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Thread: New T4/T5 - neuropathic pain, recovery, spasm

  1. #1

    New T4/T5 - neuropathic pain, recovery, spasm

    Six months ago I received an incomplete T4/T5 injury due to a motor vehicle accident. T4 and T5 became mis-aligned, crushing but not severing my spinal cord. MRI shows cord still intact, although squeezed at one point.

    3 weeks post-injury I started receiving very muted feeling in my left lap. Over the next 4 weeks I slowly got more muted pressure feeling in both legs from the lap down to the calf. Also got skin feeling in parts - could tell if a leg hair was tugged. Doctors (normally very pessimistic) were hopeful.

    Then I came out of "spinal shock" - my neuropathic pain become intense & they put me on 50mg of Amitriptyline nightly to dampen the pain. Following this I lost all feeling. (My neuropathic pain feels like pins & needles in my legs and feet with occasional sharp electric jolting pain.)

    Does neuropathic pain generally decrease over time? If it does and I stop the Amitriptyline, will I regain the sensation I had? Might I also have muscle control return?

    My only continuing physiotherapy is stretching of legs to regain some flexibility. I'm also talking Baclofen for the spasm and tone in my legs. The tone gets extremely bad at night. Is there anything else I should be doing to help my body get better? I have no motor control below my level of injury except for some stomach control (helps with bowel movements), so how can I exercise or "teach" something I don't have? I also re-gained some trunk muscles; one day I just work up and could balance when sitting whereas before I couldn't.

    Thank you for any help you can provide.

  2. #2
    When I lowered my dosage of Nuerotin a few days ago my neuro pain has gone up and, like you said, it's a very sharp, intense pain. I have read the Neurotin, or other nerve medicines, can dull sensations. Also, baclofen, can make muscles week causing it harder to move muscles that haven't been moved in months/years. I found that in order to gain the muscles in the trunk like the abs, obliques, and mid to lower back muscles, I had to do excersizes that incorporate them like using cable weights. Two cables positioned directly in front of you with minimal weight and what you do is grab the cables and reverse flye them quickly. The weight pulls you forward and your body's natural function is to use your lower back muscles and if you can't, like I couldn't, it tries to. My body eventually started to use them and now they are getting stronger. I was told, however, they will never be like they used to be. You can also position a cable above your head and position your chair to where the cable is on your right and the cable is a few steps ahead of you. You grab the cable with your left hand and bring it towards your left hip but when the cable gets directly in front of you try to turn your torso. This will try to incorporate the obliques, worked for me. Hope this helps and good luck

  3. #3
    Hello Spaus,
    I think there will be a lot of people here that will give you good advice on how to get the best of your situation. You'll see though that pain like this can often escape explanation or satisfactory solutions.
    I am T4 complete. I have pins&needles almost all the time, but some days they are like a quiet hum and other days they crank up the volume (so to speak). Because of the good days I don't take any medication. I find I can get by. But I have tried a few and none really worked anyway.
    Regarding physio/exercise I think you should try to do as much as possible. Stretching is good, but if you can get access to a motomed bike or something similar, that would be really good too. And it will help with the spasticity. Often exercise increases the pain while you do it, but afterwards the legs do feel better (my experience anyway). If you can get to use a standing frame too, that will help spasms, circulation, balance, keep your feet from dropping.
    Do look into adding more to your physio routine. I would imagine that the more you do, the more return you might get as you are incomplete.
    Good luck.

  4. #4
    One would expect changes to be happening over at least a full year after a cord injury. Amitriptylline is a good drug to prescribe for neuropathic pain but there are others and in my experience they work best in combination. I have never heard of sensation being cancelled out by amitriptylline. On the other hand, the neuropathic pain feelings could be overwhelming the other sensations so that you do not perceive them.

    Good luck with your recovery.

    RAB

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