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Thread: Local spasticity - how to reduce?

  1. #1

    Local spasticity - how to reduce?

    I need some ideas on managing/reducing very localized tone/spasticity. I have an incomplete injury at T3 with a history of syrinx and tethering, and some of sensory weirdness is up around T1.


    Overall, I have some tone and clonus, moderate spasticity which historically responds pretty well to tizanidine (I don?t tolerate baclofen or valium), stretching, estim, Botox, AFOs, weightbearing etc - except for one foot, where I have ruptured three tendons and torn up the ligaments in my foot and toes over the last few months. Nothing has changed in terms of my routine or health overall, no ?noxious stimuli?, kidney/bladder stones, UTIs or ingrown toenails/hairs triggering an increase in spasticity globally. No inexplicable increase in AD, no hyperhydrosis. Topical NSAIDs help, which I find weird.


    Toes seem pretty vulnerable to me - they easily get jammed and squinched anyway and now they?re jamming and squinching themselves all every which way so suggestions on causes/solutions would be really welcome.

  2. #2
    Sounds like a reasonable case for botox, which will give you some flaccid paralysis of those muscles. If you're incomplete you just have to be sure you're not using a certain degree of spasticity to help you ambulate/transfer/etc.

  3. #3
    Botox can be dosed by a skilled user to decrease spasm and tone, without going all the way to flaccid.

    (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.

  4. #4
    I had Botox in my gastroc and soleus too recently to be eligible for another round in my anterior tib (?) or whatever is plantar flexing with such enthusiasm. It’s maddening.

  5. #5
    I assume you are stretching and doing vigorous, at least daily ROM to the involved joints/muscles?

    Other materials such as phenol or alcohol can be used for a permanent local nerve block, but this can be also tricky if not done by an experienced neurologist or physiatrist.

    (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.

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