Did you know that up to 78% of people experience muscle spasms after spinal cord injury?
If left unmanaged, muscle spasms can drastically affect your quality of life by causing pain, interrupting a good night’s rest, and restricting your ability to perform activities of daily living.
In this article, we’ll explain everything you need to know about muscle spasms after spinal cord injury and how to effectively manage them.
What Causes Muscle Spasms After Spinal Cord Injury?
Your body sends sensory information to the brain via the spinal cord, and the brain processes that information and sends directions back down to the muscles to react.
After a spinal cord injury, sensory information can’t reach the brain because it can’t get past the site of injury.
Instead, that stimulus travels back down to the muscles, causing them to involuntarily contract.
These involuntary muscle contractions are also known as spasticity and can show up in the form of jerky muscle spasms and prolonged stiffness.
Spinal Shock and Muscle Tone
Generally, muscle spasms occur after a period of flaccid muscle tone.
After a spinal cord injury, your body may go into a state of spinal shock due to swelling of the spinal cord.
During spinal shock, you experience a temporary loss of functions and reflexes below your level of injury. The muscles go floppy and cannot contract.
As swelling dies down and blood flow is restored, some innervation below your level of injury may gradually start to return.
You’ll likely experience the other extreme, which is when the reflexes become hyperresponsive, resulting in jerky, muscle spasms.
Benefits of Muscle Spasms After Spinal Cord Injury
Believe it or not, muscle spasms after spinal cord injury can be helpful.
Increased muscle tone in the legs can help individuals prop themselves up to stand, walk, or perform transfers.
Some movement is better than no movement. Even though muscle spasms after spinal cord injury are involuntary, they help prevent muscle atrophy and promote circulation in otherwise paralyzed areas of the body.
Because of paralysis, many SCI patients are unaware of when their bladders are full or when something is irritating their skin. Muscle spasms help alert you when something is bothering your body below your level of injury.
Managing Muscle Spasms After Spinal Cord Injury
If increased muscle tone becomes painful or debilitating, ask your doctor about what management interventions will be ideal for you.
Some popular forms of spasticity management include:
Physical therapy will emphasize repetitive exercise to reduce the excitability of hyperactive muscles.
Neuroplasticity is the central nervous system’s ability to rewire itself and recover functions affected by traumatic events like spinal cord injury.
The more you practice a movement, the more your central nervous system understands that there is a demand for that movement, which prompts rewiring.
Additionally, stretching is essential for managing muscle spasms. It helps lengthen spastic muscles to limit contractures and expand range of motion.
Muscle spasms can cause you to hit nearby objects, but if you wear a brace, the jerky movements are controlled.
Orthotic devices like braces and splints will help hold your body in place to prevent spastic muscles from contracting further.
They also mildly stretch tight muscles for continuous muscle lengthening.
Muscle relaxants are often prescribed to reduce general spasticity.
They work by altering the chemical balance in the central nervous system, which reduces action potential and temporarily inhibits muscle contractions.
Because they’re absorbed into the bloodstream, muscle relaxants will affect the entire body and wear off within a few hours.
Botox is a nerve block that is directly injected into spastic muscles.
It provides temporary spasticity relief (3-6 months) but does not address the underlying problem that is causing the muscle to contract.
Afterwards, patients should take advantage of this period of reduced spasticity and focus on intensive physical therapy to promote neuroplasticity.
Surgery should only be considered if all other interventions prove to be ineffective.
Some individuals get an intrathecal baclofen pump implanted, which allows for a consistent delivery of Baclofen into the spinal column. Baclofen is a commonly-prescribed medication for spasticity.
Because it is directly administered to the spinal fluid, a smaller dose is needed, which reduces the risk of experiencing side effects like nausea, headache, and sedation.
Other surgeries involve nerve incisions to denervate the spastic muscle (rhizotomy) or manual lengthening procedures.
Muscle Spasms After Spinal Cord Injury: Key Points
Muscle spasms after spinal cord injury are extremely common due to disrupted communication between the brain and body.
Luckily, there are many ways to effectively manage them so that you can live an active and fulfilling life after spinal cord injury.
Hopefully, this article helped you better understand why you’re experiencing muscle spasms after spinal cord injury and how to manage them. Good luck!