Do Physical Modalities Have a Role in Spasticity Management?

This narrative review examines the potential role of physical modalities in the multidisciplinary management of spasticity, focusing on their physiologic mechanisms, clinical efficacy, and integration with pharmacologic and rehabilitative strategies. It discusses how interventions such as extracorporeal shock wave therapy, electrotherapy, heating methods (ultrasound and diathermy), and vibration therapies (focal and whole-body) target both the neural and nonneural components of spasticity by modulating neuronal excitability and improving muscle rheology. The review also highlights their synergistic effects with antispastic agents, particularly botulinum toxin type A, providing adjunctive mechanisms that can optimize therapeutic outcomes.