Difference Between Spasticity and Contracture

Spasticity and contracture are two conditions that affect muscle control and movement, often arising from neurological injuries or diseases.Spasticity and contracture, are interconnected , The increased muscle tone due to spasticity may result in loss of joint motion, leading to contracturesbut both shows distinct clinical entities requiring specific diagnostic and therapeutic approaches

Comparison Table: Spasticity vs Contracture

Below is the comparision of spasticity and contracture in the tabular fomat:

Feature Spasticity Contracture
Definition Abnormal increase in muscle tone Permanent shortening of muscle or joint
Cause CNS damage, imbalance of excitatory/inhibitory signals Prolonged spasticity, immobility, fibrosis
Pathophysiology Hyperexcitability of stretch reflex Structural changes, increased connective tissue
Clinical Features Increased muscle tone, exaggerated reflexes, spasms Limited range of motion, stiffness, deformities
Diagnosis MAS, Tardieu Scale, EMG Goniometry, physical examination, imaging
Treatment PT, medications, surgery PT, splinting/casting, surgery

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What is Spasticity?

An abnormally high level of muscle tone or stiffness is known as spasticity, and it can impair speech, mobility, and cause pain and discomfort. It is frequently linked to disorders of the central nervous system (CNS).

Causes of Spasticity

  • Neurological Disorders: Damage to the CNS, including the brain and spinal cord.
  • Multiple Sclerosis (MS): Demyelination of nerve fibers affects muscle control.
  • Cerebral Palsy: Damage to the developing brain affects movement and muscle tone.
  • Stroke: Brain injury resulting in impaired movement control.
  • Spinal Cord Injury: Disruption of nerve signals between the brain and muscles.

Symptoms

The Main symptoms of spasticity are as follows,

  • Stiffness and Tightness: Difficulty in moving limbs.
  • Increased Muscle Tone: Muscles remain contracted.
  • Pain and Discomfort: Persistent contraction can cause pain.
  • Clonus: Rapid muscle contractions in response to stretching.
  • Exaggerated Reflexes: Hyperactive reflex responses.

Treatment procedures

Physical Therapy: Exercises to improve range of motion and muscle strength.

Medications: Medicines that help in Muscle relaxants like baclofen, tizanidine, and diazepam.

Botox Injections: Botulinum toxin to reduce muscle stiffness.

Surgery : In severe cases, surgery may be necessary to release tendons or cut nerves.

 

 

What is Contracture?

A contracture is a condition characterized by the permanent shortening of muscles, tendons, or other soft tissues, resulting in restricted joint movement and deformity. It often arises from prolonged immobility, spasticity, or fibrosis of the affected tissues.

Causes

These are considered as the primary symptoms

  • Prolonged Immobility: Lack of movement leads to muscle and tendon shortening.
  • Neurological Disorders: Conditions like cerebral palsy or stroke cause muscle imbalances.
  • Spasticity: Chronic muscle stiffness from nerve damage can result in contractures.
  • Fibrosis: Formation of excess fibrous tissue in muscles.
  • Injury or Surgery: Scar tissue formation limits movement.
  • Burns: Skin and underlying tissues tighten during healing.

Symptoms

  • Limited Range of Motion: Reduced ability to move the affected joint.
  • Difficulty with Daily Activities: Challenges in performing tasks like walking or dressing.
  • Muscle Stiffness: Persistent tightness in muscles.
  • Joint Deformity: Abnormal positioning of the affected limb.
  • Pain or Discomfort: Soreness in the involved muscles or joints.
  • Visible Muscle Tightening: Noticeable shortening of muscles and tendons.

Treatment and Procedures

The treatment procedure includes a combination of physical therapy, medications,surgical procedures etc.

  • Physical Therapy: Regular stretching and strengthening exercises to improve flexibility.
  • Occupational Therapy: Techniques to enhance daily living skills.
  • Splinting and Casting: Use of braces or casts to maintain proper joint position.
  • Medications: Anti-inflammatory drugs to reduce pain and inflammation.
  • Surgical Interventions: Tendon release or lengthening procedures for severe cases.
  • Heat Therapy: Application of heat to relax muscles before stretching.
  • Electrical Stimulation: To stimulate muscle activity and improve range of motion.

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Differences and similarities between and Contracture

Differences:

  • Spasticity: Increased muscle tone due to CNS damage.
  • Contracture: Permanent muscle or tendon shortening.
  • Spasticity arises from nerve hyperexcitability while contracture is from prolonged immobility or fibrosis.
  • Spasticity often uses medications for treatment while contracture focuses on physical therapy and surgery.

Similarities:

  • Both limit movement and daily activities.
  • Often arise from neurological disorders.
  • Require multidisciplinary approaches, including physical therapy and potential surgical interventions.
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FAQ's

What is contracture?

Contracture is the permanent shortening of muscles, tendons, or other soft tissues, leading to restricted joint movement and deformity.

What causes contracture?

Contracture can be caused by prolonged immobility, spasticity, fibrosis of muscles and connective tissues, neurological disorders, injury, surgery, or burns.

What are the symptoms of contracture?

Symptoms include limited range of motion, muscle stiffness, joint deformity, pain or discomfort, difficulty with daily activities, and visible muscle tightening.

What are the common treatments for contracture?

Treatments for contracture include physical therapy, splinting and casting, medications to reduce inflammation, and surgical interventions like tendon release or lengthening procedures.

What are the common treatments for spasticity?

Treatments for spasticity include physical therapy, medications like muscle relaxants (baclofen, tizanidine), benzodiazepines (diazepam), botulinum toxin injections, and surgical interventions such as intrathecal baclofen pumps or selective dorsal rhizotomy.