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Derived via Latin from the Greek spastikos ("drawing in" or "tugging"), the word at its root still refers to an alteration in muscle tone affected by the medical condition spasticity, which is seen in spastic diplegia and many other forms of cerebral palsy and also in terms such as "spastic colon". In this usage, which is still today the word's main environment, the word spastic has absolutely no negative connotations, because it is accurately descriptive of the condition. In India, 'The Spastics Society of India' (now known as 'ADAPT - Able Disable All People Together'), a non-profit and non-governmental organization, kept its name for many years without being criticised.
Colloquially, the word spastic can be, but is not necessarily, pejorative; largely this depends on whether one understands the word as it is used in the United States or the United Kingdom. In British English today the mention of the word spastic is typically extremely inappropriate, as in the UK it is considered an offensive way to refer to disabled people.
However, the word began to be used as an insult and became a term of abuse used to imply stupidity or physical ineptness: one who is uncoordinated or incompetent, or a fool. It was often colloquially abbreviated to shorter forms such as "spaz".
Its derogatory use grew considerably in the 1980s. This is sometimes attributed to the BBC children’s show Blue Peter. During the International Year of Disabled Persons (1981), several episodes featured a man with cerebral palsy (described as a "spastic") named Joey Deacon. Phrases such as "joey", "deacon", and "spaz" became widely used insults amongst children at that time.
The current understanding of the word is well-illustrated by a BBC survey in 2003, which found that "spastic" was the second most offensive term in the UK relating to disability (retard was deemed most offensive). In 2007, Lynne Murphy, a linguist at the University of Sussex, described the term as being "one of the most taboo insults to a British ear".
In American slang, the term "spaz" is largely inoffensive, and is generally understood as a casual word for clumsiness, sometimes associated with overexcitability, excessive startle response ("jumpiness"), excessive energy, or hyperactivity. Its usage has been documented as far back as the mid-1950s. In 1965, film critic Pauline Kael, explained to her readers, "The term that American teenagers now use as the opposite of 'tough' is 'spaz'. A spaz is a person who is courteous to teachers, plans for a career, and believes in official values. A spaz is something like what adults still call a square." The New York Times columnist similarly explained to readers that spaz meant "You're strictly from 23-skidoo." Benjamin Zimmer, editor for American dictionaries at Oxford University Press and researcher at the University of Pennsylvania's Institute for Research in Cognitive Sciences, writes that by the mid-1960s the American usage of the term spaz shifted from "its original sense of 'spastic or physically uncoordinated person' to something more like 'nerdy, weird or uncool person.'" By contrast, in a June 2005 newsletter for "American Dialect Society", Zimmer reports that the "earliest [written] occurrence of uncoordinated "spaz" (as opposed to uncool "spaz")?" is found in The Elastik Band's 1967 "undeniably tasteless garage-rock single" "Spazz".
Later in 1978, Steve Martin introduced a character Charles Knerlman, aka "Chaz the Spaz" on Saturday Night Live, in a skit with Bill Murray called "Nerds". Bill Murray later starred in the movie Meatballs which had a character named "Spaz." Both shows portrayed a spaz as a nerd or somebody uncool in a comic setting. Thus, while Blue Peter shaped the modern British understanding of the term, American viewers were being bombarded with a different image. In time, the term spaz, like its counterparts nerd and geek, lost its offensive nature and evolved into a term often used in self-deprecation.
In his song 'Goodnight Saigon', Billy Joel tells the story of young American soldiers going to Vietnam, naive on arrival and some going back home in body bags in the end. He sings, "We came in spastic like tameless horses, we left in plastic as numbered corpses." The lyrics are in no way offensive in this American context.
The term occasionally appears in other North American movies or TV series such as Friends and receives a different reaction from British and American audiences. In one episode, Rachel refers to herself as a "laundry spaz" due to her inability to do the laundry. This comment was deemed offensive enough by the British Board of Film Classification to give the episode a 12 rating. Other episodes in the series are rated a step lower at PG. Similarly, Rugrats: Tales From the Crib Snow White got a PG rating based on Angelica calling Kimi "Spazzy". 
The difference in understanding of the term between British and American audiences was highlighted by an incident with the golfer Tiger Woods; after losing the US Masters Tournament in 2006, he said, "I was so in control from tee to green, the best I've played for years... But as soon as I got on the green I was a spaz." His remarks were broadcast and drew no attention in America. But they were widely reported in the United Kingdom, where they caused offence and were condemned by a representative of Scope and Tanni Grey-Thompson, a prominent paralympian. On learning of the furore over his comments, Woods' representative promptly apologized.
Multiple products in America use the word Spaz as part of their name.
Controversy arises if products are sold in the UK under the same name. In particular the manufacturers and importers of the Spazz wheelchair were criticised by the British charity Scope when they put the wheelchair on sale in the UK. Scope expressed a fear that the usage of the word as an insult would increase again, after a steady decline since the 1980s.
An energy drink is called "Spaz Juice" and has a slogan, "all the energy you need to annoy everybody else."
The Transformers Power Core Combiners line of robot toys was to include a character named "Spastic". Hasbro, the makers of Transformers, said that it would not release "Spastic" in the UK. This did not stop vocal British fans from alerting various news outlets, eventually resulting in the name being changed for all markets to the less-offensive "Over-Run." The online biography for another Transformer, Strafe, described him as "spastic" in early releases, but when the controversy erupted about the word, they changed the word to "twitchy."
On June 29, 2007, Ubisoft of France pulled one of their games called Mind Quiz: Your Brain Coach, for referring to players who did not perform well at the game as "Super Spastic". The company stated "As soon as we were made aware of the issue we stopped distribution of the product and are now working with retailers to pull the game off the market."  One of the playable characters, a brother of eponymous main character, in Jazz Jackrabbit game series (introduced in Jazz Jackrabbit 2) is named "Spaz". Similarly, Nintendo recalled Mario Party 8 in the UK after releasing a version containing the line "turn the train spastic" in its dialogue.
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