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Leg Pain After Spinal Cord Injury: Causes and Effective Management

experiencing leg pain after spinal cord injury

Leg pain after spinal cord injury can be distracting and significantly affect your quality of life.

Luckily, there are ways to manage it so that you can go about your everyday life and focus on rehabilitation.

This article will explain why you might be experiencing leg pain after spinal cord injury and what you can do about it.

Let’s get started!

Causes of Leg Pain After Spinal Cord Injury

Many different factors can contribute to leg pain after spinal cord injury.

More often than not, it is caused by a combination of different causes including:

1. Nerve Damage

leg pain after spinal cord injury nerve damage

Damage to the nerves in your spinal cord can cause pain because sensory and motor signals cannot pass through the lesion.

This can cause the brain to misinterpret the stimuli that are getting through and overreact (i.e. the stimuli may be benign but your brain perceives it as pain). One example of this type of pain is neuropathic pain, which occurs below your level of injury. This kind of leg pain can range from tingling to sharp, shooting or burning sensations.

Another result of nerve damage that can cause leg pain after spinal cord injury is spasticity (involuntary muscle contractions).

Prolonged muscle contractions can cause leg muscles to tighten and shorten, which in itself can be painful. Additionally, spasticity can make it difficult to move. This  may cause you to walk with an abnormal gait or transfer on/off different surfaces with improper technique, and place too much pressure on certain joints.

Spasticity can also result in jerky spasms, which can cause you to hit your leg on nearby surfaces.

2. Overuse

Being enthusiastic about rehabilitation and trying to be as active as possible after spinal cord injury is fantastic.

However, it’s also important to listen to your body and try not to force anything so that you can pursue recovery long-term.

Musculoskeletal pain occurs when the muscles are being overused or used in an improper manner.  This type of leg pain is usually temporary.

Additionally, this type of leg pain will only occur if you have some sensation remaining below your level of injury (in other words, you have an incomplete spinal cord injury).

3. Muscle Atrophy

muscle atrophy due to spinal cord injury

On the other end of the spectrum is pain caused by not moving enough.

Our bodies are incredibly adaptive, and function on a basis of ‘use it or lose it’.

If you don’t use certain muscles, they’ll shrink. This is called muscle atrophy and it’s extremely common after SCI.

Because spinal cord injury can significantly affect your mobility, a little bit of muscle atrophy is inevitable.

However, when your muscles shrink too much and you try to move, you might experience pain due to stiffness and increased strain.

4. Pressure Sores

Whether you have full paralysis or just weakness with some degree of sensory impairment, you need to shift positions frequently to prevent pressure sores from developing. When in bed, you should be changing positions (i.e. switch to laying on the other side) every two hours, and you should perform a “pressure relief” every 30 minutes in your wheelchair if you use one.

Pressure sores are caused by staying in the same position for prolonged periods.

When there’s too much pressure being applied on an area of the body for too long, circulation gets cut off, which deprives the tissues of oxygen and increases the risk of damage to the skin (as well as the deeper levels of tissue and even bone if left untreated). If not cared for, pressure sores can become life threatening.

Pressure sores occur most commonly on bony areas of the body such as the heels, tailbone, sit bones, ankles, knees, and hips. If you have a higher-level injury, pressure sores can even affect shoulder blades.

5. Weight Gain

Physical inactivity can also result in weight gain after spinal cord injury.

Not only do many spinal cord injury patients become less active, but they may also turn to overeating as a coping mechanism. The amount of food intake that classifies as “over-eating” may also be different for you now that you have a SCI. Most individuals with SCI require fewer calories than they did before.

Excessive weight gain places extra pressure on the joints, which can cause leg pain (especially when accompanied by muscle atrophy).

6. Deep Vein Thrombosis

leg pain after spinal cord injury caused by blood clotting

Deep vein thrombosis is when a blood clot develops in a deep vein.

It’s most common in the legs and is often caused by not moving for long periods.

Symptoms of deep vein thrombosis include pain, swelling in only one leg, and increased temperature in the affected leg.

Managing Leg Pain After Spinal Cord Injury

treating leg pain after spinal cord injury

Because every spinal cord injury is different, leg pain management after SCI will vary from person to person.

Depending on the causes of your pain, pain management may include:

  • Physical Therapy. Physical therapy will help SCI patients improve their mobility through exercises intended to strengthen and stretch the muscles. This will help reduce the hyperexcitability of spastic muscles, increase range of motion in the joints, and promote circulation in the legs.
  • Medications. Depending on the severity and cause of your leg pain, your doctor will suggest different medications. Medications can range from over-the-counter painkillers to opioids to topical numbing creams.
  • Botox Injections. Botox injections can block the nerve signals that cause involuntary muscle contractions.
  • Diet. To avoid excessive weight gain after spinal cord injury, patients may need to adjust their diets to reduce their caloric intake.
  • Electrical Stimulation. Electric stimulation sends electric impulses through your body that interrupt and block pain signals.
  • Heat. Applying heat to the legs can help relax the muscles and increase blood flow to reduce pain. Try soaking in a warm bath or using heat pads, but be cautious as many spinal cord injury patients experience difficulty with body temperature regulation depending on their level of injury.
  • Orthotics. If pain caused by spasticity is causing you to walk with an abnormal gait and place unnecessary pressure on the joints, your physical therapist may consider having you wear a leg brace. This can help ensure proper form, combat spasticity, and gently stretch spastic muscles.
  • Rest. Pain caused by overusing your muscles typically goes away on its own with a few days of rest.
  • Skin Care. As mentioned above, change positions and perform pressure reliefs frequently to minimize your chance of developing pain (and other more serious complications) associated with pressure sores. Additionally, you should perform a “skin check” twice daily (checking all high-risk areas of skin for redness that doesn’t disappear within 20-30 minutes). If you notice skin breakdown occurring, contact your doctor and keep pressure off this area completely.

Understanding Leg Pain After Spinal Cord Injury

Chronic pain in the legs after spinal cord injury is very common, and now you know why.

Leg pain can be attributed to many different causes but is most commonly linked to nerve damage and physical inactivity.

Luckily, leg pain after spinal cord injury can be effectively managed.

Hopefully, this article helped you better understand why you’re feeling leg pain and what you can do to take care of it. Good luck!

Featured image: © Thongcharoen/kzenon

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