Go back to the infocomic TBI and Chronic Pain: Part 3

Traumatic Brain Injury and Chronic Pain Part III: Managing Spasticity

Infocomic Main Characters

Woman: A middle-aged Spanish woman with black hair pulled into a ponytail.

Lupe: A middle-aged Spanish woman with straight, chin-length black hair.

Store clerk: A young Asian woman with shoulder-length black hair. She is wearing glasses.

Sonia: A middle-aged Spanish woman with curly black hair pulled into a messy bun. She is wearing yoga clothes and a headband.

Friend: A middle-aged White woman with shoulder-length blonde hair.

Infocomic Story Description

Spasticity

A TBI can cause damage to the brain or to the nerves. As a result, muscles may not respond like they should. This is known as spasticity. Spasticity is not pain, but it can be painful. It may make muscles stay flexed when they should relax or make them shake in a way that is hard to control. Over time, spasticity can cause muscles to lengthen or shorten, which can cause pain. Not getting enough sleep, stress, an infection, and pain in another part of the body can make spasticity worse.

Slow, controlled stretching and low-impact strength training can help control spasticity. Other techniques that people often use to manage pain can work well for spasticity. Relaxation and mindfulness strategies can also help. Yoga uses slow movements, stretching, strengthening, and mindful breathing to help you connect with and be in control of your body. Because of this, yoga can be helpful for people with spasticity. There are many ways to practice yoga. You may need to try a few ways before you find the one that is right for you.

A woman is talking to her friend, Lupe. “Lupe, I can identify with you. I had to learn how to work with my body and my abilities before I could get more control over them,” she says.

The woman reflects on visiting a bookstore and looking for a certain book. The store clerk points up some stairs. “That book would be upstairs,” the clerk says.

The woman reflects on how her muscles don’t always do what she wants them to. Even basic things can be a challenge.

The woman asks the clerk, “Do you have an elevator?” The clerk apologizes, “Sorry, no.”

The woman reflects on how her life has become much smaller as she talks herself out of doing things that may be hard to do.

She imagines how hard walking up the stairs will be. Then she imagines carrying books and tripping over a power cord.

She reflects on how her anxiety over falling or doing something embarrassing in public has made her avoid those situations. This has decreased her activity, which has made her spasticity and balance worse.

There are many ways to manage spasticity. They include stretching, strength training, mobility exercises, heat packs, oral medication, Botox injections, motor blocks, and baclofen pumps. Talk with your health care provider to learn more about these options.

The woman admits that she slipped into a cycle of depression. The less she did, the less she was able to do, and the less she wanted to do. She was very active before her injury. Since then, there have been a lot of obstacles.

The woman is on a video call with her friend, Sonia, who asks, “Do you want to come to yoga with me?”

The woman responds, “I don’t know.”

Sonia says, “I understand. Do you mind if I stop by for a minute? I have something for you.”

The woman says, “Sure!”

Sonia shows up with a yoga mat as a gift. She says, “I got you this. I thought that we could do yoga. Here!”

The woman tells her, “That’d be great. I won’t feel so self-conscious.”

Sonia then came to her house every Wednesday. They would catch up and do yoga for an hour. The woman even started doing yoga through online videos each day. Some of the poses were hard, but she could always find a way to adapt them that worked for her.

The woman reflects on how, in the community, her walking was now faster and more stable. She is seen climbing the stairs onto a bus.

Being able to do things more easily has expanded her life. When she stopped feeling isolated, she was able to better manage her depression. Soon, she felt comfortable going out with friends.

“This is my favorite coffee place!” the woman says as she takes a seat next to her friend.

Her friend replies, “They have the best coffee here.”

Later, the woman thanks Sonia by taking her to a movie.

Both anti-depressant medicines and counseling may be helpful in managing depression.

Authorship and Illustration

Source: This infocomic was written by Silas James and Ayla Jacob and illustrated by David Lasky and Tom Dougherty in collaboration with the Model Systems Knowledge Translation Center. This infocomic is adapted from the factsheet series Chronic Pain After Traumatic Brain Injury (https://msktc.org/tbi/factsheets/traumatic-brain-injury-and-chronic-pain) developed by Silas James, MPA; Jeanne Hoffman, PhD; Sylvia Lucas, MD, PhD; Anne Moessner, APRN; Kathleen Bell, MD; William Walker, MD; CJ Plummer, MD; and Max Hurwitz, DO, in collaboration with the Model Systems Knowledge Translation Center.

The content in this infocomic is based on research and/or professional consensus. This content has been reviewed and approved by experts from the Traumatic Brain Injury Model Systems (TBIMS), funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), as well as experts from the Polytrauma Rehabilitation Centers (PRCs), with funding from the U.S. Department of Veterans Affairs.

Disclaimer: This information is not meant to replace the advice of a medical professional. You should consult your health care provider regarding specific medical concerns or treatment. The contents of this infocomic were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant numbers 90DP0031 and 90DP0082). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this infocomic do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the federal government.

Copyright © 2021 Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.