Spasticity Clinic

Spasticity refers to muscles that are stiff, rigid or unusually tight. This can interfere with a child’s functional abilities such as walking, movement and speech. At CHOC, we have years of experience treating spasticity with a host of treatment options, including medication, injections, orthotics and surgery. Our Spasticity Clinic is the only program of its kind in Orange County, providing multispecialty evaluation and medical management of the condition. Our orthopaedic specialists work closely with other CHOC experts, including neurologists and neurosurgeons, as well as a child’s pediatrician and family to oversee a comprehensive treatment plan. The clinic is led by Dr. Samuel Rosenfeld, a nationally recognized expert in pediatric neuromuscular diseases.

What is spasticity?

Spasticity can affect one extremity or all of them, one side of the body or both, or the entire body. If not treated, the increased contraction of a muscle may cause it shorten over time, and the spasticity will likely get worse. Spasticity may occur on its own or as a result of other conditions, including:

• Cerebral palsy
• Congenital brain deformities
• Traumatic brain injuries
• Hypoxic encephalopathy
• Spinal cord injuries
• Intra-uterine stroke
• Brain tumors
• Encephalitis and meningitis

Protecting a Child’s Bones

Children with spasticity are often deficient in calcium and vitamin D, which can result in bone loss. To prevent future pain and osteoarthritis, a supplement may be an important part of spasticity treatment. Read our recommendations for calcium and vitamin D supplements.

How is spasticity treated?

Every patient responds differently to treatments for spasticity. Our specialists bring advanced knowledge in knowing which treatment will work best for each child, depending on his or her unique symptoms. Treatments include:

• Muscle relaxer medications
• Intrathecal baclofen pump. An intrathecal baclofen pump delivers muscle relaxant straight to the spinal cord. It is an option for children who experience excessive sleepiness from taking baclofen orally. We have one of the largest intrathecal baclofen pump programs in the country, with many children showing improvement in muscle contraction, walking, bowel and bladder problems, speech and daily living activities.
• Botox® injections. These injections, also called Myobloc®, are effective for some children with spasticity and can be an alternative to wearing a brace. Our orthopaedic team was among the first in the world to research the effectiveness of Botox® for children with spasticity and continues to be a leader in this innovative treatment. Regular injections are performed during an office visit, and our child life specialists are available to provide comfort and distraction during the procedure as needed.
• Casts and braces.  Learn more about casting.
• Physical therapy and occupational therapy. Learn more about therapy services at CHOC.
• Surgery. This includes selective dorsal rhizotomy, tendon transfers, neurectomies and joint stabilization

Contact Us

For more information or to contact the Spasticity Clinic, call the Orthopaedic Institute at (888) 770-2462 and press 2 for specialty care clinics.