Is Everyday Life With HSP Manageable? Stairs, Driving, Work and Pacing Strategies

The first thing Daniel noticed was not pain. It was the third step of the staircase at his parents’ house, the one he had taken two at a time for thirty years, suddenly asking for a hand on the rail. His toes caught the edge. A few months later his running shoes were wearing through at the front, and a neurologist was explaining a diagnosis he had never heard of.

Questions about daily life with HSP rarely start with genetics. They start with a staircase, a long shift on a hard floor, a motorway journey where the right foot will not relax off the accelerator, or a wedding where standing for the photographs feels like a marathon. People want to know whether the ordinary shape of their day can survive the diagnosis.

The honest answer is that it usually can, with adjustments that are practical rather than dramatic. This explainer walks through what the condition does to the body, what helps on stairs, behind the wheel and at work, and how to pace a body that tires and stiffens in ways other people cannot see.

What is HSP, and why do the legs feel stiff before they feel weak?

Hereditary spastic paraplegia is a group of inherited conditions in which the longest nerve fibers of the spinal cord slowly lose function. Those fibers, called the corticospinal tracts, carry movement commands from the brain to the legs. Because they are the longest wiring in the body, they are the most vulnerable to a fault in the proteins that keep nerve cells supplied and healthy. According to the NIH’s National Institute of Neurological Disorders and Stroke (NINDS), more than 80 different genetic forms have been identified, which is why two people with “HSP” can have quite different experiences.

The hallmark is spasticity: muscles that stay partly switched on because the brain’s calming signal no longer reaches them cleanly. Spasticity is a velocity-dependent increase in muscle tone; in plain language, the faster you try to move a limb, the more it resists. That is why the first sign is often stiffness, tripping or a scuffed shoe toe rather than obvious weakness. Weakness usually follows, mainly in the hips and ankles, together with brisk reflexes and, for many people, urinary urgency.

In the “pure” form, symptoms stay largely in the legs and bladder. In “complicated” forms, other features such as balance problems, altered sensation or cognitive changes can appear. NINDS notes that symptoms can start at any age, from early childhood to late adulthood, and that progression is typically slow, measured in years rather than months. The most common inherited pattern is autosomal dominant, where one altered gene copy is enough, and MedlinePlus Genetics reports that a single gene, SPAST (type SPG4), accounts for roughly 40 percent of those dominant cases.

Knowing the mechanism matters for daily life. Spastic muscles shorten if they are never lengthened, so stretching is not a nicety but part of keeping the range of motion you already have.

Is daily life with HSP manageable? What the evidence honestly says

Manageable is not the same as unchanged. The NHS describes HSP as a condition that gets gradually worse over time but does not usually shorten life expectancy, and that most people remain able to walk, sometimes with aids, for many years. NINDS puts it similarly: the course is highly variable, some people need a cane, walker or wheelchair eventually, while others never do. No reputable source can tell you in advance which group you will be in, and any article that promises otherwise is guessing.

What the evidence does support is that the day-to-day burden depends heavily on three modifiable things: how much joint range you preserve through stretching and physiotherapy, how early you adopt aids that reduce falls and fatigue, and how well you match your energy to your commitments. None of these change the underlying genetics. All of them change what a Tuesday feels like.

It also helps to separate the condition from the fear of the condition. Many people spend the first year after diagnosis mentally rehearsing a wheelchair that may be decades away or may never arrive, while neglecting the calf stretch that would help this week. An opinion, grounded in what rehabilitation teams consistently report: the people who adapt best tend to treat HSP as a management project with a long horizon, reviewing what works every six to twelve months rather than reacting to each bad day.

Finally, manageable does not mean solo. Occupational therapists, physiotherapists, continence nurses, driving assessors and workplace advisors exist precisely for the questions in this article. Asking for them early is a sign of planning, not decline.

Stairs with HSP: what helps and what tends to backfire

Stairs expose the two core problems of HSP at once: the foot does not clear the step because the ankle will not flex up, and the hip muscles that lift the leg are working against stiff resistance. Going up demands strength; coming down demands controlled lengthening of the calf and quadriceps, which spastic muscles do poorly. Most people find descending harder than climbing.

Practical adjustments that physiotherapists and occupational therapists commonly teach include:

• Lead with the stronger leg going up and the weaker leg coming down, one step at a time when needed. The old rhyme “up with the good, down with the bad” exists for a reason.
• Use a rail on both sides if possible; a second rail is one of the highest-value home adaptations because it lets you distribute load rather than lean.
• Pause on landings deliberately, not only when tired. Spasticity increases with fatigue, so stiffness late in a climb is predictable.
• Wear the same supportive footwear indoors as out; socks on wood or laminate turn a foot-clearance problem into a fall.
• Ask about an ankle-foot orthosis (AFO), a lightweight brace worn inside the shoe that holds the foot at a right angle so the toes clear the step.

What tends to backfire: rushing because someone is behind you, carrying loads in both hands, and skipping the rail out of pride. Long flights done quickly leave many people with cramping and worse stiffness for hours afterward. If your home has stairs you must use daily, an occupational therapy home visit can look at rails, step lighting, a half-landing chair or, if needed, a stair lift. The NHS lists these adaptations among the standard supports for HSP, and they are decisions to make while stairs are still possible, not after a fall.

Driving with hereditary spastic paraplegia: safety, assessments and adaptations

Driving worries people more than almost anything else, because it stands for independence. The medical concern is specific: spasticity can make it hard to move the foot quickly between accelerator and brake, a sustained spasm can press a pedal unintentionally, and fatigue late in a journey slows reaction time. Bladder urgency adds its own distraction on a long drive.

None of that means you must stop. It means the question deserves a formal answer rather than a private worry. In many countries, including the United Kingdom and the United States, drivers are legally required to notify the licensing authority of a medical condition that could affect safe control of a vehicle, and rules differ by jurisdiction, so check the requirement where you live. An independent driving assessment, usually run by occupational therapists with a specially adapted car, tests reaction time, pedal control and transfers, then recommends adaptations if needed.

Common adaptations include hand controls that move accelerator and brake to a lever, a left-foot accelerator, automatic transmission, a steering knob, and swivel seats to make getting in and out easier. Many people with early HSP simply switch to an automatic and plan breaks. Others move to hand controls years before they need a walking aid, because hand controls remove the pedal problem entirely rather than working around it.

A few everyday habits also matter: stretch calves and hamstrings before a long drive, break journeys every hour or so if stiffness builds, and never drive when a new spasticity medicine has just been started or changed, because drowsiness is a recognized side effect of several classes, according to Cleveland Clinic’s overview of spasticity treatments. The final say on fitness to drive sits with your neurologist and the licensing authority, and it is a conversation worth having before it becomes urgent.

Work and HSP: energy budgeting, accommodations and the honest conversation

Most people with HSP keep working for many years; the question is how the job needs to bend. The physical demands that cause trouble are predictable: prolonged standing, walking long corridors, carrying items while walking, stairs without rails, and shifts long enough that fatigue-driven spasticity sets in. Desk-based work brings the opposite problem, sitting for hours so that hip flexors and hamstrings shorten and the first steps after a meeting are alarmingly stiff.

Reasonable accommodations are a legal entitlement in many countries, including under the Americans with Disabilities Act in the United States and the Equality Act in the United Kingdom. Commonly requested adjustments include a parking space near the entrance, a desk close to restrooms (urgency is common), a sit-stand desk, permission to take short movement breaks, flexible start times on bad days, a trolley instead of carrying, and remote working for part of the week. Occupational health services can document what is needed so the request is not a negotiation between you and a manager who has never heard of the condition.

The honest conversation is the part people postpone. You do not owe colleagues a genetics lecture, but a short, factual disclosure to the right person usually works better than years of hiding a limp and declining site visits. A useful script: name the condition, state that it affects walking and stamina, describe the two or three adjustments that would help, and say what you can still fully do.

Think in terms of an energy budget rather than hours. A day with a long walk from the parking lot, a stair-only meeting room and a late finish can cost more than a longer day at a well-set-up desk. Tracking which days leave you stiff the next morning, for a month or so, often reveals the fixable pattern.

Pacing strategies for HSP fatigue and spasticity

Fatigue in HSP has a mechanical explanation. Walking with stiff legs uses far more energy per step than normal walking, because the muscles are fighting themselves as well as gravity. The NHS lists fatigue among the common symptoms, and people often describe a ceiling: below it, they function; above it, spasticity, cramps and clumsiness escalate for the rest of the day and sometimes the next.

Pacing means spending energy on purpose. The strategies rehabilitation teams most often teach are simple and, done consistently, effective:

• Split tasks. Two fifteen-minute walks are cheaper than one thirty-minute walk, because stiffness rises steeply once fatigue sets in.
• Front-load the day. Many people are loosest mid-morning after moving around and stiffest at night, so schedule walking-heavy tasks earlier.
• Sit for what can be sat for. Ironing, showering (with a shower seat), cooking prep and phone calls do not need standing.
• Plan recovery, not just activity. A short lie-down with legs stretched out after a demanding outing prevents the evening spasm cycle better than pushing through.
• Keep warm. Cold reliably worsens spasticity; layered clothing and warm-ups before activity are not fussiness.
• Schedule stretching like a medicine, twice daily, rather than “when I remember.”

Pacing is not the same as resting more. Too little activity shortens muscles and weakens the hip and trunk muscles you rely on, and NINDS emphasizes regular physical therapy and exercise to maintain strength and range of motion. The goal is a steady, sustainable level of movement, adjusted upward slowly rather than in bursts followed by crashes.

One more piece of honesty: pacing means saying no to some things. Choosing the wedding over the stag weekend, or the school play over the shopping trip, is not giving in. It is budgeting for what you actually value.

Who is usually referred for treatment now, and who is asked to wait and watch?

HSP does not have a treatment that alters the underlying nerve degeneration, so “treatment” means managing spasticity, weakness, bladder symptoms and their consequences. Who gets which intervention, and when, follows the pattern of the symptoms rather than the name of the gene.

People are usually referred promptly for physiotherapy and occupational therapy at diagnosis, whatever the severity, because stretching and gait advice have the greatest value while joints are still fully mobile. A referral for orthotics assessment (braces and footwear) is typical once foot clearance becomes a problem or trips begin. A continence service referral is offered when bladder urgency or frequency affects daily life. Genetic counseling is normally offered to anyone with a confirmed or suspected inherited form, particularly those considering children, because the pattern of inheritance shapes the conversation for relatives.

Medicines for spasticity are generally considered when stiffness interferes with function or comfort rather than at the first sign of brisk reflexes. Someone whose main complaint is a slight limp with no pain or falls is often asked to continue stretching and review in six to twelve months, because these medicines all have side effects, and, importantly, some spasticity is useful: a stiff leg can bear weight where a weak, floppy one cannot. Reducing tone too aggressively can make walking worse.

People with rapid change over weeks, pain out of proportion, or new symptoms outside the legs are usually seen sooner, partly to manage them and partly to check that something else is not being missed. Referral thresholds vary between health systems, and your neurologist decides the pathway; the useful thing to know is that being asked to wait is usually a judgment that watching costs less than intervening, not that nothing can be done.

Living with spastic paraplegia: physiotherapy, stretching and the right walking aid

If there is a backbone to everyday management, it is physiotherapy. NINDS and the NHS both put it first, and the reason is mechanical: muscles that are always partly contracted shorten over months, and shortened muscles turn stiffness into fixed contracture, which no medicine reverses. Daily stretching of calves, hamstrings, hip flexors and adductors (inner thigh) preserves the range you need for stairs, sitting in a car and standing upright.

Beyond stretching, physiotherapists work on hip and trunk strength, balance, and gait patterns that reduce tripping. Water-based exercise is popular because warm water reduces tone and supports body weight. Walking aids are introduced not as a surrender but as a tool that lowers fall risk and energy cost, and the right one changes over time.

Aid	Best suited when	Trade-offs
Ankle-foot orthosis (AFO)	Toes catch on steps or ground; ankle will not flex up	Needs roomier shoes; must be fitted and reviewed
Walking poles or a single cane	Mild imbalance, fatigue on longer walks	Occupies a hand; technique matters
Rollator (wheeled walker with seat)	Fatigue limits distance; falls or near-falls	Bulky on stairs and in small homes
Mobility scooter or wheelchair for distance	Outings limited by stamina rather than by the first steps	Storage, transport; must be paired with continued walking and stretching

Many people use several at once: an AFO every day, poles for the weekend walk, a scooter for the airport. The common mistake is delaying each aid until after the fall that makes it unavoidable. The NHS and NINDS both describe this layered approach; your physiotherapist and occupational therapist match the tool to the task.

HSP spasticity treatment: how the medicines work and who decides

Several medicine classes are used to reduce spasticity, and understanding what each does makes the conversation with your neurologist more productive. None of them slow the condition; they change how much the muscles resist movement.

Oral muscle relaxants such as baclofen act on the spinal cord to dampen the overactive reflex loops that keep muscles tense. Tizanidine works through a different receptor system with a similar end result. Both are typically started low and adjusted over weeks by the prescriber, and both can cause drowsiness and weakness, which is why the balance between looser muscles and legs that still hold you up has to be judged individually. Cleveland Clinic’s spasticity overview lists these effects, along with the point that stopping some of these medicines abruptly can be dangerous, so any change is made with the prescriber.

Botulinum toxin injections target specific overactive muscles, most often the calves or inner thighs, by blocking the nerve signal at the muscle for a limited period. Effects typically build over a couple of weeks and wear off over roughly three to four months, according to Cleveland Clinic, so injections are repeated in cycles, usually combined with stretching or casting to gain range while the muscle is relaxed.

For severe spasticity that oral medicines cannot control, an implanted pump delivering baclofen directly into the spinal fluid is an option some centers offer; it involves surgery and ongoing refills, so it is reserved for a minority.

Bladder urgency is often treated separately with medicines that relax the bladder muscle, alongside timed voiding and pelvic floor advice from a continence service. The principle across all of these: the aim is function you can feel on stairs and at work, not a number on a tone scale, and the decision to start, adjust or stop always sits with the prescribing clinician.

Hereditary spastic paraplegia symptoms nobody warns you about: bladder, feet, sleep and mood

Textbooks lead with the legs, but the questions that fill neurology clinic time are often about everything else.

Bladder urgency, the sudden need to go with little warning, affects a large proportion of people with HSP because the same spinal pathways help control the bladder. It shapes daily life more than many people admit: choosing aisle seats, mapping restrooms, avoiding long drives. It is treatable, and a continence service can offer timed voiding, pelvic floor training, medicines and, where needed, further assessment. Ignoring it risks infections and falls from rushing.

Feet take a beating. Spastic calves pull the foot into a pointed position, toes may curl, and high arches are common, so shoes wear unevenly and pressure points form. A podiatrist can help with footwear, insoles and skin care, and any sore that does not heal deserves attention, because reduced sensation in some forms means you may not feel it.

Sleep is disturbed by nighttime cramps and spasms, particularly after an overexerted day, and by bladder trips. Evening stretching, a warm bath and keeping legs warm in bed help some people; persistent night spasms are a reason to review medicines with the prescriber rather than to endure.

Mood matters and is under-discussed. Living with a slowly progressive condition, an uncertain trajectory and a body that other people do not read as disabled is a real psychological load. Low mood and anxiety are common in long-term neurological conditions generally, and asking for psychological support is as legitimate as asking for an AFO. Peer support groups for HSP, of which there are several long-established charities, offer something clinicians cannot: people who already know what the third stair feels like.

What the first weeks and months after an HSP diagnosis usually look like

Diagnosis often arrives after a long road, because the early symptoms are easy to attribute to tight muscles or a back problem. Once HSP is confirmed, usually by clinical examination plus genetic testing and scans to rule out other causes, a typical early pathway looks like this, though health systems vary.

In the first few weeks, expect a follow-up appointment to go through the results, including whether a specific gene was identified and what that means for relatives. Genetic counseling is normally offered around this time. Many people describe this phase as oddly quiet: nothing physical has changed, but the story of the symptoms has.

Over the following one to three months, referrals usually land: physiotherapy for an assessment and a home stretching program, occupational therapy if home or work adjustments are needed, orthotics if foot clearance is a problem, and a continence service if the bladder is troublesome. The physiotherapy assessment is the most useful appointment to prepare for; bring your shoes, describe your worst surface and your worst time of day.

By six to twelve months, most people have a routine: stretches morning and evening, a review schedule with neurology (often annually for slowly changing forms, per NHS guidance that describes long-term follow-up), and a clearer sense of their own energy ceiling. This is also when driving notification and any workplace adjustments are usually sorted.

Nothing about this timeline is a promise; it is the common shape. Progression in HSP is measured over years, and NINDS stresses how much it varies between individuals and even within families. The first year is less about the legs than about building the team and the habits you will lean on for a long time.

What people often get wrong about HSP

“HSP means highly sensitive person.” The acronym collides badly online. Searches for HSP return pages about a personality trait involving sensitivity to noise, criticism and other people’s moods, a self-described trait rather than a medical diagnosis. It has nothing to do with hereditary spastic paraplegia, and HSP is also used for a childhood blood vessel condition, Henoch-Schönlein purpura, now called IgA vasculitis. If you are reading advice about “overstimulation” and “gentle living” while your neurologist is talking about corticospinal tracts, you are on the wrong page.

“It will put me in a wheelchair by fifty.” NINDS and the NHS both describe wide variability; some people never need one, others do, and neither age of onset nor family history predicts it reliably.

“If I rest, I will slow it down.” The opposite is closer to the truth. Rest does not change the nerve degeneration, but inactivity shortens muscles and weakens the hip and trunk strength that keeps you walking.

“Stronger medicine means better walking.” Some spasticity supports weight-bearing. Over-relaxing the legs can make them buckle. Dose decisions are about function, not about abolishing stiffness.

“Because it is genetic, my children will definitely get it.” Inheritance depends on the type. In autosomal dominant forms each child has a 50 percent chance of inheriting the altered gene, according to MedlinePlus Genetics; recessive and X-linked forms follow different rules, and even those who inherit it can have very different severity. Genetic counseling exists for exactly this question.

“It is just tight calves.” Stretching helps, but HSP is a spinal cord condition; a diagnosis matters for driving, work, family planning and access to the right services.

Questions to ask your care team about daily life with HSP

Appointments are short and the questions that matter are rarely the ones on the leaflet. Taking a written list changes what you leave with. Consider asking:

• Which type of HSP do I have, and how confident is that? Has a specific gene been identified, and what does it mean for my relatives?
• What should my daily stretching program include, and how will I know it is working?
• Would an ankle-foot orthosis help me now, and who fits and reviews it?
• Am I safe to drive? Do I need to notify the licensing authority, and would a formal driving assessment be useful?
• What work adjustments would you support in a letter to my employer or occupational health?
• Is my bladder urgency something you can refer me for now?
• If we start a spasticity medicine, what should improve, what side effects should I watch for, and how long before we judge it?
• Which of my symptoms would make you want to see me sooner than the next scheduled review?
• Are there exercise types I should avoid, and any I should prioritize?
• Is there a specialist HSP or spasticity clinic, physiotherapy service or patient organization you would suggest?
• What is the plan for review, and who do I contact between appointments?

It also helps to bring one concrete example of a bad day and one of a good day: what you did, how you felt that evening and the next morning. Clinicians can do more with “stairs at work plus a supermarket trip left me cramping until midnight” than with “I get tired.” If a partner or friend comes with you, ask them to note what the clinician recommends, because it is hard to listen and remember at the same time.

When to call your doctor

HSP changes slowly, so anything that changes quickly deserves a call rather than a wait for the next annual review. Contact your neurology team or family doctor promptly if you notice:

• A clear worsening of walking, stiffness or weakness over days or a few weeks rather than months.
• New symptoms outside the legs: arm weakness or clumsiness, slurred speech, swallowing difficulty, double vision or new numbness.
• New or worsening loss of bladder or bowel control, difficulty emptying the bladder, or pain and fever suggesting a urinary infection.
• Back pain with new weakness or numbness, especially after a fall.
• A fall causing head injury, or repeated falls where before there were none.
• A foot sore or wound that is not healing, or an area of redness and warmth over a pressure point.
• Sudden severe spasms, confusion, high temperature or agitation after a spasticity medicine has been missed or stopped, which can signal withdrawal and needs urgent assessment.
• Excessive drowsiness, dizziness or new falls after a medicine has been started or adjusted.
• Low mood that persists, or thoughts of harming yourself.

Seek emergency care immediately for sudden loss of leg function, new incontinence with back pain or numbness around the genitals and buttocks, chest pain, breathing difficulty, or a swollen, painful calf, which can indicate a blood clot in people who move less than they used to.

Between those extremes sits the ordinary question of whether something is “HSP or something else.” A useful rule from NINDS and NHS guidance: HSP itself progresses gradually and mostly affects the legs and bladder. Anything abrupt, painful, one-sided or above the waist should be checked, because people with HSP can still develop unrelated problems, and some of those are treatable in a way HSP is not. Your treating team decides what needs to be seen and how quickly.

Frequently asked questions

Is HSP the same as being a highly sensitive person?

No. In neurology, HSP means hereditary spastic paraplegia, an inherited spinal cord condition causing leg stiffness and weakness. “Highly sensitive person” is a personality trait describing strong reactions to noise, criticism and others’ emotions; it is not a medical diagnosis. The shared acronym causes real confusion in search results. If your doctor has diagnosed HSP, information about overstimulation or emotional sensitivity does not apply to your condition.

What are the main hereditary spastic paraplegia symptoms in everyday life?

The most common are progressive stiffness and weakness in the legs, tripping because the toes catch, a stiff or scissoring walk, muscle cramps, fatigue on walking, and urinary urgency. In pure forms symptoms stay mostly in the legs and bladder; complicated forms may add balance, sensory or cognitive changes. Symptoms can begin at any age and typically progress slowly over years, with wide variation between individuals.

Can HSP cause anxiety or low mood?

Yes, indirectly. Living with a slowly progressive, unpredictable condition that others often cannot see is a recognized source of anxiety and low mood, as with many long-term neurological conditions. HSP itself does not usually affect the brain’s mood circuits in pure forms. Persistent worry, sleep disturbance or low mood are worth raising with your care team, who can offer psychological support alongside physical management.

Will I end up in a wheelchair with HSP?

Not necessarily. NINDS and the NHS both describe the course as highly variable: some people need a cane, walker or wheelchair eventually, and others walk unaided for life. Neither age of onset nor family history reliably predicts this. Many people use a wheelchair or scooter only for long distances while continuing to walk at home. Your neurologist can discuss what your pattern so far suggests.

What HSP walking aids are usually suggested first?

An ankle-foot orthosis is often the first aid, because catching toes is an early problem and the brace holds the foot at a right angle so it clears the ground. Walking poles or a single cane commonly follow for balance and fatigue on longer walks. A rollator with a seat helps when stamina limits distance. Physiotherapists and orthotists match the aid to the task, and most people layer several.

Can I keep driving with HSP?

Often, yes, sometimes with adaptations. The concern is slowed or unreliable pedal control from stiff legs and fatigue. In many countries you must notify the licensing authority of the diagnosis. A formal driving assessment by specialist occupational therapists can test reaction time and recommend changes such as an automatic transmission, left-foot accelerator or hand controls. Decisions on fitness to drive rest with your neurologist and the licensing authority.

What is the usual HSP spasticity treatment?

Management starts with daily stretching and physiotherapy to preserve range of motion. When stiffness limits function or comfort, neurologists may consider oral muscle relaxants such as baclofen or tizanidine, or botulinum toxin injections into specific muscles, whose effect lasts roughly three to four months. Severe cases may be offered an implanted baclofen pump. None slow the condition, and the prescribing clinician makes and adjusts every decision.

Does exercise make HSP worse?

No; inactivity is the bigger risk. Regular stretching and moderate strengthening help maintain range of motion and the hip and trunk strength needed for walking, and NINDS recommends ongoing physical therapy. What does cause trouble is unpaced exertion, which increases spasticity and cramps for hours afterward. Water-based exercise, cycling and split sessions are commonly better tolerated than long, fast walks. A physiotherapist can tailor a program.

Why is bladder urgency common in HSP?

The spinal pathways affected in HSP also carry signals that control the bladder, so the bladder muscle can become overactive, producing sudden urges with little warning and sometimes frequency or incomplete emptying. It is one of the most common non-leg symptoms and is treatable through timed voiding, pelvic floor training and bladder-relaxing medicines from a continence service. Untreated, it raises the risk of infections and rushed falls.

Will my children inherit HSP?

It depends on the type. In autosomal dominant forms, the most common pattern, each child has a 50 percent chance of inheriting the altered gene, though severity varies widely even within families. Recessive and X-linked forms follow different rules. Genetic counseling, usually offered at diagnosis, explains your specific inheritance pattern, testing options for relatives and reproductive choices without pressure in either direction.

References

• Hereditary Spastic Paraplegia, NIH National Institute of Neurological Disorders and Stroke
• Hereditary spastic paraplegia, NHS
• Spastic paraplegia type 4, MedlinePlus Genetics
• Muscle spasticity, MedlinePlus Medical Encyclopedia

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.