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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.

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Louise W.

Dr Petros is amazing!  When he uses a needle his aim is "right on".  He is also very personable, an altogether great guy.  I always find my visits to him to be very informative. I have had both sides of my degenerated back injected (epidural shots) with complete success.  He allows me to have no sedative, which is cool because his jokes and stories in the operating room are really good.  He greatly enjoys his work, and enjoys the difficult challenges of getting a needle into the right place in my back.  My arthritic knee is perhaps more straight-forward, but other doctors have failed to give me pain relief.  Dr Petros studies the structure with ultrasound before injecting it.  The result - instant relief! On my recent visit for a broken back (ski accident) the doctor and staff were very accomodating to help me make a dinner engagement shortly after my appointment.  This is definitely a five-star operation!

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Keith M.

Simply the best doctors and staff in the area. I've fought back and neck pain for over 30 years, and Dr. Petros and his team have kept me from the operating table and able to enjoy my life. I've had injections, acupuncture, as well as back braces. He listens to my concerns, cares very deeply for my pain and discomfort, and has successfully treated everything from stenosis, pinched nerves, herniated disks, and even helped me with the symptoms from shingles and lung disease. I couldn't be happier with the care he has given me over the years.

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I have been a patient of Dr. Vaidya for a few years after not getting what I needed from other spine and pain doctors. I was looking for a doctor who would think outside the box and come up with some other ways to treat my growing amount of pain. Between Dr. Petros and Dr. Vaidya, they have brought me to a place where my pain is better managed. And let's just talk about bedside manners! I have never met doctors in the past 23 years of this back journey of mine that has as amazing bedside manners as these guys. I have cried and laughed with the team at Allied Spine. The way that I am always greeted and promptly cared for is bar none! The front office staff, and especially Nas, has been a God sent. I would never go anywhere else.

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I am a new patient of DR Petros and my experience was great for my first two visits so far. He really takes time to listen to your issues and provides thorough answers and treatment options. The front desk staff are all very nice and respond in a timely manner to requests. Highly recommended all around!

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