Spaulding Rehabilitation Hospital Cape Cod’s Centers for Comprehensive Spasticity Management are offering expanded services to persons living with spasticity. “We bring all the components together -- medical and rehabilitation expertise, therapists skilled in neurological rehab, and technologies to enhance treatment -- to improve the lives of our patients,” says Scott Abramson, M.D., staff physiatrist at SCC. He and Susan Ehrenthal, M.D., Andrew Judelson, M.D., and Jay Rosenfeld, M.D., all specialists in rehabilitation medicine, evaluate and treat spasticity at outpatient centers in Sandwich, Yarmouth, Orleans and Plymouth.
Spasticity occurs when nerve pathways within the brain or spinal cord that control muscles are damaged by stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, cerebral palsy, ALS and other neurological conditions. Muscles can become overactive, resulting in excess muscle tone, stiffness and pain. Diagnosis can be tricky, as symptoms can develop months or years after a diagnosis, when care is often managed by a primary care physician.
“Physiatrists are a resource to PCPs,” says Dr. Abramson. “We have the experience to differentiate types of spasticity and to develop the best treatment plan based on the patient’s whole picture. When injections are indicated, we use techniques to isolate the specific muscles that will respond. We work with our therapists to time interventions to maximize the effectiveness of therapy. As a result, we make a pretty big impact on the patient’s quality of life.”
SCC’s physicians team up with physical, occupational and speech therapists to overcome the limiting effects of spasticity. Early diagnosis is critical, since untreated spasticity can lead to hygiene problems, sleep problems, fungal and other infections, and progressive loss of function. In more extreme cases, a surgeon implants a pump that releases a steady dose of medication into the spinal cord, or the patient undergoes surgery to release tendons or sever the nerve/muscle pathway to try to restore function.
“When spasticity is caught early, therapy, splints and certain medications can often stretch out the muscles,” says Dr. Abramson. When the condition is more severe, SCC physicians inject botulinum toxin into the overactive muscles. This localized treatment affects only the targeted muscles and does not interact with other medications.
“I’ve had patients in severe pain respond within a few days after the injection. Then the therapist can focus on improving the patient’s range of motion. Working together, we’ve been able to take the pain out of the picture,” says Susan Ehrenthal, M.D.
For more information or to make an appointment, please call 508-833-4141.