Stroke and Spasticity in Chicago, IL
Up to 43% of people who experience a stroke may have spasticity within one year. This common and frustrating complication can cause stiffness, pain, and severe muscle tightness, disrupting daily life. If that sounds familiar, there’s new hope through advanced surgical procedures.
In her Chicago, IL, practice, elite fellowship-trained plastic and reconstructive surgeon Lindsay E. Janes offers advanced surgical solutions for people whose spasticity does not respond to medication or therapy.
Her goal is to help patients move more freely, feel more comfortable, and regain independence after a stroke.
Flexed Elbow
Bent Wrist
Pronated Forearm
Clenched Fist
Thumb in palm
Understanding Spasticity After Stroke
A stroke affects the brain’s ability to communicate with the muscles. It can cause spasticity, characterized by involuntary muscle contractions and increased muscle tone, particularly in the hands, arms, and shoulders.
Because they’re constantly active, the affected muscles become stiff, tight, or resistant to movement. People who struggle with spasticity after a stroke often have a clutched hand, rigid fingers, or other issues with their hands and arms.
Problems Spasticity Causes After Stroke
Spasticity after a stroke can cause common symptoms, including:
- Stiffness and tightness in the arms or hands
- Muscle spasms or jerking movements
- Pain when trying to stretch the fingers or open the hand
- Difficulty with fine motor tasks like dressing, hygiene, or eating
For some people, these symptoms may gradually improve with the right therapy.
For others, spasticity persists or even worsens over time. This can cause serious problems, such as contractures, in which the affected muscles, tendons, and joints permanently shorten, as well as joint deformities and a reduced quality of life.
When Is Spasticity Surgery Considered?
If nonsurgical treatments are not enough, surgery may be a helpful next step. Dr. Janes offers several surgical techniques to relieve spasticity and restore function, including hyperselective neurectomy, tendon lengthening, and joint and bone procedures.
Surgery may be considered if spasticity:
- Causes contractures or joint deformities
- Limits your ability to complete basic tasks
- Causes chronic pain
- Presents hygiene concerns
- Doesn’t improve with nonsurgical approaches
- Improves after Botox injections
It’s also important to understand that physical therapy is an integral part of recovery, so you must be able to participate in it actively to be a good candidate.
Dr. Janes carefully evaluates each patient’s goals and function. She meets with every patient personally to understand how spasticity affects their lives. She formulates a highly personalized surgical approach to match your individual needs, stage of recovery, and potential for improvement.
Dr. Janes draws upon her specialized training in nerve and reconstructive surgery to offer thoughtful, comprehensive care.
What to Expect After Spasticity Surgery
Mild to moderate discomfort is normal after surgery and typically improves within a few days. Pain is usually managed with oral medications.
Some surgeries, like neurectomy, require only a short period of soft dressing care. Others, such as tendon lengthening, may require splinting and therapy for several weeks.
Dr. Janes works closely with physical therapists and other members of your medical care team to guide your recovery and help you make meaningful functional gains to improve your quality of life in the long term.
How Spasticity Surgery Addresses Muscle Tightness
Spasticity can affect different parts of the arm in different ways, so treatment is based on which muscles are overactive and whether the joints and tendons have also become stiff. Surgery may focus on reducing excessive nerve signals, lengthening shortened tissues, or improving joint position.
Hyperselective neurectomy targets selected motor nerve branches that are contributing to excessive muscle activity. Tendon lengthening may be used when persistent tightness has shortened a tendon and restricted movement. When long-term spasticity has changed a joint’s position or stability, bone or joint procedures may also be considered.
These procedures have different goals and are not interchangeable. Dr. Janes evaluates muscle activity, joint flexibility, remaining voluntary movement, and the activities affected by spasticity before determining the best approach.
What Can Spasticity Surgery Improve?
The goal of surgery depends on how spasticity affects daily life. For some patients, surgery may improve active use of the hand or arm. For others, the priority may be reducing pain, making the hand easier to clean, improving positioning, or preventing worsening contractures.
Potential goals can include:
- Making it easier to open or position the hand
- Improving comfort when dressing or performing hygiene
- Reducing painful muscle tightness
- Improving the position of the wrist, fingers, or elbow
- Supporting more useful movement when voluntary muscle control remains
Dr. Janes discusses realistic goals before surgery so treatment is focused on changes that can meaningfully improve comfort, care, or independence.
Stroke and Spasticity FAQs
How do I know if my spasticity is severe enough for surgery?
Surgery may become an option when muscle tightness limits hygiene, causes persistent pain, interferes with daily tasks, or causes joint stiffness that therapy can’t correct. Dr. Janes evaluates how spasticity affects your movement, comfort, and independence before recommending any procedure.
Is it better to have surgery soon after a stroke or wait?
Spasticity often evolves. Many patients first try physical therapy, splinting, and medication. If muscle tightness stabilizes but continues to limit function, surgery may offer benefit. Dr. Janes considers your neurologic recovery, response to prior treatments, and current goals before recommending next steps.
Will surgery eliminate spasticity?
Surgery aims to reduce abnormal muscle overactivity and improve positioning and comfort. It doesn’t reverse the underlying brain injury. Many patients experience improved range of motion, easier hygiene, and better function, but results vary depending on the condition of the muscles and joints.
What if my hand has been clenched for years?
Long-standing tightness can lead to tendon shortening and joint stiffness. Even in chronic cases, spasticity procedures such as tendon lengthening or selective nerve surgery may improve hand position and ease of care. Dr. Janes assesses your joint mobility and muscle balance to determine realistic improvement.
Can surgery improve pain caused by spasticity?
Yes. Constant muscle contraction can strain joints and soft tissues. By reducing abnormal muscle signals or releasing tight structures, surgery may decrease discomfort and make your daily activities easier.
What role does therapy play after spasticity surgery?
Therapy plays an essential role in your recovery after surgery. Structured rehabilitation helps retrain muscles, maintain improved range of motion, and reduce the risk of recurring tightness. With consistent participation in therapy, many patients make meaningful functional gains that improve comfort, mobility, and independence over time.
Why Choose Dr. Lindsay E. Janes for Post-Stroke Spasticity Treatment?
Dr. Lindsay E. Janes brings specialized training in plastic and reconstructive surgery, hand surgery, and peripheral nerve surgery to treating complex upper extremity spasticity. She completed her plastic surgery residency at the McGaw Medical Center of Northwestern University before pursuing fellowship training in hand and peripheral nerve surgery at the University of Pennsylvania.
Her experience includes nerve reconstruction, tendon procedures, limb reconstruction, and surgical treatment for spasticity. As an Assistant Professor of Surgery at Northwestern University Feinberg School of Medicine, Dr. Janes also conducts research and surgical education related to complex reconstructive care. Treatment planning is based on how spasticity affects each patient’s comfort, movement, hygiene, and daily activities, allowing surgery to be directed toward practical, individualized goals.
Help With Post-Stroke Spasticity in Chicago, IL
If post-stroke spasticity is affecting your ability to move or care for yourself, surgical treatment may help. Dr. Lindsay E. Janes specializes in procedures that improve the quality of life for stroke survivors.
Call us today at (312) 695-6022 to schedule a consultation with a leading upper extremity surgeon in Chicago.