Muscle spasms after a spinal cord injury result from impaired control of the body’s reflexes, and motor neurons in the spinal cord reacting to a variety of stimuli. If something stimulates the arms or the legs, for example, the signal travels along the nerves to the spinal cord on its way to the brain’s reflex center. Since the stimulus can’t get past the injured portion of the spinal cord this causes motor neurons in the spinal cord to bounce the reflex back to the muscles, usually causing a much stronger contraction than necessary. The effect is called Spastic Hypertonia (SH). Hypertonia means excessive muscle tone, in this context.
Many stimuli can cause spastic hypertonia; something as simple as pressure from a piece of clothing or a full bladder can set off a reaction.
What Happens in the Body?
There are good and bad things about spastic hypertonia. When the muscles contract, the movement increases circulation and muscle tone which can help decrease pooling of blood in the extremities. This reduces the risk of blood clots in the legs. With rehabilitation, it’s also possible to use SH to one’s advantage, for example when transferring out of bed, when going to the bathroom or getting dressed.
Sometimes the spasms are so powerful they interfere with any type of activity. They can also be very painful, similar to muscle cramping, and may interfere with sleeping. Another problem with SH is an increased risk of skin breakdown in areas that experience repeated shearing, such as rubbing against part of the wheelchair. This risk can be modified by paying attention to areas of friction, changing position, frequently checking skin integrity and intervening as necessary.
Treating Spastic Hypertonia
One treatment that has been successful is injecting Botox into the affected muscles, blocking the signals from the nerves. In some cases, surgery is needed. There are also medications that can help, but many are used sparingly because of their sedating side effects.
Spastic hypertonia is a common complication of spinal cord injury that needs lifelong management. As a rehabilitation specialist, Dr. Greg Vigna has treated many spinal cord injury patients suffering from this complication. He integrates spastic hypertonia, and all potential sources of suffering, into a comprehensive life care plan that addresses individual care needs. Dr. Vigna is also a personal injury attorney dedicated to helping patients receive the best care possible for all complications from their injury. Contact him today for a free case evaluation.
