Overview of Chronic Pain and Spasticity
Pain is the body's way of warning us that harm or damage is happening, or is about to happen, to tissues in our bodies. It is estimated that 30 to 40 million Americans a year suffer from pain that does not respond to aspirin or ibuprofen. Many of these people are older adults.
Chronic Pain
Chronic pain is longstanding pain that persists beyond the usual recovery period or occurs along with a chronic health condition. Because this pain is not protective or the result of an ongoing injury, it is referred to as "pathological" and is therefore treated as a condition, not as a symptom. Chronic pain may affect people to the point that they cannot work, eat properly, participate in physical activity, or enjoy life.
The most commonly treated conditions that cause pain are trigeminal neuralgia (a form of facial pain), failed spinal surgery, phantom limb pain, stroke and headaches.
Spasticity
Spasticity is a condition in which certain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and may interfere with walking, movement and speech.
Treatment of spasticity may include the following: baclofen, diazepam or clonazepam; muscle stretching, range of motion exercises and other physical therapy regimens to help prevent joint contractures (shrinkage or shortening of a muscle) and reduce the severity of symptoms; or surgery, including tendon release, selective dorsal rhizotomy (precise severing of the nerve-muscle pathway) and implantation of intrathecal (inside the sac of the spinal cord) catheters and pumps to deliver baclofen to the spinal cord.
Types of Treatment
- Microvascular decompression involves microsurgical exposure of the trigeminal nerve root, identification of a blood vessel that might be compressing the nerve, and gentle displacement of it away from the point of compression. "Decompression" may reduce sensitivity and allow the trigeminal nerve to recover and return to a more normal, pain-free condition.
- Radiofrequency rhizotomy involves treating trigeminal neuralgia through the use of electrocoagulation (heat). It is also used to treat pain in any area of the spine, including cervical, thoracic and lumbar regions.
Neurosurgeons at the University of Washington and at Harborview Medical Center treat chronic pain with state-of-the-art medical technology.
Content provided by UW Medicine Neurological Surgery, Seattle, Washington
Symptoms of Chronic Pain and Spasticity
Symptoms for chronic pain include trigeminal neuralgia, which is a form of facial pain that can be very debilitating and painful. Some patients describe it as being stabbed in the face with an electrical bolt. The pain can last for seconds, disappear, and then return without any warning.
Symptoms for spasticity may include hypertonicity (increased muscle tone), clonus (a series of rapid muscle contractions), exaggerated deep tendon reflexes, muscle spasms, scissoring (involuntary crossing of the legs) and fixed joints. The degree of spasticity varies from mild muscle stiffness to severe, painful and uncontrollable muscle spasms. The condition can interfere with rehabilitation in patients with certain disorders, and often interferes with daily activities.
Causes of Chronic Pain and Spasticity
Chronic Pain
In some patients, pain may begin with an initial incident, such as a fall or accident or serious infection, or an underlying medical condition, such as arthritis or cancer. However, some people suffer chronic pain in the absence of any past injury or evidence of physical damage.
Spasticity
Spasticity is usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement. It may occur in association with spinal cord injury, multiple sclerosis, cerebral palsy, anoxic brain damage, brain trauma, severe head injury, some metabolic diseases such as adrenoleukodystrophy and phenylketonuria.
Self Care of Chronic Pain and Spasticity
If medications have proven ineffective in treating trigeminal neuralgia, there are several surgical procedures which may help control the pain.