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The Beyond Pain Foundation

Conditions we support

Conditions guide

Cerebral palsy in adults

Cerebral palsy is a lifelong condition that affects movement and co-ordination. The brain injury behind it does not get worse, but the strain on muscles and joints can bring pain, stiffness and tiredness as you get older. This guide explains the types, how things can change in adult life, the treatments available in the UK, and your rights at work.

Children in the UK with cerebral palsy
About 1 in 400
Adults with cerebral palsy who have pain
About 7 in 10
Most common place for pain
The legs
Adults compared with children
More adults now live with CP

This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.

What cerebral palsy is

Cerebral palsy (CP) is the name for a group of lifelong conditions that affect movement, muscle tone and co-ordination. It is caused by damage to, or differences in, the developing brain before birth, during birth or soon after.

Causes can include bleeding in the baby's brain, a lack of oxygen or blood supply, infections during pregnancy, meningitis or a serious head injury in early childhood. Often the exact cause is never known.

CP affects everyone differently. Some people have mild stiffness in one hand. Others use a wheelchair and need help with daily tasks. Many people with CP also live with epilepsy, learning disability, or problems with speech, swallowing, sight or hearing.

Most children with CP grow up into adulthood, and there are now more adults living with CP than children. Yet many adults find that health services built around children stop when they turn 18.

Types of cerebral palsy

Doctors describe CP by the way it affects movement and by which parts of the body are involved. Many people have a mix of types.

Spastic cerebral palsy

The most common type. Muscles are stiff and tight, which makes movement hard and can cause painful spasms. Over time, tight muscles can pull on joints.

Dyskinetic cerebral palsy

Muscle tone changes between tight and floppy, causing movements you can't control, such as twisting or jerking. It can be tiring and cause pain from constant movement.

Ataxic cerebral palsy

The least common type. It affects balance and co-ordination, so movements can be shaky or clumsy and falls are more likely.

Mixed cerebral palsy

Features of more than one type, for example stiffness in the legs with uncontrolled movements in the arms.

Hemiplegia (unilateral)

One side of the body is affected, either left or right. The arm is often more affected than the leg.

Diplegia

Both sides are affected, with the legs much more affected than the arms. Walking, balance and hip and knee pain are common concerns.

Quadriplegia

The whole body is involved, including the trunk and often the face and mouth. People are more likely to need a wheelchair and support with posture.

How it can change over time

The brain injury in CP does not get worse. But years of moving in a different way put extra strain on muscles, joints and energy. Many adults notice changes earlier than people without CP.

  1. Childhood and teens

    Growing years

    Care is usually led by children's services with regular physio. Tight muscles can get worse during growth spurts.

  2. Around 16 to 25

    Moving to adult care

    Care moves to adult services. This can mean fewer regular check-ups, so new pain may go unnoticed.

  3. Adult life

    Pain and fatigue

    Pain in the legs, back, neck and hips becomes more common, along with tiredness from the extra effort of moving.

  4. Later adult life

    Early ageing

    Some people develop arthritis, weaker bones or reduced walking earlier than expected. Planning ahead with your team helps.

Ages are rough guides, not exact rules. Everyone's CP is different.

Common causes of pain in adults with CP include:

  • Muscle stiffness and spasms
  • Joint wear and arthritis
  • Hip problems
  • A curved spine (scoliosis)
  • Foot problems
  • Poor posture or seating
  • Constipation
  • Pressure sores
  • Infections
  • Stress and low mood

When to get urgent help

Call 999 or go to A&E if

  • a seizure lasts more than 5 minutes, or one follows another
  • you are choking or struggling to breathe
  • you have a fall and can't move a limb, or think you've broken a bone
  • you have a baclofen pump and suddenly get high fever, confusion, severe itching or a rebound in stiffness

Call NHS 111 if

  • pain or spasms suddenly get much worse
  • you have signs of a chest or urine infection
  • you are coughing or choking more when eating or drinking
  • you have a red, hot or broken area of skin that is getting worse

See your GP if

  • you have new or worsening pain in your hips, back, neck or joints
  • walking, standing or moving is getting harder
  • you are much more tired than usual
  • you feel low, anxious or are sleeping badly

Never stop baclofen suddenly. Stopping too fast can cause serious withdrawal effects.

Reviews and referral

Most people are diagnosed with CP as young children. As an adult, the question is usually not "do I have CP?" but "what is causing my pain now, and who can help?"

NICE guidance on CP in adults says you should have access to a local network of care, including physiotherapy, occupational therapy, speech and language therapy, orthopaedics, mental health support and wheelchair services. You should be told who your main point of contact is between appointments.

People with more complex needs, such as limited mobility, communication difficulties or a learning disability, should be offered a yearly review with a team experienced in neurodisability. Your GP is usually the person who refers you to these services, or to a pain clinic or orthopaedic surgeon.

Up to 18 weeks

The maximum NHS waiting time in England from referral to starting consultant-led treatment, for non-urgent care. In practice, many services have longer waits, and adult CP services vary a lot by area.

Treating pain and stiffness

NICE says the first step is to find and treat the cause of pain. That might mean easing tight muscles, treating constipation or an infection, or changing your seating. Your team should use pain scales or body maps to check your pain, especially if speaking is hard for you.

Simple painkillers

From a pharmacy, or prescribed by your GP

Paracetamol and anti-inflammatory painkillers such as ibuprofen can help joint and muscle pain. Ask a pharmacist if you take other medicines, such as for epilepsy.

Muscle relaxants

Prescription, usually started by your GP or specialist

Baclofen is the first choice for widespread stiffness. NICE suggests the dose is built up slowly over about 4 weeks to find what works. Diazepam may be used for short spells of severe spasms or distress, but not long term.

Botulinum toxin injections

Specialist spasticity or rehab service

Injected into specific tight muscles. The effect builds over a couple of weeks and lasts a few months, so injections are repeated. They work best with physio and stretching afterwards.

Baclofen pump

Specialist neurosurgery or spasticity centre

A small pump under the skin delivers baclofen into the fluid around the spine. It is for severe stiffness when tablets haven't helped or cause side effects. You will need hospital visits to refill it.

Nerve pain medicines

Prescription

If pain is burning, shooting or tingling, your doctor may suggest medicines made for nerve pain. They usually take a few weeks to work fully.

Surgery

Orthopaedic surgeon, after referral

For joint pain that hasn't improved with other treatment, for example hip, spine or foot problems. Recovery and rehab can take several months.

Be careful with strong painkillers

Opioid painkillers such as codeine can cause constipation, which is already common in CP and can make pain worse. They can also cause drowsiness and dependence. If you rely on them, talk to your GP or pharmacist. Don't stop any regular medicine suddenly without advice.

Specialist and rehab services

Therapy is often the most useful long-term help for pain in CP. You may need to ask for a referral, as adult services are not always offered automatically.

  1. Physiotherapy

    Often a block of sessions over 6 to 12 weeks

    Stretching, strength work and a home exercise plan to ease stiffness and keep you moving. Hydrotherapy (exercise in a warm pool) can help if it is available locally.

  2. Occupational therapy

    Assessment, then follow-up as needed

    Ways to save energy and reduce strain at home and work, plus advice on equipment and adaptations. Ask your GP or your council's adult social care team.

  3. Orthotics and wheelchair services

    Waits vary from weeks to months

    Splints, insoles and footwear to support joints. Wheelchair services assess your seating and posture, which has a big effect on back and hip pain. You can ask about a personal wheelchair budget.

  4. Spasticity clinic or pain clinic

    By GP or specialist referral

    A spasticity clinic can offer injections or a baclofen pump. A pain clinic can help with long-term pain using medicines, therapy and pain management programmes.

Self-help

On a bad pain day

  • Use warmth on tight muscles, such as a warm bath or heat pack
  • Do gentle stretches from your physio plan
  • Change position often and use supportive cushions
  • Rest, but avoid staying still for too long
  • Ask for help with heavy tasks

Day to day

  • Pace yourself: split tasks up and plan rest
  • Keep active at a level that suits you
  • Eat well, drink enough and treat constipation early
  • Look after your bones with regular weight-bearing activity if you can
  • Keep in touch with others with CP for tips and support

Getting the best care

Tips for appointments

  • Keep a pain diary for a few weeks: where it hurts, when, and what helps
  • Mark painful areas on a body map to show your doctor
  • Ask who your main point of contact is between appointments
  • If you have complex needs, ask about a yearly review, as NICE recommends
  • Bring someone who knows you well if communication is hard
  • Ask for longer appointments if you need them. This can be a reasonable adjustment

Cerebral palsy and work

Cerebral palsy usually counts as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland). This applies when a condition has a substantial, long-term effect on your daily life, which CP usually does.

If your employer knows, or should know, they must make reasonable adjustments so you are not put at a disadvantage. These might include:

  • An ergonomic chair with good back and side support
  • A sit-stand desk set at the right height
  • Adapted keyboards, large mice or trackballs
  • Voice recognition software
  • A workspace near the entrance or toilets
  • Flexible hours and extra breaks
  • Working from home some days
  • Time off for therapy and appointments

Access to Work is a government grant that can pay for equipment, a support worker or taxis to work if you can't use public transport. It doesn't have to be paid back. For advice on your rights, contact Acas, Citizens Advice or the Scope helpline.

Benefits

Depending on how CP affects you, you may be able to get Personal Independence Payment (PIP), or Adult Disability Payment in Scotland, Universal Credit, Employment and Support Allowance or Statutory Sick Pay if you are off work. PIP can be paid whether or not you work. Turn2us, Citizens Advice and Scope can help you check.

How The Beyond Pain Foundation can help

If NHS waits are too long, or the help you need isn't available to you on the NHS, we may be able to fund:

  • A private assessment with a specialist in adult CP, spasticity or pain
  • A course of physiotherapy or hydrotherapy from a registered therapist
  • Splints, insoles or orthotic footwear recommended by your clinician
  • Seating, cushions or mobility aids recommended by an occupational therapist
  • Workplace or home equipment, such as an ergonomic chair, sit-stand desk or adapted keyboard

We fund treatment, equipment and support, not general living costs. Prices vary, so always get a written quote to include with your application.

Apply for funding Check the requirements

Support and sources

Scope

Disability equality charity

Helpline 0808 800 3333, Monday to Saturday, 10am to 5pm. Advice on CP, work, benefits and equipment.

scope.org.uk

Cerebral Palsy Scotland

Charity for people with CP

Information for everyone, plus therapy sessions for adults in Scotland. Call 0141 352 5000, Monday to Friday, 9am to 5pm.

cerebralpalsyscotland.org.uk
Sources for this guide

Last reviewed: October 2026.