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How Permanent A Spinal Cord Contusion Can Be?
Question: Just curious how permanent a spinal cord contusion can be. I got hit by a semi truck 6 months ago (drivers side at 45 mph). I still get stabbing pains and have some limited range of motion. I had an MRI and they diagnosed it about 4 months ago. Considered it to be mild contusion at C-2 level
I am in physical therapy twice a week where they try to massage out some of the painful muscle spasms I have developed and then to strengthen my muscles and range of motion.
I have had several rounds of injections for the muscle spasms which can at times cause a lot of pain
I get muscle twitches like every day in all parts of the body and then pain usually ensues after I do active work, like clean the house, vacuum, etc. Sometimes the nerve pain rises to the top of my skull.
I really just want to know if this can be permanent injury. It has gradually gotten better since the accident, but I am still concerned.
I am in physical therapy twice a week where they try to massage out some of the painful muscle spasms I have developed and then to strengthen my muscles and range of motion.
I have had several rounds of injections for the muscle spasms which can at times cause a lot of pain
I get muscle twitches like every day in all parts of the body and then pain usually ensues after I do active work, like clean the house, vacuum, etc. Sometimes the nerve pain rises to the top of my skull.
I really just want to know if this can be permanent injury. It has gradually gotten better since the accident, but I am still concerned.
Brief Answer:
That possibility is present
Detailed Answer:
I read your question carefully and I understand your concern.
In general improvement is expected after spinal cord injury. Most improvement happens during the first 9-12 month and it reaches a plateau, meaning no further improvement is seen, after around 18 months.
So the fact that after only 6 months you seem to be active, even with the limitations you mention, is a positive things and should make you feel hopeful.
Regarding the possibility that some symptoms remain permanent though, unfortunately that that possibility is present, some symptoms may be left in the long term. Exact predictions can't be made, apart from degree of initial injury it varies from person to person. Also symptoms like nerve pain and neck range of movement are influenced by damage to other neck structures (bones, discs, joints and ligaments) as well.
Medication can help to alleviate symptoms but physical therapy is the only means to achieve recovery so you should remember the tremendous improvements you have had and keep working hard.
I hope to have been of help.
That possibility is present
Detailed Answer:
I read your question carefully and I understand your concern.
In general improvement is expected after spinal cord injury. Most improvement happens during the first 9-12 month and it reaches a plateau, meaning no further improvement is seen, after around 18 months.
So the fact that after only 6 months you seem to be active, even with the limitations you mention, is a positive things and should make you feel hopeful.
Regarding the possibility that some symptoms remain permanent though, unfortunately that that possibility is present, some symptoms may be left in the long term. Exact predictions can't be made, apart from degree of initial injury it varies from person to person. Also symptoms like nerve pain and neck range of movement are influenced by damage to other neck structures (bones, discs, joints and ligaments) as well.
Medication can help to alleviate symptoms but physical therapy is the only means to achieve recovery so you should remember the tremendous improvements you have had and keep working hard.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I just want your thoughts on something else important to me. I immediately after the accident was nauseous and had headaches for a week following. Slowly, I started noticing things were a little off after about 2-3 months. I was forgetting things, becoming irritable, having trouble processing simple tasks.
After about 4 months I was still having these issues and my treating neurologist ordered neuropsychological testing where it was found I had short term memory impairments (for someone with an MBA), attention deficitis, and a couple other issues.
Before the accident I was applying for jobs like everyday because I had just finished my masters degree. I am at the time in the application process where I am receiving offers for Accounting jobs, Auditing jobs, management jobs. Do you think it is advisable to jump right into a full time job with some of the issues that have presented in my case. Or should I try to find some part time work and ease into things so I do not get burned out.
Just with your expertise I was wondering what your thoughts are returning to work with a TBI.
After about 4 months I was still having these issues and my treating neurologist ordered neuropsychological testing where it was found I had short term memory impairments (for someone with an MBA), attention deficitis, and a couple other issues.
Before the accident I was applying for jobs like everyday because I had just finished my masters degree. I am at the time in the application process where I am receiving offers for Accounting jobs, Auditing jobs, management jobs. Do you think it is advisable to jump right into a full time job with some of the issues that have presented in my case. Or should I try to find some part time work and ease into things so I do not get burned out.
Just with your expertise I was wondering what your thoughts are returning to work with a TBI.
Brief Answer:
Read below.
Detailed Answer:
Thank you for bringing some more info on your condition.
Those changes on neuropsychological testing shouldn't be related directly to your cervical spinal cord injury. There is the possibility of a brain lesion due to injury as well, or in theory a cervical artery dissection, a tear in the neck blood vessels wall leading to a stroke. However I believe they would've been looked for by your doctors and changes should have been found on MRI imaging, so I don't think it is likely.
So since at your age one doesn't have dementia all of a sudden, I think it's much more probable that neuropsychological testing was affected by possible anxiety and depression which affects concentration as well. Those psychological changes are common after such an injury with the painful symptoms, the movement limitations and the worry for the future it can be accompanied with.
Regarding the return to work, if your concern is related to the neuropsychological changes, I do not think the work itself constitutes any obstacle, it might even help. From a wider angle though you must take into account also how much pressure there will be on you. If you will be in a competitive environment with deadlines to meet and extra pressure to meet expectations which might cause/exacerbate anxiety, depression and affect your dedication to physical therapy than it would be better perhaps to take things slowly and start part time to see how it goes.
Also from a physical point of view you should see how sitting in a desk for prolonged hours will affect your spine, if you notice it affects your symptoms it is another argument in favor of taking it slowly.
Read below.
Detailed Answer:
Thank you for bringing some more info on your condition.
Those changes on neuropsychological testing shouldn't be related directly to your cervical spinal cord injury. There is the possibility of a brain lesion due to injury as well, or in theory a cervical artery dissection, a tear in the neck blood vessels wall leading to a stroke. However I believe they would've been looked for by your doctors and changes should have been found on MRI imaging, so I don't think it is likely.
So since at your age one doesn't have dementia all of a sudden, I think it's much more probable that neuropsychological testing was affected by possible anxiety and depression which affects concentration as well. Those psychological changes are common after such an injury with the painful symptoms, the movement limitations and the worry for the future it can be accompanied with.
Regarding the return to work, if your concern is related to the neuropsychological changes, I do not think the work itself constitutes any obstacle, it might even help. From a wider angle though you must take into account also how much pressure there will be on you. If you will be in a competitive environment with deadlines to meet and extra pressure to meet expectations which might cause/exacerbate anxiety, depression and affect your dedication to physical therapy than it would be better perhaps to take things slowly and start part time to see how it goes.
Also from a physical point of view you should see how sitting in a desk for prolonged hours will affect your spine, if you notice it affects your symptoms it is another argument in favor of taking it slowly.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yeah, I keep thinking of things that I failed to mention to you. I also treat with a psychologist once a week for PTSd and some other general anxiety issues that have worsened since the accident. The accident was pretty violent. I was hit (rear ended), spun around, then hit again by the same truck.
Some days I am extremely tired for no apparent reason and doing any type of brain work; Updating resume, applying for a job, balancing bank statements. These tasks often make me tired and they take a lot longer than they used to. Like it just seems like there is a fog is up there in the brain and I can't focus on what is at hand.
You were right about sitting on the computer for an extended amount of time. I have found that bad posture even for a time of 30 seconds, sends the pains up and down my spine, especially when driving in the car. My posture must remain perfect to avoid discomfort.
Some days I am extremely tired for no apparent reason and doing any type of brain work; Updating resume, applying for a job, balancing bank statements. These tasks often make me tired and they take a lot longer than they used to. Like it just seems like there is a fog is up there in the brain and I can't focus on what is at hand.
You were right about sitting on the computer for an extended amount of time. I have found that bad posture even for a time of 30 seconds, sends the pains up and down my spine, especially when driving in the car. My posture must remain perfect to avoid discomfort.
Brief Answer:
Read below
Detailed Answer:
Thank you for bringing some more info. That I believe reinforces my hypothesis. As I already said anxiety and PTSD are common after an injury such as yours, as well as some damage to the supporting structures of the spinal column (vertebrae, joints, ligaments) making for those symptoms on upright position.
So a gradual return to activity is more advisable.
I hope things will gradually work out.
Read below
Detailed Answer:
Thank you for bringing some more info. That I believe reinforces my hypothesis. As I already said anxiety and PTSD are common after an injury such as yours, as well as some damage to the supporting structures of the spinal column (vertebrae, joints, ligaments) making for those symptoms on upright position.
So a gradual return to activity is more advisable.
I hope things will gradually work out.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yeah, I'm just in a weird spot where I over analyze everything that happens to me right now. I was prescribed valium almost immediately after the accident to help me sleep. This is one of the best drugs ever as far as making my symptoms disappear. It also helped relax my muscles at night. After I began to stabilize some of the anxiety and got my sleep under control, my doctor began to gradually take me off valium. As I began to stop taking valium, I began to start the nausea again and vertigo, where the room felt like it was spinning constantly. My doctor believed that the valium was actually treating the vertigo the entire time and once I went off of it it re-appeared. I just wanted to know your comments on this additional info.
I have a bunch of tests scheduled next week. Like an electrostatagram and some other stuff to test vertigo.
I have a bunch of tests scheduled next week. Like an electrostatagram and some other stuff to test vertigo.
Brief Answer:
Read below.
Detailed Answer:
I completely agree with your doctor, apart from a muscle relaxer valium, valium influences vertigo as well stabilizing the vestibular system which is part of the balance maintenance. Also helping with the anxiety component can have a beneficial effect on vertigo. The reappearance of the symptoms once off it, supports that.
The trouble is that if used regularly for a long time it creates dependance and tolerance that is why it is not commonly prescribed for the vertigo treatment.
The tests you'll have will probably give more info on your vertigo origin.
Read below.
Detailed Answer:
I completely agree with your doctor, apart from a muscle relaxer valium, valium influences vertigo as well stabilizing the vestibular system which is part of the balance maintenance. Also helping with the anxiety component can have a beneficial effect on vertigo. The reappearance of the symptoms once off it, supports that.
The trouble is that if used regularly for a long time it creates dependance and tolerance that is why it is not commonly prescribed for the vertigo treatment.
The tests you'll have will probably give more info on your vertigo origin.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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