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Spasticity, caused by various injuries and disorders, can be a serious source of pain and discomfort for you or your child. The Spasticity Management Clinic at Mary Free Bed is focused on developing one- to two-year management plans for patients who experience a muscle control disorder because of conditions like spinal cord injury, cerebral palsy, brain injury, multiple sclerosis or stroke.

A personalized treatment plan is developed through coordination between your therapists, physicians, you and your family and your other care providers. Education and communication are an important part of what we do. We’ll make sure you understand your treatment options and what to expect as you or your family member progress through rehabilitation.

Treatment starts with a thorough evaluation from your physician and therapists, who you’ll work with on a continuing basis to determine the most appropriate path to spasticity management. This may include:

• Physical therapy with special stretching, strengthening and range-of-motion exercises
• Oral medications (such as Baclofen, Zanaflex, Dantrium and Valium, alone or in combination)
• Serial casting
• Splinting
• Functional skills training
• Orthotics consultation
• Therapeutic electrical stimulation

Intrathecal baclofen may be considered as a treatment option, with a test dose administered here at Mary Free Bed during a short-stay admission. Your physician, nurse and physical therapist will evaluate the effectiveness of the medication and monitor your reaction to it. They’ll be focused on things like your respiratory status, functional mobility and spasticity.

If you or your family member have a positive response to the medication and it is agreed to proceed, you’ll receive a referral to a neurosurgeon. This specialist will conduct the consultation and placement of the pump. Once it’s in place, the pump can be monitored on an ongoing basis for dose adjustments and refills at Mary Free Bed.

During the course of your treatment, you may see a variety of specialists:

• Physiatrist – a physician specializing in physical rehabilitation medicine will manage your medical care and direct your spasticity rehabilitation team.
• Occupational therapist – an occupational therapist will focus on upper limb movement, daily living activities and making recommendations for special adaptive equipment and splinting.
• Orthotist – a specialist with extensive experience in orthoses for spasticity management will provide expertise in customizing and fitting orthoses to help with comfort and activity.
• Physical therapist – a physical therapist will provide consultation, treatment, evaluations and hands-on therapy as appropriate for your care.
• Rehabilitation nurse – a nurse will develop and oversee your nursing care plan with a focus on self-care, comfort and education, while also collaborating with the Mary Free Bed inpatient nursing team to provide round-the-clock coverage of intrathecal baclofen issues.

Your Spasticity Clinic team works closely with your primary care or referral physician to provide you a holistic, thorough management plan.


For more information, please call:


Health care providers: click here for information about Intrathecal Baclofen Emergency Algorithms (ITB) and Autonomic Dysreflexia (SCI above T6).