Searching FOR SOLUTIONS to
Spasticity
M
ost wheelers who live with spasticity know all too well just how irritating and inconvenient spasms can be and how much they can limit your ability to get through the day. Spasms can be more than just a pain in the keister. They can also be disruptive and dangerous — leading to insomnia, pain and further injury. The nerves of the brain and spinal cord form a complex communication circuit that controls our body movements. Information on sensations or processes such as touch, movement or stretching is sent up the spinal cord to the brain. In response, the brain interprets the signal and sends the necessary commands back down through the spinal cord to tell the body how to react. An SCI disrupts that flow of signals, making them bounce back to the spinal cord’s motor cells, where they cause a reflex spasm. This can result in a twitch, jerk or stiffening of the muscle. Just about anything can trigger and sustain spasms. And, as with so many other things SCI-related, spasticity varies widely from person to person. Common spasm triggers include irritation to the skin, such as rubbing, chafing, a rash or ingrown toenails, and anything very hot, cold or painful. Pressure sores, a urinary tract infection or full bladder, constipation or large hemorrhoids can set them off, as can a fracture or practically any injury below the SCI level. I’ve come to intimately know spasms and the havoc they wreak over the past 33 years. I’ve gone through most everything physical therapists and pharmacists have offered to rid myself of them. Initially, I tried contorting myself into advanced yoga pretzel positions, a common approach recommended by PTs, who advocate range-of-motion stretching to maintain flexibility and reduce muscle tightness. I also tried weight-bearing or standing with support to help stretch muscles, and I even wore splints, braces and progressive casting to provide continuous muscle stretching.
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NEW MOBILITY
BY RICHARD HOLICKY
EVERYONE IS DIFFERENT Like many with spinal cord injuries, Ben Hernandez, a C5-6 incomplete quad, deals with spasms daily. When asked if he experienced bouncy leg syndrome, contractions, extension or other types of spasms, he quickly responded, “Oh, pretty much all of the above.” Whether it’s cold temperatures, pain, a UTI or something else, Hernandez has learned what to expect in the 24 years since his injury. Likewise, he knows what works and what doesn’t for his body. He often has better luck with natural solutions than with pharmacological ones. “For a while, I took about 160 mg of Baclofen, along with Klonopin, Valium and Elavil for nerve pain,” he says. “The side effects, primarily mental acuity, were too much to deal with.” He quit cold turkey against his doctor’s advice, which led to a seizure. His experience is a good reminder that many of the most common anti-spasticity medications come with serious and potentially dangerous drawbacks. Even moderate doses of some of these medications can result in drowsiness. He now sticks to marijuana, which he has found helpful, and what sounds like a lesson plan for a yoga class. “I stretch twice a day following a routine of yoga poses for about 30 minutes. I also do massages, using a TheraGun and a licensed massage therapist,” he says. “Deep breathing is quite effective, especially breathing in through the nose and out of the mouth, with the exhale a bit longer than the inhale.” He occasionally incorporates acupuncture, acupressure and dry needling. More rigorous exercise also helps reduce his spasms, as long as he can fight through an initial increase in spasticity. He regularly sits for 45-minute sessions on an FES bike. Jim Erjavec, a C5-6 incomplete quad, battles powerful spasms that make daily activities difficult. “I’ve got great grip in my right hand, but the tone interferes with that,” he
