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Pain Management


Meet Our Sponsors: United Spinal Association

We are proud to welcome the United Spinal Association as a sponsor of Push Nation Fest 2016! United Spinal Association is dedicated to enhancing the quality of life of all people living with spinal cord injuries and disorders (SCI/D), including veterans, and providing support and information to loved ones, care providers and professionals. Since 1946, their goal has been to offer people living with SCI/D programs and services that maximize their independence and enable them to remain active in their communities. They believe no person should be excluded from opportunity on the basis of their disability.

Stop by their booth at Push Nation Fest on April 22nd & 23rd to meet the people behind United Spinal Association and find out more about what they can do!


Life with muscle spasticity

Our spinal cord is the key component to sending signals from the brain to the very corners of the body.  So what happens when those signals are disrupted?  Depending on how the spinal cord is injured it can leave the signals either completely or partially cut off from the brain. The result is a Quadripelgia (Tetraplegia) or Paraplegia. When a catastrophic injury like an SCI occurs, people often experience an array of side effects due to lack of motor use and movement.  One of the most common and most varied is muscle spasms.

So what are muscle spasms?

                Muscle spasticity is an uncontrollable tightening or relaxing of muscles. About 65%-78% of the SCI population suffers from some form of spasticity, occurring mostly in the cervical (neck), than thoracic (chest) and lumbar (lower back) injuries. It’s usually sudden, resulting in an involuntary flexing or bending of a limb.

SCI patients have limbs that are typically stiff or tight at rest, causing difficulty relaxing or stretching and a lack of control of movement. The most common type of reflex muscle contraction seen in SCI patients are extensor spasms. These are a ridged straightening of knees and pointing of toes. Flexor spasms, which cause bending or drawing up of a limb, are the second most common followed by clonus, which is a fast rapid collection of movements.

Muscle spasms are a struggle for some injured patients because the pain can vary from mild to severe and can last seconds to longer than several minutes. These episodes can also cause sleep disruption, difficulty with breathing, difficulty with movement, pressure sores, digestive issues, and intimacy problems.

What causes spasticity?

                Many of our movements are controlled by the spinal cord and directed by our brain. When one sustains a catastrophic injury to the spine, the brain can no longer regulate motion and reflexes may become exaggerated over time. With a complex system of circuits that controls our body movement, the missing link between the brain and the spinal cord leaves the body with no idea how to react.  The body can no longer have quick, automatic reactions, such as jerking away from a hot object.

         Here are some common triggers that cause muscle spasms:

  • Stretching
  • Limb movement
  • Skin irritation
  • Pressure sores
  • Full bladder or UTI
  • Constipation
  • Bone fracture or tendon injury
  • Tight clothes

How can I stop muscle spasms?

The simplest road to minimizing spasticity is maintaining a healthy lifestyle and practicing self-care. It is important to maintain flexibility and range of motion to encourage movement and work toward weight bearing while standing. The next step is to wear splints and braces to promote muscle stretching and help maintain a position that does not trigger a spasm.

Oral Medication – A doctor may prescribe muscle relaxants like Benzodiazepines, Diazepam, Clonazepam, Dantrolene or Tizanidine. Some patients may be hesitant to use medication because of the side effects and success rate.

Motion blockers – If a specific body part is spasming, these injections into the muscle provide temporary relief with minimal side effects.

Surgery – Though not recommend initially, some patients opt for Intrathecal medication therapy.  The battery powered pump injects a muscle relaxant drug directly into the area around the spinal cord. Commonly referred to as a pump or baclofen pump, it needs to be replaced every 5-7 years.  Be sure to discuss the surgical risks with your doctor when weighing out your options.

Functional Electrical Stimulation – This treatment option applies small electrical pulses to paralyzed muscles to restore or improve their function. FES is commonly used for exercise, developing muscle mass, and assistance with breathing, grasping, transferring, standing and walking. Additionally, FES can help some to improve bladder function, bowel function, and reduces pressure sores.

Are there any benefits to muscle spasms?

Health professionals actually believe that a certain amount of muscle spasticity can be a good thing. Movement, even when it is uncontrolled, helps maintain muscle mass and tone. It can also help aid functional activities such as standing or transferring or getting dressed. Below are some additional benefits of muscle spasms:

  • Help indicated medical complications
  • Assist in bladder and bowel problems
  • Increase blood flow
  • Decrease the chances of blood clots
  • Help maintain bone density

With all these therapy options, be sure to communicate with your health care professional about your choices and which ones are covered by insurance. Get advice from fellow SCI patients who have experienced this and can help you make a sound decision. Muscle spasms may not be ideal, but it is good to know that there are options to help you manage the condition.


Spasticity by S. Brown

Spasticity and Spinal Cord Injury by the Department of Rehabilitation Medicine

Electrical stimulation for therapy and mobility after spinal cord injury by Centre for Neuroscience

Analysis of Spasm and Periodic Leg Movement in Spinal Cord Injury by G. Suresh

Highway to Health

Pain Management Through Hypnosis

Photo Credit: http://www.shastahypnosis.com/

Photo Credit: http://www.shastahypnosis.com/

Chronic pain is a significant problem for spinal cord injury (SCI) patients that can play a huge factor in a person’s quality of life. Although there are hundreds of medications and therapies out there for pain management, relief is usually followed with a line of side effects. This article explores the concept of an alternative medicine: Hypnosis- the method of reaching healing powers within your subconscious mind. And no, we’re not talking about a sideshow act where the hypnotist is trying to get a good laugh out of the audience.

This form of hypnosis focuses on the connection of the body and mind and is known to increase feelings of well-being, reduce anxiety, help with sleep, and control over body pain. Pain is usually categorized into two categories – acute and chronic pain. Acute pain is the sensation that takes place before we begin healing, where your body tells you something is wrong. Chronic pain is what remains after the healing process has begun and continues for months or years after.

Long term discomfort is proven to be significantly more difficult to heal through hypnosis because there are many factors and complications that can greatly affect a patient’s mental receptiveness. This includes but is not limited to physiological stress, pain source, resentment to their condition, deactivation, and guarding. Some spinal cord injury patients may expect hypnosis to essentially cure them of the pain when, in truth, hypnosis makes it more manageable. The focus is more energy and willingness to participate in exercise and physical therapy. It also is shown to improve sleep and avoid disruptions due to pain. These things increase a patient’s quality of life.

Hypnosis has proven to work significantly for acute pain scenarios. For example, burn patients have been hypnotized in the emergency room to feel a cooling sensation on the burned area. A study done by Ewin (1978) stated that patients experienced more comfort and faster wound healing with this approach. This alternative form of treatment can also be used to ease muscle tension which is highly associated with pain.  With hypnotherapy, the patient is aroused into physical relaxation such as “floating” or “lightness” to relax the muscles.

During hypnosis, mental clarity and positivity can be used to change one’s subconscious and, in effect, prevent pain receptors from registering in the brain. Hypnosis turns off this conscious part of the brain to kick start into alpha brain waves, allowing the mind to become more attentive and open to changing the signals sent to the body. Essentially, this form of treatment changes the way patients perceive pain messages and are able to decrease activity in the part of the brain that experiences pain intensity.  Those who undergo this form of treatment train the active part of the brain to modify how they allow pain to make them feel.

Hypnotherapy has begun to be widely used throughout the medical industry. According to the International Journal of Clinical and experimental Hypnosis, this treatment has been known not only help chronic pain in SCI patients but also assist in the treatment of mental disorders, addiction, burn victims, and so much more.

With its increasing popularity, more doctors and clinics are exploring hypnotherapy as a new method to attack pain. The great thing about hypnosis is that it can be used alongside your prescribed medications or solo. In a time of expensive medical bills, it’s nice to explore a treatment that can reduce your cost of pain management.  If this form of treatment is something you’re interested in, talk to your doctor about discovering this alternative option.


Hypnotherapy for the Management of Chronic Pain, Elkins et al.

Profile of Perpetual-cognitive Traits and Personality Style of Possible Relevance to Creative Productivity, Ewing et al.

Trance and treatment: clinical uses of hypnosis, Speigal et al.