Contracture Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Contractures are conditions of tissue stiffness in the body that should be flexible and easy to move.
This condition can occur in muscles, tendons (the tendons that connect muscles and bones), ligaments (tissue that attaches bones to joints), and skin. The location of the contracture usually occurs in a joint, such as a knee joint or elbow joint.
Contractures in the muscles cause the muscles to shrink and shorten. Contractures in the ligaments or tendons in the joint area cause the joints to freeze and become immovable.
Meanwhile, contractures in the skin are generally in the form of scar tissue which causes the skin to shorten and stiffen.
| Medical specialist | Specialist surgeon (orthopedic or plastic surgery), Specialist in physical medicine and medical rehabilitation |
| Symptoms | Less able to move an area of the body, limiting normal movements, difficulty moving the hands as usual, stretching the legs, and straightening the fingers |
| Diagnosis | Medical interview, thorough physical examination, x-ray examination, MRI, brain CT scan or electromyography examination. |
| Treatment | Physiotherapy, occupational therapy, use of splints and casts, drugs, surgery |
| Drug | Pain meds, botulinum injections |
| Complications | Limited range of motion that persists; Stiff muscles, joints, and skin over a long period of time |
| When to See a Doctor? | If the ability to move a body part in an area of the body is suddenly limited |
Symptoms
The main symptom of a contracture deformity is reduced ability to move certain areas of the body.
You may also experience pain, depending on the location and cause of the problem.
Contractures will limit normal movement if symptoms continue to progress and the connective tissue in the muscles that are normally pliable becomes less flexible.
Then, contractures will also limit the patient’s range of motion.
You may also find it difficult to:
- Move your hands as usual
- stretch your legs
- straighten fingers
Contractures can also occur in various areas of the body, including the:
- Muscle contractures involve shortening as well as tightening of muscles.
- If there is a joint contracture, you will experience a limited range of motion in that area of the body
- Skin organs can contract at the site of a scar, for example due to burns, injuries, surgical wounds. This will limit your ability to move the skin area.
Reason
There are several causes of contractures. However, most often it is due to a lack of movement in the area. For example, in patients with joint disorders, such as rheumatism or severe osteoarthritis.
Generally, people with this disease minimize the movement of the joint that is having problems to prevent the pain from getting worse.
This action will cause the tissue around the joint to stiffen and shorten. Joints also become difficult to move.
The same thing can also happen to patients undergoing long treatment in the hospital. Conditions that constantly demand lying down where ligaments, tendons, and/or joints can contracture.
In addition, other causes of contractures are:
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Muscular dystrophy
One of the most common types of muscular dystrophy is Duchenne muscular dystrophy. This is a genetic condition that causes muscles to shrink and have difficulty contracting.
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Cerebral palsy
This disease is a neurological disorder that occurs in infants and children, which is characterized by scissor-shaped legs and muscles in almost all parts of the body experiencing stiffness.
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Parkinson
Parkinson’s disease is a neurological disorder due to interference with dopamine in the brain which causes symptoms of tremors, muscle stiffness, and balance disorders.
Diagnosis
To ensure the presence of contractures, the doctor will first conduct a complete interview to find out the time span for the occurrence of stiffness, medical history, and so on.
After that, the doctor will carry out a thorough physical examination. The doctor will try to move the contracted part of the body and assess the degree of movement that can be done.
Furthermore, additional examinations can be carried out to assess the cause of the contracture. If a contracture is suspected to be a problem with the muscles, tendons, or ligaments, X-rays or magnetic resonance imaging (MRI) are sometimes needed.
If the contracture is suspected to be caused by a nerve disorder, a CT scan of the brain or electromyography may be required, depending on the type of nerve disorder involved.
Treatment
Treatment for contractures varies widely. The doctor will consider the severity of the contracture, its location, the disease that causes the contracture, the length of time the contracture has been experienced, and the limits on the range of motion that can be done.
Generally, several medications are taken together to speed up recovery. Treatments that can be done include:
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Physiotherapy
The type of action performed will be determined by a medical rehabilitation specialist and will be carried out by a physiotherapist.
This type of action can be in the form of stretching the muscles, warming the contracted muscles, tendons or ligaments, as well as providing sonographic waves or stimulation using electricity.
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Occupational Therapy
This therapy is generally carried out in conjunction with physiotherapy. Occupational therapy is an action to train patients to be able to carry out daily activities independently.
For example, the patient is trained to be able to stand or walk.
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Use of Splints and Casts
Splints or casts are a common treatment for fractures.
In contracture conditions, splints or casts can also be used to realign the bones, muscles, and tendons to their proper range of motion.
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Drugs
When undergoing exercises to overcome contractures, generally there will be pain. To overcome this, pain medication can be given.
If there is severe muscle stiffness, botulinum injections can be given by the doctor.
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Operation
If the contracture has occurred in the long term, treatment generally involves surgery. The operation is performed to correct the anatomy of the contracted muscles and bones.
Prevention
To prevent contractures, a person must always actively move his joints regularly, properly, and precisely.
Patients who have to undergo treatment for a long time in the hospital are advised to keep their joints moving regularly, both actively and passively.
Physical therapy, occupational therapy, and devices that passively move your joints can also help prevent problem areas from stiffening.
Regular exercise and adopting an active lifestyle can help prevent muscle and joint stiffness. If you are injured, see a doctor immediately and follow their treatment recommendations to help prevent contractures.
Complications
Delaying or ignoring treatment can make it difficult or impossible for you to regain your normal range of motion.
Stiff muscles, joints and skin can interfere with daily activities at home and at work.
For people with diseases such as cerebral palsy, muscular dystrophy, and multiple sclerosis, ongoing medical care is recommended to maximize the available treatment options and their benefits.
If you’ve been in the hospital for a long time or have been injured, it’s especially important to tell your healthcare provider about any stiffness or loss of movement you have.
When to See a Doctor?
If you have a burn or injury, seek medical help immediately. Call your healthcare provider if your ability to move the injured body part is suddenly limited.
If you have other conditions that can trigger contractures, such as rheumatoid arthritis, seek medical attention immediately. Immediate treatment can help reduce and prevent contractures.