Spasticity Clinic

Spasticity Clinic offers comprehensive interdisciplinary evaluation and management for patients who have difficulty with spasticity.

Spasticity is a common complication observed in patients with spinal cord and brain disorders such as stroke, multiple sclerosis, transverse myelitis, cerebral palsy, brain and spinal cord injuries and other conditions leading to upper motor neuron pathology.

Spasticity is frequently associated with pain, causes limitation of joint range of motion, contributes to development of joint contractures and pressure ulcers, and interferes with personal care, transfers and ambulation. For number of patients with severe impairments, spasticity also contributes to a significant burden of care.

Physical Medicine and Rehabilitation physicians (physiatrists) in collaboration with physical and occupational therapists assess each patient and provide recommendations and treatment to meet individual patients’ needs.

Available treatments options include:

  • Medication Management
    Antispasticity medications are carefully selected and titrated based on patient’s pre-existing medical conditions, side effect profile and therapeutic effect
  • Physical and Occupational Therapy
    Traditional physical and occupational therapy provides muscle stretching, range of motion, positioning, and exercises to improve strength and enhance functional abilities
  • Splinting
    Custom splinting and bracing complement other treatment modalities and further assist in spasticity reduction and functional improvement.
  • Botulinum Toxin Injections
    Botox-A is an effective therapy for regional spasticity. Injections are done directly into the affected muscle(s) and cause muscle relaxation and elimination/reduction of muscle spasms.
  • Intrathecal Baclofen Therapy (ITB)
    Intrathecal Baclofen therapy is one of the most effective methods of controlling spasticity of both spinal cord and brain related etiologies. It involves surgical placement of a small pump in the abdominal wall that delivers medication directly to the spinal fluid via catheter. Patients are carefully screened for this treatment to ensure that they meet the criteria for this treatment option.
  • Orthopedic Surgery
    Patients with tendon shortening and joint contractures might require surgical intervention to correct deformities resulting from spasticity and to augment the effects of other antispasticity treatments.
  • Durable Medical Equipment
    Custom wheelchairs and seating systems, as well as orthotic devices, are often recommended as a part of the interdisciplinary evaluation to prevent further musculoskeletal complications and to enhance overall function.

The Spasticity Clinic coordinates treatment plans for all patients. Outpatient and home care rehabilitative therapies are set up whenever necessary. Referrals to other specialists, such as orthopedic and plastic surgery, neurosurgery and pain management are facilitated.

Patients and their families receive a thorough explanation and education regarding spasticity management options. The Spasticity Clinic provides long term follow-up and management to ensure continuity of care and successful treatment outcomes.

Contact Information: Spacticity Clinic

The Spasticity Clinic is located at:

The Rehabilitation Institute of St. Louis
4921 Parkview Place, Suite 6C
St. Louis, MO 63110

For an appointment, please call 314-362-4503


Oksana Volshteyn, MD
Rimma Ruvinskaya, MD
Neringa Juknis, MD