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    Pain and Spasms

    Spasms
    My wife is a T3 a/o 12/01/08 she has been home since 2/10/09 and has recently (3 weeks or so) started developing spasms that have begun to last all day and night. She has tried a couple of medications with no long lasting effect. It stops the spasms for say four hours but then they return. An additional dose (not prescribed) does not help. I'll have to find out the medication names I think it is baclofen and levaquin?
    Pain
    She is fused from the skull to C3 and from T2 - T8 she has severe pain around her shoulder blade area. She has been taking morphine and Neurotine which we now find out the Morphine shouldn't be helping. The Neurotin doesn't seem to do anything and the Morphine seems to be starting to do less (tolerance?). Her doc now is going to try a Tens unit.

    So on top of the spasms keeping her awake the pain is not going away this is not good.

    #2
    Levaquin is an antibiotic. It does nothing for spasms.

    Spasticity (very tight muscles) is a part of life for most people with SCI. The goals for treatment should not be to make it go away, but only to tone it down, as spasticity is also good for you. It maintains muscle mass, serves as a warning of something seriously wrong (broken bone, UTI, impaction, etc.), burns calories, and can sometimes be used functionally. It should only be treated if it is interfering with function or mobility or safety or hygiene or sexual activity.

    What dose of baclofen is she taking? It should be taken 4X daily as it must maintain a blood level to work. Many take a larger dose at bedtime to help with nighttime spasticity. What other medications have been tried? Is she working with a physiatrist on this?

    Is she also doing daily stretching and ROM exercises? Is she standing daily? Laying on her stomach propped with pillows? All can help with reducing spasticity in addition to the meds.

    How much Neurontin is she taking? If it is not helping at all, the dose may need to be adjusted, but it does not help everyone. Lyrica is also an option, and there are other neuropathic pain meds too. Tricyclic antidepressants such as imipramine help many. A TENS unit is a good idea, but caution must be used in using it over spinal hardware. Shoulder blade pain, which would be right at her level of injury, may also be made worse by muscle imbalance and spasm (not spasticity). I would recommend she see a good massage therapist who is familiar with trigger point massage and see if that is the problem for her. Clear this with her physiatrist first.

    If her physiatrist is not a pain specialist, you can also ask them to refer her to one who is.

    You are right that in general narcotics such as morphine do not do a lot for neuropathic pain, but instead just drug the person so they don't care as much that they have pain, and also really can make her constipated.

    Please get your wife on-line here herself so you can both be part of our community.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

    Comment


      #3
      Question KLD re spasticity associated pain / benefit

      I'm Fused L3-4-5 after a massive rupture of L5 disc untreated until I had lost bladder, bowel and right leg movement. I am very functional, bladder and bowels returned, weakness in legs mostly right, drop right foot, and no sensation L5 nerves.

      I am pain, nerve, mechanical, sciatic, failed back. Have a Dorsal Sinal Stim that lost efficacy in 1 year

      I have spasticity in my legs and it is extremely painful, is it normally horrifically painful? I get bouts most nights and some days. I ask because you said spacitycan be beneficial??

      Baclofen helped but turned me into a zombie as do narcotics and everything else. My pain doc has referred me for a morphine/baclofen pump feeling the direct small dosage should be tolerable. The doc who would do it has seen me and thinks I'm a viable candidate. My trial is in June.

      any helpful info?

      Bill
      Kindly,

      The Ketamine Kitty

      All the tears, all the pain, all the rage through the night (apolgies to the rewrite) RR

      Next time I die make sure I'm gone,
      don't leave 'em nothing to work on JT

      And I ain't nothin but a dream JM

      Comment


        #4
        Have you tried Cymbalta?Good for neuropathic pain. also,
        very minimal side effects. also take an NSAID with it like Naproxen 500 mg twice a day every day.
        CWO
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

        Comment


          #5
          Thanks

          Take cymbalta, can't say it helps with pain but helps with depression.

          Naproxen does nothing.

          Thanks

          bill
          Kindly,

          The Ketamine Kitty

          All the tears, all the pain, all the rage through the night (apolgies to the rewrite) RR

          Next time I die make sure I'm gone,
          don't leave 'em nothing to work on JT

          And I ain't nothin but a dream JM

          Comment


            #6
            Levaquin is an antibiotic. It does nothing for spasms. Sorry she was originally prescribed robaxin which did nothing. The new script is for zenaflex. This worked for about for hours and then nothing. The legs started moving and kept her/us awake the rest of the night. An additional dose at that (not prescribed) time did not help. Levaquin was an antibiotic she took for a UTI she had some time ago.By the way she is now on Keflex to eliminate another UTI I guess in prep for her Suprapubic on Thursday. Doctor says that he doesn't want to risk trauma to her urinary tract with self cathing due to the 6 or so months of Foley. He says give it a rest for a little while then go to self cathing.

            Spasticity (very tight muscles) is a part of life for most people with SCI. The goals for treatment should not be to make it go away, but only to tone it down, as spasticity is also good for you. It maintains muscle mass, serves as a warning of something seriously wrong (broken bone, UTI, impaction, etc.), burns calories, and can sometimes be used functionally. It should only be treated if it is interfering with function or mobility or safety or hygiene or sexual activity. She is very loose, we stretch her pretty much every day and I don't think there is a problem there.

            What dose of baclofen is she taking? It should be taken 4X daily as it must maintain a blood level to work. Many take a larger dose at bedtime to help with nighttime spasticity. What other medications have been tried? Is she working with a physiatrist on this? Sorry see above about the medications.

            Is she also doing daily stretching and ROM exercises? Is she standing daily? Laying on her stomach propped with pillows? All can help with reducing spasticity in addition to the meds.She is very loose, we stretch her pretty much every day and I don't think there is a problem there. Not standing daily, her therapy is running out and they don't think it is that important. We are looking at getting a stander from a friend who has a son with I think CP who has outgrown his. She is only 5'1" so we are hoping it will work. Never lays on her stomach??? Why on her stomach??

            How much Neurontin is she taking? If it is not helping at all, the dose may need to be adjusted, but it does not help everyone. Lyrica is also an option, and there are other neuropathic pain meds too. Tricyclic antidepressants such as imipramine help many. A TENS unit is a good idea, but caution must be used in using it over spinal hardware. Shoulder blade pain, which would be right at her level of injury, may also be made worse by muscle imbalance and spasm (not spasticity). I would recommend she see a good massage therapist who is familiar with trigger point massage and see if that is the problem for her. Clear this with her physiatrist first.

            If her physiatrist is not a pain specialist, you can also ask them to refer her to one who is.

            You are right that in general narcotics such as morphine do not do a lot for neuropathic pain, but instead just drug the person so they don't care as much that they have pain, and also really can make her constipated.

            Please get your wife on-line here herself so you can both be part of our community. I am trying but she is PC shy.

            Comment


              #7
              My fiance has spams bad a night and we strech his legs 2 times a day and they happen when he is on his back. But nothing works for him at all. And he has very painful neck pains. So he takes hydrocodone but he says it barely takes the edge off. If the is any advice I am game for it.

              Nikki

              P.S- Drew takes d-mannose and he has never had another UTI since he started it 2 months ago.

              Comment


                #8
                If you have tried everythign and the pills by mouth make you a zombie the impanted pump can be good. They give you a test before implanting. an Baclofen and Morphine can be mixed together.

                CWO
                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                Comment

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