Spasticity of the extremities is due to degeneration of the upper motor neurons and it can be clinically severe. Spasticity makes the muscles tight and rigid, due to a loss of the inhibition of the spinal reflexes due to loss of upper motor neuron control.

When spasticity is severe it may get in the way of daily activities, sleep patterns, and caregiving. It can also be a threat to patient’s safety as a result of falls. In most cases, spasticity can be effectively relieved by appropriate medication. The medication has to be slowly titrated since a moderate degree of spasticity is usually better for mobility than a fully flaccid limb.

Baclofen, an antispasmodic, is the most widely used drug. This medication is available in two different forms. One is in pill form where large doses are taken, but only a small amount actually reaches the site of action at the spinal cord. The other form is via an implanted intrathecal pump. The baclofen intrathecal therapy is a unique treatment that delivers the medication in small doses directly to the fluid surrounding the spinal cord using a pump that is placed internally by a surgical procedure, usually under the skin of the abdomen. The medication can last up to 90 days, depending on the dose given. Refills are done every 6 to 12 weeks, using a convenient external procedure.