The Ultimate Guide to Cerebral Palsy Pain

The Ultimate Guide to Cerebral Palsy Pain

Cerebral palsy pain is complex and can be caused by the motor disorder itself or by its many secondary complications.

Did you know that roughly 75% of people with cerebral palsy experience pain?

This article will go over different types of cerebral palsy pain and how to deal with them.

Let’s get started!

Is Cerebral Palsy Painful?

Living with cerebral palsy can be painful because abnormal muscle tone and motor impairment can shorten muscles, misalign joints, and deform bones.

The prevalence of secondary complications increases with age, so adults with cerebral palsy generally have significantly higher levels of pain than children.

Unfortunately, cerebral palsy pain is often overlooked and insufficiently treated.

Some cerebral palsy patients have difficulties effectively communicating when they are in pain.

Typical indicators of pain like changes in facial expression, sleep patterns, speech, and movement tend to already be difficult to interpret and inconsistent due to physical impairment.

This can negatively affect one’s appetite, sleep quality, activity levels, social behaviors, and overall outlook on life.

Types of Cerebral Palsy Pain

Child with CP in pain

People with cerebral palsy can experience pain in many different parts of the body and varying severity levels.

The three main types of pain associated with cerebral palsy are musculoskeletal, gastrointestinal, and procedural pain.

1. Musculoskeletal Pain

The most common type of pain cerebral palsy patients experience is musculoskeletal pain.

Common causes of musculoskeletal pain are:

  • Hip dislocation
  • Dystonia (uncontrollable muscle activity)
  • Spasticity (abnormal muscle tone)
  • Scoliosis (curving of the spine)
  • General stress on the muscles, bones, and joints for prolonged periods

This type of pain is achy and is usually felt in the limbs, back, and neck.

2. Gastrointestinal Pain

Gastrointestinal pain results from problems in the digestive tract.

Common digestive problems in cerebral palsy patients include:

  • gastroesophageal reflux disorder
  • urinary incontinence
  • constipation
  • dysphagia (difficulties swallowing)

The pain will typically be felt at or near the abdominals in the form of cramps, aches, or heartburn.

3. Procedural Pain

Procedural or surgical pain is the result of invasive procedures.

For example, if your child has severe scoliosis, he or she may get a spinal fusion surgery to realign the spine.

However, the body needs time to adjust after surgery, so your child may feel pain following the procedure.

Luckily, procedural pain is short-term and should go away with time.

Signs of Pain in Children with Cerebral Palsy

pain in children with cerebral palsy

Level of impairment plays a huge role in identifying pain.

Children with significant motor impairments typically have difficulties communicating when they are in pain.

Instead, children who cannot verbalize may indicate pain through:

  • Crying
  • Reduced activity
  • Moaning
  • Irritability
  • Lack of cooperation
  • Poor sleep
  • Stiffness
  • Fidgety movements

Cerebral Palsy Pain Management

physical therapy for cerebral palsy pain management

Treatments will vary depending on the cause of pain.

Patients typically use multiple treatments to manage pain. What works for one person may not work for the other, so the perceived effectiveness of treatments tends to vary.

Exercise and Physical Therapy to Improve Mobility

Physical therapy can be helpful for cerebral palsy patients experiencing musculoskeletal pain.

Exercising helps expand range of motion, strengthens muscles, and improve flexibility.

Physical therapists can also provide tips and tricks to help make movements easier so that you feel less pain.

Exercise improves circulation and regulates neurotransmitter levels in the brain, which can alter your perception of pain.

Medications for Temporary Pain Relief

Depending on the cause and severity of your pain, doctors will recommend various types of medications.

Some of the most common medications prescribed for pain in cerebral palsy patients are:

  • Anticonvulsants: Even if your child isn’t experiencing epilepsy, anticonvulsants can help reduce pain. They calm the nerves to reduce pain sensations.
  • Antidepressants: Antidepressants can alter neurotransmitter levels in the brain to reduce the perception of pain.
  • Opioids: Opioids are powerful medications that inhibit pain signals. However, they are addictive and one can build a tolerance to them relatively quickly, so they are only ideal for short term use.
  • Non-steroidal Anti-Inflammatory Drugs (NSAIDs): You can easily get NSAIDs like ibuprofen and aspirin at your local drug store without a prescription. They help reduce inflammation to alleviate muscle and joint pain.
  • Anticholinergics: Anticholinergics block acetylcholine from causing involuntary muscle movements in the gastrointestinal tract and other areas in the body.
  • Baclofen: Baclofen is a muscle relaxant that can be injected, pumped, or taken orally to reduce spasticity.
  • Botox: Small doses of Botox can be injected into the body for spasticity treatment. It temporarily blocks chemical signals that cause muscles to contract.

Surgery

The goals of surgical interventions for cerebral palsy pain are to improve motor function, decrease spasticity, or correct deformity.

Generally, doctors will recommend non-invasive forms of treatment like medication or physical therapy first, but in cases of severe pain, surgery will provide more long-term pain relief.

Because there are so many different things that can cause pain in cerebral palsy patients, surgical interventions will vary on a case-by-case basis.

For extreme cases of musculoskeletal pain, a selective dorsal rhizotomy may provide relief.

This procedure involves selectively cutting sensory nerve fibers to decrease muscle tone. Because cut nerves cannot grow back, the spasticity reduction is permanent.

Cerebral Palsy and Pain

treating pain in cerebral palsy patients

Dealing with cerebral palsy and pain can be very challenging and may discourage people from socializing, performing daily tasks, and working towards recovery.

Children with cerebral palsy may be unable to communicate when they are in pain, so keep an eye out for signs like frustration or lack of sleep.

Effective management through exercise, medications, or surgery will ensure that pain doesn’t reduce your child’s quality of life.

Pain in cerebral palsy patients is extremely common, so don’t hesitate to seek help through doctors, therapy, and support groups!