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Spasticity Treatment and Baclophen


This week I had someone ask me about Baclophen as a treatment for spasticity after Stroke. So, I started looking for more information- beyond what my experience is with my Stroke Survivor clients. I have searched research articles and they have solidified what I know to be true in my practice. The Medical community does not know exactly what causes spasticity after Stroke and therefore, medical treatments prescribed may widely varied success.

Let's just review what we do know.

A Stroke causes injury to brain tissue because blood flow to an area is disrupted. It could be from a blockage of blood to the area - called an Ischemic Stroke. (Ischemia is just the medical term for lack of blood to an area). Or, it could be due to a vessel breaking- called a Hemorrhagic Stroke.

In the Ischemic Stroke, the area affected is mostly determined by the vessels affected. What ever area those vessels were to provide blood to are damaged. For the Hemorrhagic Stroke, the area that those vessels were to provide blood to are affected AND any brain tissue that gets compressed due to the bleeding in an enclosed place (inside your skull) causing pressure on that brain tissue. But- in general- there is brain tissue that is damaged and some tissue that dies.

Think about how your brain was "running" your body before the Stroke. It looked something like this: Your brain was sending a certain level of signal to your muscles all the time. That signal is "dampened" by some aspect of brain function to be an appropriate level. So, your muscles activity was not too much, not too little. That "just right" level of signal is generally refered to as "Tone". There is actually a typical level of "tone" in your muscles at all times. What science suspects happens when some of your brain is injured- like in a Stroke- is that the "dampening" effect is damaged and that there is inappropriate increased signal going to muscles. Sometimes medical professionals refer to this as "Tone". That is not the correct way to phrase it. It is actually "Increased Tone". Another way to refer to it is Spasticity.

I have talked a bit about how Botox works in the body in this blog . I wanted to look a bit more at a drug called Baclophen today. Baclophen can be given as a pill by mouth or it can be delivered through a pump to the spinal cord. Most folks that I help have experience with the pill form of Baclophen, so that is what we will look at.

First off, Baclophen cannot "cross the blood-brain" barrier so it cannot have a direct effect on brain tissue. It is thought to be able to "dampen" excitatory signals in the spinal cord from getting to the muscles. But, it is not known exactly how it works in the body. As with most medications, there are side effects that can include: Drowsiness, confusion, headache, lethargy. (click here for article).

Some people have positive results using Baclophen to help improve stiffness/increased tone/spasticity. Some people do not. But, you won't know if it can work for you if you don't discuss it with your doctor. So, it may be worth it for you to investigate this as an option.

I think having tools that you can actively use to decrease the signal to your muscles is a key for ultimately managing and possibly abolishing your spasticity. If you are able to do something that decreases your tightness, even 10%, then that indicates that you can actively do something for yourself to decrease your spasticity. And, combining this with medications, exercise, stretching and other things gives you a plan of action to reduc that signal. Then you can work on changing the signal all together and helping your brain learn how to send the typical level of signal so you can increase active movement in your body.

In the next Blog, I will share a strategy that I use with clients to help them learn how to start to reduce their spasticity on their own.

If you have questions or are interested in learning how to actively learn how to control your Spasticity- email me at shannon@thrivestroke.com

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