17 million people live with cerebral palsy worldwide and another 350 million are closely connected with someone who does. March is a whole month dedicated to spreading awareness about cerebral palsy. In an effort to help everyone learn about this condition, let’s spend some time going over the basics.
First things first, there are nine forms of cerebral palsy and even within those each person can have different manifestations and symptoms. Therefore, when you hear the term “cerebral palsy”, know that it encompasses a wide variety of disorders that vary in severity and meaning.
What is cerebral palsy?
In general, the National Institute of Neurological Disorders and Stroke defines cerebral palsy as a condition in which brain abnormalities or damage interfere with the normal relaying of nerve messages from the brain to the nervous system. So, what exactly does that mean? Simply put, it means that cerebral palsy can cause some serious issues.
The most common primary manifestations include:
- Lack of muscle coordination when performing voluntary movements (ataxia)
- Stiff or tight muscles and exaggerated reflexes (spasticity)
- Gait disturbances such as walking with one foot or dragging a leg
- Muscle tone that is either too stiff or too floppy
- Bone deformities
- Oral motor dysfunction such as swallowing, feeding, and speech impairments
As you can see, cerebral palsy can be displayed in many ways, but it usually appears in infancy or early childhood and permanently affects muscle coordination throughout a patient’s lifetime. It generally takes a few months up to a few years to diagnose but, on average, the signs of cerebral palsy are usually discovered before the age of three.
Cerebral palsy is differentiated from other disorders as it is a result of a one-time brain injury and therefore will not progress as further brain damage. While the brain damage will not progress, however, it is often the case that adults start suffering as they age as their underdeveloped muscles are not able to properly support the body of a grown adult.
Unfortunately, it does not stop there. Multiple conditions go along with this neurological condition and usually correlate with the degree of injury to the brain. These include associative conditions that do not directly result from the brain damage, but do occur frequently in those with cerebral palsy. These include intellectual impairments, epileptic seizures, hearing and vision impairment, along with many other associated conditions.
Cerebral palsy and chronic pain
While symptoms and manifestations vary from person to person, almost all those who suffer from cerebral palsy have to deal with chronic pain. Here are just some of the root causes of pain:
- Orthopedic pain has to do with how the bones grow as a child gets older. This can come in many forms including bone deformation, misplaced bones, hip misalignment, and bone degeneration.
- Gastrointestinal pain includes anything that has to do with the digestive tract such as incontinence, constipation, and malabsorption.
- Surgical pain refers to the pain that someone with cerebral palsy receives in the attempt to control their other symptoms and pain, such as invasive medical procedures. This classification of pain is generally short-term though and is an unfortunate side effect rather than a direct cause of the condition.
- Rehabilitative pain also refers to pain from treatment, but is moreso directed at non-invasive treatments as well as physical and occupational therapy.
The most common symptoms of pain associated with cerebral palsy include:
- Spasticity
- Respiratory problems
- Urinary tract infections
- Osteoarthritis
- Spinal/back pain
- Nerve pain and injuries
These symptoms cause pain in various ways, but they generally affect several areas of the body like the pelvis, neck, shoulders, elbows, hands, knees, and ankles. While this is not an exhaustive list, it should be clear to see how painful cerebral palsy can be and how important quality lifelong treatment is for those who suffer from its ill effects.
How can those with cerebral palsy manage their pain?
Cerebral palsy does not mean that a person cannot lead a rich and full life. There is no cure for cerebral palsy, but there are numerous treatments that exist and others that are still being researched.
One of the goals of pain management is to identify the underlying causes of pain, and what procedures, medications, or therapies can provide some relief. It is good to note, however, that since cerebral palsy can affect so many parts of the body, it usually takes multiple different specialists to collaborate to create an effective treatment plan.
Spasticity medication is one of the first-line treatment methods for cerebral palsy. Spasticity medication comes in two forms, isolated and generalized. When isolated medication is used, typically a doctor will inject the drug directly into the affected muscle or nerve. This treatment needs to be done every three months. This also comes with some side effects, such as additional pain or bruising and possible trouble breathing or swallowing. Generalized medication is taken orally and is an all-purpose muscle relaxant that may relax stiff and contracted muscles. Since there are numerous options for oral drugs, the side effect vary, but some include sleepiness, confusion, and nausea.
There are also many different types of therapies that can help improve cerebral palsy symptoms. These include physical, occupational, speech, and language as well as other alternative forms of treatment such as recreational therapy and spinal cord stimulation. While these forms of treatment can be quite extensive, here is a brief breakdown.
- Physical therapy consists of muscle training and exercises that help in improving flexibility and motor skills. It also incorporates devices such as braces to help improve walking or to stretch contracted muscles.
- Occupational therapy uses adaptive equipment and therapists to teach children with cerebral palsy to be more independent. It does this by providing the child with a way to accomplish or participate in everyday activities and routines at home.
- Speech and language therapists help improve a person’s communication skills by helping them speak more clearly or using sign language. They can also provide them with a computer that helps facilitate communication.
Invasive surgery is also an option, but it is an option that is considered after other therapy and medication options have been tried. This is usually reserved for those who have severe contractures or deformities. Although, surgery has been able to lessen pain and improve mobility for those with severe cases.
What did you learn about cerebral palsy today? How can you help spread awareness?