After spinal cord injury the nerve cells below the level of injury become
disconnected from the brain. Following the period of spinal shock changes
occur in the nerve cells that control muscle activity. Spasticity is an
exaggeration of the normal reflexes that occur when the body is stimulated
in certain ways. After spinal cord injury, when nerves below the injury
become disconnected from those above, these responses become exaggerated.
Muscle spasms, or spasticity, can occur any time the body is stimulated
below the injury. This is particularly noticeable when muscles are
stretched or when there is something irritating the body below the injury.
Pain, stretch, or other sensations from the body are transmitted to the
spinal cord. Because of the disconnection, these sensations will cause the
muscles to contract or spasm.
Almost anything can trigger spasticity. Some things, however, can make
spasticity more of a problem. A bladder infection or kidney infection will
often cause spasticity to increase a great deal. A skin breakdown will also
increase spasms. In a person who does not perform regular range of motion
exercises, muscles and joints become less flexible and almost any minor
stimulation can cause severe spasticity.
Some spasticity may always be present. The best way to manage or reduce
excessive spasms is to perform a daily range of motion exercise program.
Avoiding situations such as bladder infections, skin breakdowns, or
injuries to the feet and legs will also reduce spasticity. There are three
primary medications used to treat spasticity, baclofen, Valium, and
Dantrium. All have some side effects and do not completely eliminate
spasticity.
There are some benefits to spasticity. It can serve as a warning mechanism
to identify pain or problems in areas where there is no sensation. Many
people know when a urinary tract infection is coming on by the increase in
muscle spasms. Spasticity also helps to maintain muscle size and bone
strength. It does not replace walking, but it does hlep to some degree in
preventing osteoporosis. Spasticity helps maintain circulation in the
lefts. IT can be used to improve certain functional activities such as
performing transfers or walking with braces. For these reasons, treatment
is usually started only when spasticity interferes with sleep or limits an
individual's functional capacity.
http://weber.u.washington.edu/~rlc/complications.html
Jim Lubin
jlubin(AT)eskimo.com
http://www.eskimo.com/~jlubin
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