There is currently no cure for permanent paralysis. The aim of treatment is tohelp a personadapt to life with paralysis by making them as independent as possible.
Another important goal of treatment is to address health problems and associated complicationsthat arisefrom paralysis, such as Pressure ulcers .
Various treatment options and aids available for people with paralysis aredescribed below.
Arange of mobility aids,such as wheelchairs, are available for people with paralysis.
There are two main types of wheelchair:
The NHS supplies wheelchairs free of charge, but the range of models available is often limited. If you want a more sophisticated model, you will have to pay some or all ofthe cost. Yourlocal clinical commissioning group (CCG) may be able to help fund some of the cost. Find your local CCG .
There is also a relatively new type of wheelchair known as a standing chair, which functionslike a wheelchair but allows the person to rise to a standing position. This helps reduce their risk of developing pressure sores. However, standing chairs can be expensive and are heavier than standard chairs.
The currents stimulate the muscles to move in the same way that the brain would normally.
A neuroprosthesisis not suitable for people with conditions that directly damage the nerves in the legs, such as motor neurone disease and Guillain-Barr syndrome . This is because the nerves will not react to the electrical currents.
Neuroprotheses are expensive. Depending on the complexity of the neuroprosthesis, it can cost from 1,300 to 32,000.
Using orthoses can be physically demanding, so they may not be suitable for everyone. Alternatively, you may decideto use both a wheelchair and an orthosis.
There is also awide range of assistive technology that can help a person with paralysis maintain their independence and improve theirquality of life. Examples include:
The Disabled Living Foundation (DLF) has more information about assistive technology , and can also provide advice and support for people living with paralysis.
It may be possible for you to drive a car, even if you have limited muscle function in your hands and arms.
Devicescan be used to adapt the controls of a car to meet the needs of a person with paralysis. For example, the pedals can be replaced with levers or an electrical switching system, and the steering wheeladapted so you steer using your wrists or arms, rather than having to grip it with your hands.
The Research Institute for Consumer Affairs (RICA) is a charity that provides independent research and information, andhas good information about wheelchair-accessible vehicles .
Almost all types of spinal cord injury and many types of generalised paralysis result in the loss of normal bowel and bladder function. This is because nerves that control the bowel and bladder are located at the base of the spinal cord.
Most people use a catheter to empty urine from their bladder. A catheter is a thin, flexible tube inserted into the urethra (the opening in the penis or vagina that urine flows out of) or through a hole in the abdomen (tummy).
The catheter is then guided into the bladder, allowing urine to flow through it and into a drainage bag.
There are many methods that can be used tomanage a paralysed bladder. Therecommended method will depend on your ability, the state ofyour bladder, and the resources available.
It is important to ensure your bladder is emptied regularly becausean overly full bladder can trigger a serious complication called autonomic dysreflexia in high spinal cord injuries.
Many people with a spinal cord injury, and some with other types of paralysis, have long-term pain that persists for weeks, months, or sometimesyears after the injury or incident that causedthe paralysis.
Unlike most other types of pain, neuropathic pain does not usually respond well to ordinary painkillers, such as paracetamol or ibuprofen . Alternative medications are usually required, such asamitriptyline or pregabalin.
These types of medication can cause a wide range of side effects, soit can take time to identify one that issuitable and effective at controlling your symptoms withoutcausing unpleasant side effects.
Possible side effects include a dry mouth, sweating, drowsiness and vision problems.
There have been reports of people having suicidal thoughts while taking amitriptyline. If this happens, you should contact your GP or go to your nearest hospital immediately.
It may be helpful to tell a relative orclose friend you are taking amitriptylineand to ask them to let you knowif they notice any changes in your behaviour.
If you have had a spinal cord injury to the upper neck, your diaphragm will be paralysed. The diaphragm is a thin, dome-shaped muscle that helps you breathe in and out.
As your diaphragm will not be able to help you breathe, you will need breathing assistance from a ventilator. A ventilator is a machine that carries out thejobof the diaphragm by controlling lung pressure.
This can be done in one of two ways, using either a:
Positive pressure ventilators are more widely used becausethey are usually smaller and more convenient. A positive pressure ventilator can either be:
Non-invasive ventilatorscarry a smaller risk of causing a lung infection such as pneumonia ,but aren't suitable for people with more extensive paralysis who have difficulty swallowing.
An alternative to using a ventilator is a devicecalled a phrenic nerve stimulator. The phrenic nerve controls the diaphragm. The device is surgically implanted in the chest and sends regular electrical impulses to the phrenic nerve, causing the diaphragm to contract and expand andfill the lungs with air.
Another problem that affects most people with paralysis is thattheir ability to cough is reduced. This is because the cough reflex is triggered by muscles in the abdomen (tummy) and between the ribs pressing down on to the lungs.
If these musclesare paralysed, the force of a person's cough can be greatly reduced. This is potentially serious because a person'sability to cough enables them to clear theirlungs ofa build-up of mucus and other secretions. A reduced cough can causethe lungs to become congested, increasing the risk of a lung infection.
One technique used to compensatefor this is known as an assisted cough.It involves arelative or carer pushing against the outside of your stomach while you attempt to cough.
There are also anumber of devices available to help you cough. They usually consist of vests that can contract (squeeze) against your lungs, compensating for the loss of muscle action.
It is important youtakeprecautions to reduce your risk of developing a lung infection by:
Spasticity is a medical term that means abnormally stiff and rigid muscles. Many people with paralysis develop spasticity and involuntary muscle spasms (where muscles cramp and contract).
Spasticity and muscle spasms are usually caused by the section of the spinal cord below the point of the injury "misfiring" and sending abnormal signals to the limbs.
In some cases, spasticity and muscle spasms can be useful. For example, if you have partial paralysis in your legs, the stiffness in yourmuscles may make your legs easier to control.
Some people also find that a series of muscle spasms makes it easier for them to empty their bladder or bowel. But in other cases, spasticity and muscle spasms can be painful, affect mobility and interfere with daily activities.
Treatments for spasticity and muscle spasms are discussed below.
The first type of medication you may be prescribed is a muscle relaxant, such asbaclofen,tizanidine or dantrolene,usually taken in tablet form.
Sedatives likediazepamshould be avoided, except in severe cases. All of these medicinesmay cause sedation as a side effect.
If muscle relaxants are not effective, an injection of botulinum toxin (Botox) may be given for localised spasms. It works by blocking the signals from the brain to the affected muscles.
The effects of the injection usually last for up to three months. The treatment is most effective when used in conjunction with aprogramme of stretching and physiotherapy.
Another possible treatment is intrathecal baclofen therapy. This involves surgically implanting a small pump on the outside of the body connected to the spinal cord.
The pump delivers regular doses of baclofen directly to the spine.It blocks some of the nerve signals that cause muscle stiffness.
Paralysis occurs when a person loses the ability to move one or more muscles of the body. It may be associated with loss of feeling and other bodily functions.
Paralysis can be classified in a number of different ways. For example, it can be localised, affecting a particular part of the body, or generalised, affecting a wider area.
The four most common causes of paralysis are stroke, head injury, spinal cord injury and multiple sclerosis.
Diagnosing paralysis is not usually necessary if the cause is obvious for example, if paralysis has occurred after a stroke.
There is currently no cure for paralysis. Treatment focuses on helping you adapt to life with paralysis by making you as independent as possible.
A person with paralysis can develop a number of complications, including autonomic dysreflexia, sexual problems and depression.