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Spasticity Treatments Explained by Neurologist
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- เผยแพร่เมื่อ 16 ส.ค. 2024
- Time stamps:
0:29 What Causes Spasticity
1:32 Conservative Treatments
5:13 Drugs
7:20 Marijuana
8:43 Botox
10:49 Baclofen Pump
12:17 Other Treatments
Selected Sources:
L-Threonine for spasticity: www.ncbi.nlm.ni...
Dry needling for spasticity after stroke: academic.oup.c...
Review of spasticity treatment from Neurology India: www.neurologyi...
Review of Spasticity treatment: pubmed.ncbi.nl...
Randomized trial of tizanidine in multiple sclerosis: www.tandfonlin...
electro-dress Mollii on spasticity and functioning in chronic stroke: pubmed.ncbi.nl...
Randomized trial of botox A in spinal cord injury related spasticity: pubmed.ncbi.nl...
Dorsal rhizotomy: link.springer....
Cannabinoids in Multiple sclerosis: www.dovepress....
Randomized trial of Sativex in multiple sclerosis spasticity: pubmed.ncbi.nl...
Meta-Analysis of Randomized trials for acupuncture in post-stroke spastic hemiplegia: pubmed.ncbi.nl...
Meta Analysis of TENS vs. Placebo in Post-Stroke Spasticity: pubmed.ncbi.nl...
Randomized trial of TMS in 16 people with Multiple Sclerosis
MAS= Modified Ashworth Scale : www.ncbi.nlm.n...
Comment or ask questions below! I would be happy to answer!
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My book "Resilience in the Face of Multiple Sclerosis" on Amazon: www.amazon.com...
Dr. Brandon Beaber is a board-certified neurologist with subspecialty training in multiple sclerosis and other immunological diseases of the nervous system. He is a partner in the Southern California Permanente Medical Group and practices in Downey, California (South Los Angeles). He has several publications on MS epidemiology and has participated in clinical trials for MS therapeutics. You can follow him on twitter @Brandon_Beaber where he regularly posts about MS news and research.
Follow me on twitter: / brandon_beaber
Music: INNER GRACE - Copyright 2018 Wilton Vought Source: Really Really Free Music Link: • Video T
he video material by Dr. Brandon Beaber is general educational material on health conditions and is not intended to be used by viewers to diagnose or treat any individual's medical condition. Specifically, this material is not a substitute for individualized diagnostic and treatment advice by a qualified medical/health practitioner, licensed in your jurisdiction, who has access to the relevant information available from diagnostic testing, medical interviews, and a physical examination. To the extent that Dr. Beaber endorses any lifestyle change, behavioral intervention, or supplements, the viewer should consult with a qualified healthcare professional to determine the safety and efficacy of the intervention in light of their individualized information.
Hello I have spasticity and ataxic cerebral palsy. I take baclofen and flexeril and go to two PTs. Baclofen has changed my life. Thank you for such a great video. I have no sleepiness side effect but my PT says I have quite a lot of tone and spasticity. Take care yall.
“If you live on planet earth” You crack me up Dr. Beaber. Thanks for the helpful information!
:)
I had a spinal cord injury and Dry needing with tens has helped me progress in walking with spasticity. Similar to acupuncture but longer needles and deeper in the muscles. It has reduced my muscle spasms and allowed me to gain more flexibility and strengthen my muscles
I had a massive stroke in 2003 at 33yo spasticity is ruing my life, I've tried every technique you mentioned all to no avail, I've given up at 54yo and accepted this is my life. Botox did nothing the more i stretch the tighter it gets. very depressed about this.
I was diagnosed almost 2 years ago this April. I had the worst spasms at the very beginning. I was put on baclofen and knock on wood I haven't had one since. Thank God for that drug. The spasms got so bad they were actually painful in my abdomen area
Phenomenal video as always. Some tips that work for me are the following.
I stretch 4 to 5 times a day.
I use a massage gun
I take magnesium and use magnesium cream.
I drink 4 to 5 quarts of water a day.
I exercise daily
Thank you as always Dr. Beaber
Thankyou
for a great video Dr Brandon. You provided alot great tips to combat spasticity. I will definitely bring this up to my neurologist next month at my clinic visit. You knocked itout of the park again my friend. Have a great day and thanks again.😁
Thanks for sharing Matt. I didn't even know they were called "massage guns"
@@DrBrandonBeaber You're welcome. Yes TheraGun Massage Gun they work great. Make the investment you'll be using it everyday.
Matt Z, I was wondering what your thoughts are UBV lamps as far as healing your MS? If you don't know what I mean please check Steve Solves MS channel. He makes alot of good points and swears by weightlifting and building muscle to bring MS to a halt. He also swears buy one meal a day which I'm not sure I could adhere to. He's taking 2500 calories in that one meal and drinking water and using supplements the rest of the day. He's a different animal that's for sure. If you get a chance to check out his channel I'd be honored to know your thoughts on it. Thank you Matt.
Yes I agree massage guns /wands are amazing! I also drink a lot of water too which I find helps a lot along with the stretching - I practise qigong as its gentle but effective. I've never tried the CBD oil yet but heard good reviews about it.
Thanks for this video Dr Beaber, as always on point and informative.
Scraping of the fascia helps me.
I've had spasticity for about 7 years after my first episode which attacked my bladder. The second episode happened about a year later and hit my upper back (my main pain/tightness area) and bladder. Most major bladder symptoms went away but the spasms slowly increased over time and now spasms in my legs torso, back and arms. I did steroid injections in my back but they only seemed to help for about two weeks or so. The upper back is the worst since the pain and tightness gets worse the longer I sit or lay down on it. About a year ago I started doing deep tissue for my upper back and that has been the only thing that has helped with my upper back spasticity. I started magnesium about 6 months ago and that has seemed to reduce the smaller twitches and haven't noticed any foot cramping in a while. For about 2 months after starting magnesium I had way less bad days in my upper back pain. I seem to have to take more magnesium now to have the same effect it did about 6 months ago. I also stretch, do light exercise and have a massage gun. The small twitches are constant in my legs when relaxed, they happen so often some of them I don't feel but I can see visually. Spasticity is my main symptom. I'll try anything to improve it or reduce the symptoms. I think the next thing I'll add will be potassium and I'll try l-threonine. Standing desk is also extremely helpful.
Thanks again for all the helpful info! I'm very happy I have found your channel.
I use cannabis for spasticity issues.
In the early mourning, I wake to empty my bladder and often I am greeted with leg cramps which get much better once I urinate, however I must make it to the toilet. I find that a couple of inhalation from my medical marijuana vape pen will almost immediately loosen up my leg cramps enough to give me a safe flexible stumble to the bathroom.
Also on the subject of spasticity and cannabis, I have topical cream that I massage into my more severe leg cramps that also just loosen up my general leg movent on those days that I feel like I am wading through peanut butter up to my knees.
Thank you Dr. Beaber! My MS Specialist prescribed clonazepam for my spasticity, but cautioned me to only take a half a pill, at night time before bed, if I really, really need it. Usually a combination of THC/ CBD helps my spasticity enough that I don't need the medication. Indica strains can be more helpful than sativa strains at relieving the spasticity, though they can contribute to fatigue. A hybrid is nice, to help to not get fatigued, if you need to still be functioning, but you need relief from spasticity to function.
Last year I was in contact with GW Pharmaceuticals, who were planning to conduct studies in the US on nabiximols (sativex) but unfortunately for us US folk, they seem to now only be recruiting in Poland.
Both my mother and I just purchased a TENS unit. She has peripheral neuropathy and osteoarthritis in addition to a couple of joint replacements. I have MS with spasticity in both legs, most markedly the right leg. When they first spotted the "artifact" on T-11 at the ER 4 years ago, they also noted I had a "mildly" lumpy disc on L-4. And, though I understand in the face of an active lesion, a lumpy disc seems like chopped liver. Trust me, it ain't. It sits right on the sciatic nerve and then proceeds to aggravate the heck out of the spasticity. Ever have a spastic leg with a screaming sciatic nerve? Needless to say, as a bodybuilder, I train up to 1-2 hours/day with one day specifically dedicated to mobility. But, warm up and cool down stretches are imperative and I never skip out. In addition, all post workout recovery includes pro-sonic massage gun, 7 minute ice cold shower (beginning with hot water), 30 mgs of Baclofen, 25 mgs of CBD to help with inflammation and sleep, and now this magical TENS unit, which Mom just tried out on me last night. It's amazing! I haven't had this kind of relief in the lumbar area in years! We're going to try it out on my hips tonight (post workout) and then move down to legs. It's also interesting because it provides and understanding of the degrees of sensation or lack thereof in different areas from the waist down. I actually had to turn the thing on maximum strength to even feel it in the back & waist area, but I've grown so accustomed to lack of sensation - I can't readily tell how numb or not numb the lower extremities are. This brain no longer recalls what full sensation felt like if that makes sense, so there's no comparison? Anyhow, thank you for the suggestion - this just may help take my fitness goals to the next level in addition to help with recovery and spasticity!
I’ve been in baclofen for yes and it doesn’t have much affect on me anymore. I had taken cyclobenzaprine now and that worked great for a bit. I definitely helped with bladder
Another great video !! Thanks
I use baclofen 5 mg, I adapt the dose throughout the day .
Stretching several times a day.
Having just the right "dose" of spasticity can help to have some "strength" .
I have definitely had some patients with significant lower extremity spasticity take too much baclofen to the point of causing weakness. 5mg of baclofen is probably an amount that most adults can tolerate during the day and still be productive.
Thank you for posting i have a 40 cal bullet stuck in my spinal cord doctors can't take it out its in between t11 and t12 i take a lot of percocet 10/325 and other depression pills for nerve damage kinda sucks depending on pills but it relieves me from pain i hope my body fights bullet out they say sometimes your body trys to fight a foreign object out. Have a Great and Blessed Day
When you mentioned dry needling, which I have not tried, I also thought of dry brushing. I have found that consistently dry brushing may be moderately effective at preventing my spasticity, or perhaps just lessening it. It is something that is hard to tell exactly what the benefit is, but I notice myself having a harder time if I haven't dry brushed in a couple of days. I dry brush from my feet, going up in circular motions toward the heart, then from my neck and down towards my heart, before a shower. Then after I apply helichrysum and turmeric essential oils, in a carrier oil, and massage it down my spine starting at the base of my neck, my arms, my chest, my abdomen, for MS hug, and down my legs, ending in a foot massage.
Excellent presentation! I am taking Tizanidine and Cymbalta to reduce muscle tightness and pain associated with AMN. I do isometric exercises almost every day to improve the brain/ muscle connection. Isometric exercises seem been than just stretching. Acupuncture helps needles and cupping. Swimming or walking in a heated pool helps. My neurologist is a DO and he does hands on manipulation that helps. Also from time to time cranio sacral therapy. I would like to see a video on how releasing build up of spinal cord fluid in the brain through hands on manipulation can relieve pain and tightness. My neurologist and craniosacral therapist do it on a regular basis but I don’t understand it.
Gut cleansing really helped with my spasticity
How did you cleanse your gut?
Thank God for you, sir.
I have MS since 1996, and my spasms began a few years ago, maybe 15. I take baclofen, 3 times a days, and started Tizanidine, one time a day, before I go to bed, a month ago. Only baclofen didn't help, during the day it was ok, but at night, sometimes I coundn't sleep of so many spasms. Now combining the 2 drugs I have a better result.
Would you want yo hear some suggestions?
@@user-nt9rj8sz4m yes please
Thank you Dr Beaber for another informative and helpful video. A therapy I use not mentioned is a Confidence Fitness Vibration plate trainer. It quiets my spasticity so I can sleep at night. I've also found therapeutic horseback riding to be effective and the benefits last for up to 24 hours and keep my muscles limber. I use a walker and bilateral Bioness units have relaxed the spasticity and helped with foot drop so I can remain ambulatory. Unfortunately, they are expensive and not covered by insurance so I'm thankful for friends that raised the needed funds for me to have these helpful devices. I also eat pomegranates which are high in potassium on days when the spasticity is most troublesome. I would be interested in more information on the use of Botox for bladder spasms and urgency. Thanks again for these weekly videos!
Thanks for sharing Becky. I have a video on neurogenic bladder (mostly focused on UTI prevention) which should be published 4/7/21. I don't personally perform bladder botox, so I don't know too much about the technicalities, but I have had patients who have had good success with this. Probably, the people who get the best results are those who already do intermittent catheterization and want relief of urgency and incontinence with detrusor injections.
Thank you for responding to my comment Dr Beaber. I will take a look at the video. I would love to see some research done someday on therapeutic horseback riding and MS. I know at least for me it remains beneficial in reducing spasticity, relieving neuropathy and pain and for promoting restful sleep. I'd encourage others to seek out this option if it is available for them.
omg thank you ive got spastic cp and ive always wanted something like this
I'm glad it helped.
Excellent de-brief thank you for sharing the valuable insight Doctor
Thank you 4 your content! Greetings from Germany :-)
I have terrible spasticity my legs, arms, and back. I have tried baclofen, zanaflex, Botox, and I'm now using Dantrolene. my current medication is the only one that has had any positive effects. I will be getting a baclofen pump in about 20 days. Of all of the MS symptoms, if I could pick one to get rid of, it would be spasticity.
Wonderful explanations… #Sharingiscaring
Thanks for this beautiful information is their any surgery for mild spasticity ? Can spasticity can fully cured if worked on properly
Spasticity in legs, cramps and stiffness in the morning is the worse. Tried baclofen, BOTOX, acupuncture, clonazepam and off course stretching they all did nothing really noticeable. Full spectrum hemp oil and massages do have some effect. When I first started the hemp oil it worked amazingly, effect did ware of a bit. It does come with a side effect; better sleep. I would recommend everyone to give it a try. Still I like to try BOTOX again but not for the lateral calf head as i had before. This time for the small foot stabilisation muscle. My guess is this one is making my foot drop worse. I do have to persuade my hcp to give it a shot. Spasticity is also the only symptom I am sure of I progressed in the last years. Hope this is do to other things then smouldering MS. Thanks for the video.
I got diagnosed with inappropriate sinus tachycardia cardiologist said its multiple sclerosis related..my neurologist said it's not multiple sclerosis related unbelieveable
Great video. My doctor says 80mg is the maximum dose of oral baclofen, but I take 120mg .
You say it’s 160?
There is a risk of sedating with higher doses, but some people are able to tolerate them.
why does sativex works perfect @ night with 4-5 spray and @daytime with 7 not so good?
I can't say I have any clinical experience with this because it is not FDA approved and hence not available in the united states, but this is what the product label says: "The average dose of SATIVEX® is 4 - 8 sprays per day. There is limited experience with doses higher than 12 sprays a day
but you may need a higher number of sprays." omr.bayer.ca/omr/online/sativex-pm-pt3-en.pdf
@@DrBrandonBeaber thanks dr.beaber, i tried the max of 12, i will ask my doc if we can stack a little bit of baclofen too.
MMJ works wonders
What about newly approved time release Baclofen (called R Baclofen) FDA approved in Jan 2020. Any reviews? Thank you.
Hi dr Beaber, thanks for the informative video
Are you familiar with ECWT? I get it on the calves (3 sessions weekly) every 8-9 weeks and has a moderate (but worth it) effect on (in my case) mild spasticity in the legs and feet
Drugless with no side effects 👍
for some reason i can't tolerate the muscle relaxers bacoflen or tisanadine or nerve medication like gabapentin i do use the ems/tens units i find the one in your image the best "powerdot" tens for nerve pain and ems for muscles, the uk is starting new trials this year called 'octopus' sounds interesting 😀
Thank you for the great information. You mention mag oxide. I take mag glycinate. Is there a significant difference related to spasticity?
not that I know of. I believe the magnesium mineral is the active ingredient essentially.
Congratulations on this video
I was using Sativex for some time, it does have a quite strong taste and I couldn't walk...
Quick question, would you say it is spasticity the need of stretching one leg? It happens to me in the evening only...
Spasticity can definitely give you a feeling of muscle tightness and the need to stretch your leg.
@@DrBrandonBeaber What about the time thing?
@@jacobosantamartabarral434 happens to me too, I take 5mg/baclofen and magnesium about one hour before bedtime.
Oh can you please talk about the vaccine for MS by Biontech?
I think it's still ongoing study, I've read that a future vaccine will use the same Mrna technology used in COVID-19. For us we must wait for medication to repair myelin 💪💪💪 hope you're doing well.
@@pedrodacostapinto Thanks! I am fine, you?
@@jacobosantamartabarral434 feeling strong, waiting that COVID-19 goes away to star physical rehab 💪💪
Thanks for your information. I suffer from MS spasms and fatigue. Do you have any data on the use of Delta 8 (THC from hemp)?
I've not received any relief from Baclafin, Tizanadine, Valium, Flexeril, Ativan or Gabapenten.
Everything I have found is related to delta-9-tetrahydrocannabinol.
My leg spasticity has worsened steadily since last relapse many years ago. Is my spasticity worsening as it does with other forms of BI and SCI or is my MS worsening. This is what I ask myself, but I would like to know what someone else thinks as it probably is not cut and dried. Of course it doesn’t make a difference I just want to understand better.
Ok I guess the ethereal quality of disease progression continues in my mind. L Threonine I had not heard of before so that’s a great lead! I have gained so much from you and Dr. Boster and managing my disease the best way I can. Thank you for what you do.
Mark this
No one understands ppms...