upper limb spasticity. Managing upper limb spasticity often involve a number of therapies, which may include:
- Physical and occupational therapy, which are important components of treatment for many people with upper limb spasticity. A physical therapist works to help you stretch your affected limbs and improve your strength and mobility. An occupational therapist works to help you achieve functional improvement so you can perform daily activities.
- BOTOX® (onabotulinumtoxinA) which was approved by the U.S. Food & Drug Administration for the treatment of increased muscle stiffness in the elbow, wrist, and finger muscles of adults with upper limb spasticity. BOTOX® neurotoxin works by blocking the signals that cause excess activity in the muscles of the elbow, wrist and fingers – the muscles that are compromised due to upper limb spasticity. BOTOX® is not a substitute for usual standard of care rehabilitation regimens. Learn more about BOTOX® for upper limb spasticity at www.botoxmedical.com or by calling 1-888-ULS-INFO.
- Oral medications, which work through the whole body to reduce muscle stiffness and pain.
- Intrathecal medications, which uses a surgically inserted pump and plastic tubing (called a catheter) to deliver medication directly into the fluid-filled area around the spinal cord.
- Surgery, which is usually only considered under special circumstances such as when upper limb spasticity goes untreated and results in contractures.
The Upper Limb Spasticity Care Team
Upper limb spasticity is usually managed by a team of health care professionals that often including neurologists, physiatrists, and physical or occupational therapists. They can help manage different components of the condition and can work with patients and their caregivers to provide a customized treatment plan that works best for individual needs.
- Neurologist: A physician who specializes in the diagnosis and treatment of disorders in the nervous system, whether caused by disease or injury.
- Physiatrist: A physician specialized in physical medicine and rehabilitation. Physiatrists aim to enhance and restore functional ability to those with physical impairments or disabilities.
- Physical therapist: A health care professional who diagnoses and treats people of all ages who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. Physical therapists use specially designed exercises and equipment to help patients regain or improve their physical abilities.
- Occupational therapist: A healthcare professional that focuses on modifying the physical environment to help maximize the independence and function of people with disabilities. Occupational therapists offer expertise on adaptive devices (e.g., wheelchairs, bath equipment), teach modifications for self-care (e.g., grooming, feeding) and advise on modifications to the home and/or workplace to enhance accessibility.
Find out how upper limb spasticity impacts people with the condition and their loved ones
"Open Arms: Raising Awareness for Upper Limb Spasticity" Educational Campaign Advocacy Partners. Sponsors of the Open Arms educational campaign do not endorse any specific treatment for upper limb spasticity
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BOTOX® is a prescription medicine that is injected into muscles and used to treat increased muscle stiffness in elbow, wrist, and finger muscles with upper limb spasticity in people 18 years and older.
It is not known whether BOTOX® is safe or effective for other types of muscle spasms.
BOTOX® may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX®:
- Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months.
- Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice (dysphonia), trouble saying words clearly (dysarthria), loss of bladder control, trouble breathing, trouble swallowing.
There has not been a confirmed serious case of spread of toxin effect away from the injection site when BOTOX® has been used at the recommended dose to treat severe underarm sweating, blepharospasm, or strabismus.
The dose of BOTOX® is not the same as, or comparable to, another botulinum toxin product.
Serious and or immediate allergic reactions have been reported. These reactions include itchy rash, swelling, and shortness of breath. Tell your doctor or get medical help right away if you experience any such symptoms, further injection of BOTOX® should be discontinued.
Do not take BOTOX® if you: are allergic to any of the ingredients in BOTOX® (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc® or Dysport®; have a skin infection at the planned injection site.
Tell your doctor about all your muscle or nerve conditions such as amyotrophic lateral sclerosis [ALS or Lou Gehrig's disease], myasthenia gravis or Lambert-Eaton syndrome as you may be at increased risk of serious side effects including severe dysphagia (difficulty swallowing) and respiratory compromise (difficulty breathing) from typical doses of BOTOX®.
Tell your doctor about all your medical conditions, including if you have: plans to have surgery; had surgery on your face; weakness of forehead muscles, such as trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (It is not known if BOTOX® can harm your unborn baby); are breast-feeding or plan to breastfeed (It is not known if BOTOX® passes into breast milk).
Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins and herbal products.
BOTOX® may cause loss of strength or general muscle weakness, or vision problems. If this happens, do not drive a car, operate machinery, or do other dangerous activities.
Other side effects of BOTOX® include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes.
For more information refer to the Medication Guide or talk with your doctor.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Please see full Product Information, including Medication Guide for BOTOX®.