Spasticity and Pain in Neurological Disorders: Shared Pathways and Multimodal Rehabilitation Strategies

The field of neurorehabilitation increasingly recognizes the entwined nature of spasticity and pain as disabling complications arising from neurological disorders. Traditionally considered and managed as distinct entities, spasticity and neuropathic pain are now understood to be underpinned by common mechanisms, including maladaptive central sensitization, spinal disinhibition, neuroinflammation, and altered supraspinal modulation. Their co-occurrence not only worsens functional impairment but also significantly degrades patient quality of life, making effective intervention an urgent need. Recent literature originating from multiple sclerosis research has introduced the concept of ‘Spasticity-Plus Syndrome’, which groups spasticity with spasms, pain, sleep disturbances, and autonomic dysfunction into an interconnected symptom cluster sharing common neurobiological substrates. Whether analogous symptom constellations operate across other neurological conditions remains an open and compelling research question that this Research Topic aims to address. However, comprehensive clinical trials and mechanistic studies remain scarce, and the rehabilitative management for this multifaceted symptom cluster often lacks coordination and sufficient evidence. This Research Topic aims to advance our understanding of the shared pathophysiological processes connecting spasticity and pain in neurological disorders. It further seeks to bridge the current gap between pathophysiological insight and clinical application by promoting the development and validation of integrated, multimodal rehabilitative strategies. Key objectives include elucidating common neurobiological substrates, refining clinical assessment for both symptoms, optimizing established therapies, and investigating the effectiveness of emerging non-pharmacological interventions. Contributions are encouraged that address disease-specific factors, innovative diagnostic measures, and both pharmacological and non-pharmacological management strategies, with a particular emphasis on translating mechanistic insights into practical neurorehabilitation protocols.The scope of this Research Topic centers on patients with neurological disorders—such as stroke, spinal cord injury, multiple sclerosis, traumatic brain injury, and cerebral palsy—where spasticity and pain commonly overlap. To gather further insights in this field, we welcome submissions across a diverse range of manuscript types supported by the journal—including Original Research, Brief Research Reports, Perspectives, Protocols, Mini-Reviews, and more—exploring, but not limited to, the following themes:- Shared mechanisms and pathophysiology of spasticity and neuropathic pain- Clinical assessment tools, scales, biomarkers, and neurophysiological measures- Optimizing botulinum toxin type A protocols and pain modulation strategies- Emerging non-pharmacological interventions: focal muscle vibration, neuromuscular and functional electrical stimulation, and non-invasive brain stimulation- Robotic-assisted and exoskeleton-based neurorehabilitation- Integrated and interdisciplinary treatment pathways (pharmacological, physical, and technological)- Clinical and rehabilitative approaches to the Spasticity-Plus Syndrome- Disease-specific manifestations and treatment adaptations across neurological disorders- Patient-reported outcomes, participation, and quality of life measuresArticles will be published online as soon as they are accepted after peer review and approved for publication.Sign up now to participate in this exciting Research Topic.Topic Editor Alessandro Picelli has received research funding for recent and ongoing projects from AbbVie, Merz, and Ipsen, and serves on the Advisory Board of AbbVie, Merz, and Ipsen. Topic Coordinator Davide Dalla Costa was on the Advisory Board for IPSEN in 2024. Topic Editor Dr. Rajiv Reebye reports no competing interests with regard to the Research Topic subject. Topic editors: Rajiv Reebye, Alessandro Picelli Source: https://www.frontiersin.org/research-topics/82692/spasticity-and-pain-in-neurological-disorders-shared-pathways-and-multimodal-rehabilitation-strategies