Paraplegia and Phantom Leg Cramps

May 7, 2008 3:00 PM

What can be done to eliminate/reduce "phantom" leg cramps in persons with paraplegia?

My wife had an incomplete spinal cord injury 20 years ago, but is now experiencing an increase in phantom leg cramps that are extremely painful. During these episodes, she "feels" incredible pain but there's no physical movement of the muscles in her legs. They last about 2-3 minutes and not triggered by anything in particular. In a nutshell, what the doctors say is happening is that the messages being sent by the nerves get all jumbled up and have no place to go because of the spinal cord injury, thereby resulting in the effect of a leg cramp pain. This is an undergraduate explanation of the phenomenon.

Any ideas on how to minimize or even eliminate these, either in terms of intensity or frequency?

posted by webhund to health (9 comments total)

Mirror therapy seems pretty simple for a start.
posted by i_am_a_Jedi at 3:07 PM on May 7

i_am_a_Jedi - I thought of that, too (here's the NEJM article). However, those studies were conducted on patients who were amputees - the mirror simulates the image of two whole, working legs. In this case, webhund's wife has (presumably) no working legs at all, making mirror therapy difficult.

However, webhund, perhaps you could encourage your wife's doctor or her specialists to contact the research group who published the mirror therapy results and see if they have any similar techniques for paraplegics.
posted by muddgirl at 3:11 PM on May 7

Yeah sorry. I just realized that - I had that article on the brain.
posted by i_am_a_Jedi at 3:13 PM on May 7

The idea behind mirror therapy is to fool the patient's mind into seeing the arm/leg there, so they can finally get some feedback to the brain about what's going on. Relax the mirrored leg and the brain sees that as the phantom limb relaxing and the cramp goes.

As silly as it might sound, could you mock something together to have a similar effect? E.g. you lie down and she assumes a position that from her visual perspective looks as though she has legs? Covering the waist/thigh area with a towel etc. Maybe move your legs to the beat of a song, and have her imagine that movement along, as see if you can get her mind image of the body complete.

Worse case, you'll have a fun afternoon together, best case, it actually helps.
posted by Static Vagabond at 3:26 PM on May 7

I lived with a person with SCI, C8-T1, incomplete, for several years. I would stretch his legs manually, which seemed helpful WRT leg pain.
posted by ClaudiaCenter at 5:35 PM on May 7

Research on this phenomenon -- I would call the co-authors of the study. SCI research is a pretty small world.
posted by ClaudiaCenter at 5:41 PM on May 7

What sorts of medical therapy has she tried, and is there a physiatry/rehab medicine center anywhere near you?
posted by docpops at 5:51 PM on May 7

Agree with docpops - there are some medications to try. A physiatrist or neurologist should know what they are and how to proceed.
posted by ikkyu2 at 9:47 PM on May 7

No answers from me but my dad had horrible phantom pains after his leg was amputated. For many many years, and nothing really helped. I'm so sorry to hear that your wife is going through this.
posted by miss lynnster at 8:19 AM on May 8