Clinical management of spasticity

Physical and pharmacological treatments can reduce pain and discomfort without compromising function S pasticity is a common symptom seen in many neurological condi-tions, notably head injury, spinal cord injury, stroke, cerebral palsy, and multiple sclerosis. It is also the domi-nant feature in several rarer conditions such as tropical and hereditary spastic paraparesis. The fact that it is relevant to many chronic neurological conditions and that the absence of multidisciplin-ary input can result in progressive disability makes it an ideal model to reflect service provision In the future more long term care for such patients will be done in primary care and the community. It is therefore essential that a multidisciplinary approach is used with successful liaison between second-ary, primary, and social care. Optimum management of spasticity is dependent on an understanding of its underlying physiology, an awareness of its natural history, an appreciation of the impact on the patient, and a com-prehensive approach to minimising that impact which is both multidisciplinary and consistent over time. Regrettably, these essential requirements are rarely met; consequently, inadequately mana-ged spasticity results in a range of painful and disabling sequelae which, with the right approach, are for the most part preventable.