Recovering from a stroke often comes with a number of physical challenges. One of the most common, and sometimes frustrating, issues is upper limb spasticity — the involuntary muscle stiffness and tightness that affects movement and function. This guide is designed to help you understand spasticity, recognise its symptoms, and explore the treatment options and strategies that can support your recovery. Whether you’re a stroke survivor or a caregiver, this practical guide offers knowledge and reassurance every step of the way.
What Is Spasticity and How Does It Affect Daily Life?
Spasticity is a condition that results from damage to the brain or spinal cord — such as from a stroke — affecting how the nerves communicate with the muscles. In people who’ve had a stroke, spasticity often affects the upper limbs, including the shoulder, elbow, wrist, and fingers.
It may feel like muscles are always tense or contracted, making movement difficult. Everyday tasks such as dressing, brushing your teeth, cooking, or picking up a cup can become frustrating or even painful.
Spasticity doesn’t just make life harder — it can also lead to joint stiffness, muscle contractures (where muscles shorten and limit joint movement), and in some cases, pain. These effects can impact independence and confidence, making it even more important to recognise the signs and seek proper support.
Identifying Symptoms and When to Seek Help
Spasticity often develops gradually, especially in the weeks or months following a stroke. Common symptoms include:
- Tight or stiff muscles in the arm or hand
- Difficulty straightening or bending the elbow
- A clenched fist that’s hard to open
- Involuntary movements or spasms
- Pain or discomfort when trying to stretch the arm
- Changes in posture due to muscle imbalance
If you’re noticing these symptoms — or if simple tasks are becoming more difficult — it’s time to talk to your rehabilitation team. Early intervention can prevent the condition from worsening and improve long-term outcomes.
Your GP, neurologist, or physiotherapist may refer you to a specialist rehabilitation service, such as My Rehab Team, where a multidisciplinary approach can help manage your symptoms effectively.
Stretching, Bracing and Everyday Strategies
Managing upper limb spasticity involves a variety of physical strategies aimed at improving flexibility, relieving tension, and maintaining function. These include:
Daily Stretching
Regular passive and active stretching of the affected arm can reduce stiffness and prevent muscles from shortening. A therapist can guide you or a family member on how to do this safely and effectively. Consistency is key — even a few minutes a day can make a big difference.
Positioning and Splinting
Keeping your arm in a proper position helps prevent contractures. Splints or braces may be used to support the wrist or hand, especially during rest or sleep. Some splints are custom-made and should be fitted by a health professional.
Use and Repetition
Using your affected arm in everyday tasks — even if it’s just to assist the stronger arm — encourages brain re-wiring, also known as neuroplasticity. Repeating movements and tasks helps retrain the brain and can slowly restore function.
Adaptive Techniques
Therapists can also teach you modified ways of doing daily tasks. For instance, using larger-handled utensils, wearing clothes with easy fasteners, or adjusting the way you hold objects can make daily life easier and less frustrating.
Medications and Injection Options Explained Simply
In some cases, physical strategies alone aren’t enough to manage spasticity. That’s where medications and targeted treatments come in.
Oral Medications
Doctors may prescribe muscle relaxants such as baclofen, tizanidine, or diazepam. These work throughout the body and can reduce overall muscle tightness. However, they can cause drowsiness or weakness, so your doctor will weigh the benefits against any side effects.
Botulinum Toxin (Botox) Injections
This is a common and effective treatment for upper limb spasticity. Botulinum toxin is injected directly into the overactive muscles, helping them relax. The effects usually begin within a week and can last for 3–4 months.
Injections are often done under ultrasound or electrical guidance to ensure precision, and they can be repeated as needed. They’re usually combined with therapy to make the most of the improved muscle tone.
Phenol Nerve Blocks
In some cases, a phenol injection may be used to block nerve signals to specific muscles. It can be useful for more severe cases, but it’s less commonly used than Botox.
Every treatment has its place, and the right approach depends on your symptoms, goals, and overall health. Your rehabilitation team will work closely with you to find the best fit.
Setting Realistic Goals for Recovery
One of the most important aspects of stroke recovery — especially when managing spasticity — is setting realistic, meaningful goals.
Recovery from upper limb spasticity isn’t always about getting your arm back to what it was before the stroke. Sometimes, success is measured in being able to hold a toothbrush, use your hand to stabilise an object, or reduce the pain that interferes with sleep.
Work with your rehabilitation team to set SMART goals — Specific, Measurable, Achievable, Relevant, and Timely. For example:
In four weeks, I want to be able to stretch my arm with less pain.
I want to wear my splint for 6 hours each day to prevent finger tightness.
By next month, I’d like to use my affected hand to assist with eating.
These small, achievable goals help maintain motivation and give you clear markers of progress. They also help your therapists adjust your treatment plan to keep you moving forward.
How My Rehab Team Can Help
At My Rehab Team, we understand that spasticity can feel overwhelming — but you’re not alone. Our Brisbane-based neurological rehab professionals provide in-home and community-based services to support stroke survivors with tailored treatment plans.
Whether you need guidance on stretching routines, help with splinting, or advice on injection treatments, we’re here to help you work towards improved comfort, mobility, and independence.
We believe recovery is personal. That’s why we combine clinical expertise with compassion and encouragement, every step of the way.
Final Thoughts
Spasticity after a stroke doesn’t have to mean the end of independence or comfort. With the right mix of therapy, medical support, and personal effort, it’s possible to manage symptoms and regain meaningful function. Recovery isn’t always a straight path — but with the right support, every step forward counts.
If you or someone you care about is living with upper limb spasticity post-stroke, reach out to My Rehab Team today. We’re ready to support your journey towards recovery — one step, one stretch, and one goal at a time.
We believe recovery is personal. That’s why we combine clinical expertise with compassion and encouragement, every step of the way.
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