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Thread: Doc for spasms

  1. #1

    Doc for spasms

    We are looking for a doctor who can help with spasms related to SCI. Can anyone tell me what type of doctor would be best suited to addressing this issue? Thanks.
    - Moody

  2. #2
    I saw this post yesterday and I'm surprised nobody has replied yet. I haven't gone to a doctor about spasms because they are good for muscle tone and things like that. I keep them in check by stretching and putting on my leg braces. If it does get out of control i would think a neurologist would be the one to see.

  3. #3
    I go to my rehab doctor about my muscle spasms and if they get really really bad like mine has I got a baclofen pump put in this past Jan. I saw a neurologist and he put the pump in for me. but rehab doctor should be able to put you on spasm medications if that's what the two of you think should be done first.

  4. #4
    I actually see a physiatrist who specializes in pain. She takes care of my baclofen pump and has lots of experience with them, especially for pain, although all we have in mind is baclofen at this point. In the past, I just saw a spinal cord injury rehab specialist to take care of all of my medications. Hope this helps.
    C-5/6, 7-9-2000
    Scottsdale, AZ

    Make the best out of today because yesterday is gone and tomorrow may never come. Nobody knows that better than those of us that have almost died from spinal cord injury.

  5. #5
    what's out there? i have really, really terrible spasms........Steve.

  6. #6
    Quote Originally Posted by steve garro View Post
    what's out there? i have really, really terrible spasms........Steve.
    Steve,

    I moved this thread to the care forum where most people will see and comment on it.

    Do you have spinal cord injury? What medications are you now taking? What do you mean by spasms? Do you mean rigidity and stiffness, which is usually called spasticity. Or do you mean sudden spontaneous movements of your legs and arms? The latter is usually spasms.

    Spasticity is treated with drugs like baclofen and tizanidine. These will reduce the tone of your muscles, decreasing the intensity of reflexes, including clonus (the repeated to and fro movements of your joint once it starts).

    Spasms are usually treated with drugs such as gabapentin (neurontin). Note that every high doses of baclofen can reduce spasms as well. For example, a baclofen pump can deliver enough baclofen to the spinal cord to stop spasticity and reduce spasms.

    Both spasticity and spasms are aggravated by pain or irritation. So, if you have a decubitus, a bladder infection, heterotopic ossification (HO) of the hip, anal hemorrhoids, venous thromboses (clots in your leg veins), etc. they make spasms worse. The first treatment is to eliminate the cause.

    Wise.

    Wise.

    In general

  7. #7
    Quote Originally Posted by Moody View Post
    We are looking for a doctor who can help with spasms related to SCI. Can anyone tell me what type of doctor would be best suited to addressing this issue? Thanks.
    The first doctor I saw about my severe spasms and tone was the neurosurgeon who monitors me to ensure that my SC tumor is still in remission. He put me on oral Baclofen.

    As I moved from city to city over the next eight years, management of my spasticity and Baclofen use switched from the neurosurgeon to a neurologist to a physiatrist.

    When the oral dose of Baclofen (at 80 mgs four times a day), stopped providing me any relief, the physiatrist referred me to an anesthesiologist/pain management specialist who implanted my first Baclofen pump. (Best thing I ever did for myself.)

    When I moved again down here to the US Virgin Islands, management of my spasticity is split between a physiatrist in Puerto Rico, who refills and adjusts my pump, and a local (on-island) neurologist, who prescribed methocarbomol to help quell problems with spasticity/spasms in my upper body (above the level of my intrathecal catheter for the pump).

    Long story short -- you have a choice of medical disciplines which can deal with this problem. The key is finding someone with whom you feel comfortable, in whom you are confident, and who is knowledgeable and flexible enough to explore all of the options to find what works best for you.

    --THC

  8. #8
    Quote Originally Posted by Wise Young View Post
    Steve,

    I moved this thread to the care forum where most people will see and comment on it.

    Do you have spinal cord injury? What medications are you now taking? What do you mean by spasms? Do you mean rigidity and stiffness, which is usually called spasticity. Or do you mean sudden spontaneous movements of your legs and arms? The latter is usually spasms.

    Spasticity is treated with drugs like baclofen and tizanidine. These will reduce the tone of your muscles, decreasing the intensity of reflexes, including clonus (the repeated to and fro movements of your joint once it starts).

    Spasms are usually treated with drugs such as gabapentin (neurontin). Note that every high doses of baclofen can reduce spasms as well. For example, a baclofen pump can deliver enough baclofen to the spinal cord to stop spasticity and reduce spasms.

    Both spasticity and spasms are aggravated by pain or irritation. So, if you have a decubitus, a bladder infection, heterotopic ossification (HO) of the hip, anal hemorrhoids, venous thromboses (clots in your leg veins), etc. they make spasms worse. The first treatment is to eliminate the cause.

    Wise.

    Wise.

    In general
    yep. i'm an SCI. t11/t12 incomplete. on baclophen, 20mg 3x a day, lyrica 100mg 3x a day. i'll take 5-10mg valium at bedtime to help with spasms, depending on how my day is going. spasms are worst at night & keep me awake. no problem going to sleep if spasms are not present. i don't want more baclophen, my spasticity is under control, and i use tone allot to walk. plenty flexible, do lots of sports........really the only issue i have is these damn spasms & no sleep, which screws up everything else - attitude, energy - ........don't want more valium, gotta go to work in the morning & more then 20mg puts me in a haze.........where to go? thanks allot for the generous giving of your time, Steve.

  9. #9
    We are looking for a doctor who can help with spasms related to SCI. Can anyone tell me what type of doctor would be best suited to addressing this issue? Thanks.
    Moody,
    Most here will tell you a physiatrist, and generally that is true, but I think the answer always should be qualified by saying it should be a doctor who specializes in treating spinal cord injuries. While physiatrists are "physical medicine and rehabilitation" specialists and will always have been trained in spinal cord injuries, not all are particularly interested, and may not have kept up in this area. If they have spent the last 20 years treating pain patients, or stroke patients, they might not be the best choice...... as was the case with the two that I have seen. On the other hand, you could conceivably run into a neurologist, as another poster mentioned, and as I did, I actually originally went to him for my migraines, who happens to be very well versed in this area. Although I have since moved (and my migraines have disappeared), he is responsible for helping me find my current regimen, that I am very happy with...........and my regular doctor continues for me. If I were looking for somebody again, I would be looking at physiatrists BUT I would ask first how many SCI people they treat every year.

    Steve,
    I have been taking a stiff dose of tizanidine, 12 mg, for night-time spasms for many years, and I find it quite helpful. What I like about tizanidine is that it seems to be very short-acting, so by morning there isn't any residual effect. In fact, the only problem is that it doesn't make it all the way through the night, lasts 6 hours max, so sometimes I will get up and redose again, but with a smaller dose (4 mg) the second time. I don't find that it effects my tone at all the next day....... I wish. I can't use it during the day because the effective dose makes me too sleepy (more than valium), but during the night, this is a good thing. I use neurontin during the day, kissin cousin to Lyrica, but for tone, spasms are rarely an issue during the day. I don't hear much about neurontin (gabapentin) being used for tone, but unlike baclofen, it seems to help some for me. Valium loses it punch if I use it more than occasionally, so it's not an option, guess I am pretty well stuck with gabapentin anyways.

  10. #10
    Quote Originally Posted by dunwawry View Post
    Steve,
    I have been taking a stiff dose of tizanidine, 12 mg, for night-time spasms for many years, and I find it quite helpful. What I like about tizanidine is that it seems to be very short-acting, so by morning there isn't any residual effect. In fact, the only problem is that it doesn't make it all the way through the night, lasts 6 hours max, so sometimes I will get up and redose again, but with a smaller dose (4 mg) the second time. I don't find that it effects my tone at all the next day....... I wish. I can't use it during the day because the effective dose makes me too sleepy (more than valium), but during the night, this is a good thing. I use neurontin during the day, kissin cousin to Lyrica, but for tone, spasms are rarely an issue during the day. I don't hear much about neurontin (gabapentin) being used for tone, but unlike baclofen, it seems to help some for me. Valium loses it punch if I use it more than occasionally, so it's not an option, guess I am pretty well stuck with gabapentin anyways.
    hey, thanks, D. i'll look into that for sure! i was on neurontin, but it zoned me out hard, all day. with lyrica, i'm OK. no lyrica = severe nerve pain........Steve.

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