In a normal central nervous system, our brains act as an inhibitor for muscle contraction. When we send a signal to move a muscle from the brain down the spinal cord to a muscle, the brain and nerves work together to tell that muscle “You have contracted enough for this task, you can relax now.”
So, what is tone? When an SCI occurs, there are either no signals or very slow signals from the brain telling certain muscles to relax. Our spinal cord is now acting reflexively and telling certain tendons and muscles to continue contracting constantly. This most commonly occurs in flexor muscles causing hamstrings, calves, hand flexors, biceps, and pectoral muscles to stay in a state of constant contraction.
Imagine working out one muscle group 24/7, sounds exhausting, right? Spasms can occur with movement, pain, infection, etc… These spasms can cause sudden rapid firing of muscles that can throw us out of our chair, bed, or if walking, can cause a fall. Sometimes these spasms last for a couple of seconds, but often, they cause clonus.
Clonus is a rapid twitching of muscles causing legs and/or arms to bounce up and down until fatigued, pressure is applied, or stretching occurs. Imagine running in place multiple times a day without an end in sight, I’m tired just thinking about it! There are medications and treatments to reduce spasticity, tone, and clonus, but they include their side effects of dizziness, dry mouth, and fatigue.
I have major tone, spasticity, and clonus, especially on the left side of my body. I get Botox injections in the flexors on my left arm so I can open my hand and my left leg and so I can straighten my leg. Any time I go over a bump my legs will spasm with clonus. Sometimes when I’m just walking my legs will spasm with clonus. This constant muscle activity causes joint pain, sleeplessness, and chronic fatigue.
I want to stress to all the readers that this is NOT a “poor me, pity me” post. This is meant to bring awareness to the many other things people with SCI deal with on top of paralysis or partial paralysis. Even those of us that can stand or walk with or without assistance have to deal with these somewhat invisible secondary conditions on a day-to-day basis.
In 2013 I was in a car accident resulting in an incomplete C5/6 SCI. I recently received my Master’s degree in nursing from University of Michigan and am working on my Doctorate in nursing practice. I’m passionate about changing healthcare for people with disabilities using education and awareness. I live in Oregon with my husband and 3 dogs. We participate in activities like skiing, kayaking, biking & ATV’s! Every summer we explore the country in an adaptive RV.