Spinal Cord Injury and Spasticity
Spasticity is common in those with spinal cord injuries (SCI), as approximately 65 to 78 percent of these people are affected by some degree of spasticity. This uncontrolled contracting or tightening of the muscles tends to be more common in cervical (neck) injuries as opposed to thoracic (chest) and lumbar (lower back) injuries.
Causes
The expansive communication route that regulates your body movements following various stimuli such as movement or touch is formed by the brain and nerve cells located in the spinal cord. Following a SCI, there is a disconnection between the nerve cells and your brain at the level of injury.
The spine is a series of segments of your vertebrae – neck, chest, back, and tail – which are each responsible for various neurological functions. The level of injury is the first level of segmented spine that shows loss of normal neurologic function. This disconnection is caused by the formation of scar tissue in the structure of the area of spinal cord damage, interfering with a messages capability to reach the brain below the level of injury.
Once message delivery to the brain fails, those with a SCI may experience a reflex muscle spasm such as a jerk, twitch or stiffening of the muscle. Common triggers of these spasms include:
- Stretching of your muscles
- Movement of your arm or leg
- Any skin irritation such as hot, cold, a rash, rubbing etc.
- Having a full bladder or urinary tract infection
- Pressure sores
- Hemorrhoids or constipation
- Any injury to the tendons, muscles or bone below the level of SCI
- Wraps, binders or tight/restrictive clothing
Symptoms
Symptoms and their severity vary for each person and may include:
- Rapid muscle contraction
- Increased muscle tone
- Muscle spasms
- Exaggerated deep tendon reflexes
- Fixed joints
- Involuntary crossing of the legs (scissoring)
Commonly, muscles that tend to spasm the most are the flexor muscles that bend your elbow and the extensor muscles that extend your leg.
Treatment
Controlling the frequency and severity of spasticity associated with a SCI may initially include the prescription of various oral medications and participation in rehabilitation therapy that may include an individualized plan consisting of the combination of occupational and physical therapy. If these treatment methods prove unsuccessful, additional treatments for spasticity include:
- Neurosurgery: A rhizotomy, also referred to as radiofrequency ablation is a form of neurosurgery performed to reduce pain associated with spasticity by reducing the number of pain signals sent through a specific area. The interference of pain signals occurs when nerve tissue is heated via an electric current produced by radio waves.
- Botox Injections: After the area of muscle causing pain is determined, Botox is injected using a fine needle directly into the muscle. Injections are performed for muscle relaxation as Botox blocks the release of acetylcholine, a neurotransmitter which triggers muscle spasticity.
- Nerve Blocks: Using x-ray imaging, a long lasting steroid medication is injected into the peripheral nerves located outside of the spinal cord. This treatment prevents the transmission of pain signals from these nerves to the brain. Nerve blocks relieve local – not widespread – spasticity for a period of two to five months if a longer-acting block is used.
- Spinal Cord Stimulation: This method of electrical stimulation is an effective treatment for spasticity by relieving discomfort associated with stiff or rigid muscles in the lower extremities. The spinal cord stimulator is a medical device that is implanted into the epidural space of your spine, relieving pain by sending a mild electric current to the spinal cord altering your body’s perception of pain.
Contact Allied Pain & Spine Institute today to schedule a consultation with one of our specialists.
