Spasticity is a condition that alters the skeletal muscle, causing the sensation of pulling, tightening, or stiffness in the limb that is affected. Upper limb spasticity is a very common side affect of people who have had a stroke, spinal cord injury, traumatic brain injury, or suffer from multiple sclerosis. This condition can cause an increase in muscle tone and exaggerated jerk movements resulting in an increase in morbidity and disability. People who have been diagnosed with upper limb spasticity can display a decreased ability in performing activities of daily living.
In 2010, the Food and Drug Administration (FDA) approved the use of Botox in treating upper limb spasticity. Botox is injected into the flexor muscles of the elbow, wrist, and fingers resulting in improvements in the upper limb. Botox is the most widely studied drug on the market today. It is FDA approved for 8 therapeutic indications as well as 2 cosmetic indications.
A study performed in 2007 reported that after multiple injections of Botox in the upper limb flexor muscles, patients showed an improvement in muscle tone and reported an improvement in functional outcome.
In another study a 35-year-old woman who suffered from a stroke resulting in loss of function in her left hand gained improvement and function with the help of Botox injections. Over the span of 25 months, this woman received physical and occupational therapy, as well as with multiple injections of Botox in the muscles of her left hand and arm. Botox injections were discontinued when results were obtained and improvements reached a plateau. After 2.5 years of no longer receiving the injections, improvements of range of motion and dexterity were maintained.
Henry Winkler also know as “The Fonz” on the hit TV show Happy Days is currently the spokesperson for an organization called Open Arms. Open arms is an outreach and educational program for people who suffer from limb spasticity as well as their caregivers. Henry Winkler had a mother who suffered from a stroke and upper limb spasticity and fully supports the research and use of Botox for upper limb spasticity.
Patients who suffer from upper arm spasticity can live a debilitating, challenging and painful life. I encourage these patients to do their research and see if Botox injections can help.