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HomeAnswersNeurologymyelopathyI have been on long-term medication for myelopathy leading to C6 arthritis. How long will the recovery take?

Is it normal to suffer increased nerve tightness and excitability while coming off a drug like Gabapentin?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At September 4, 2023
Reviewed AtMarch 20, 2024

Patient's Query

Hello doctor,

I suffered from traumatic myelopathy six months ago when I was hit by a car. I had severe arthritis at C6, so the whiplash contused my spinal cord. I do not have motor deficits. I have sensory deficits, mainly in the hips, legs, and feet (back of my arms). The neurologist said I could expect gradual remission over 12 to 24 months. My broken bones have healed well (arm and leg), but I do not think the tightness (spasticity) and numbness have subsided in any great length. What signs should I look for when recovering sensations and spasticity? Is there anything I can do to speed it along? Does recovery take this long? I have been taking the tablet Gabapentin, but I am tapering off so I can try the tablet Lyrica. The doctor says I have to completely stop the tablet GABA for three days before taking the tablet Lyrica. Is that true? Also, today is the first day of no tablet Gabapentin, and all my nerves have been super excitable and tight, and I feel a bit unwell. Is this typical when tapering off a drug? Please help.

Thank you.

Hi,

Welcome to icliniq.com.

I understand your concern.

Yes, the recovery in such cases is slow and gradual. It may take a year or two at times to get complete relief. Gabapentin should be gradually stopped before starting Pregabalin. When you begin taking tablet Pregabalin (Lyrica), symptoms will improve. Please avoid lifting heavy weights or bending forward. If you have to pick up something from the floor, prefer sitting before picking it up. Please take a high calcium and high protein diet. Drink plenty of water.

I hope this information will help you.

Thank you.

Patient's Query

Hello doctor,

Thank you for your response.

I have one more question. What do you suggest is the best way to treat, resolve, or get relief from spasticity? There is a nerve that runs through my buttocks and alongside my genitalia area that is particularly uncomfortable and tight. It has always been that way since my accident. Please help.

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

In such cases, medicines like Baclofen, Trihexyphenidyl, and Tizanidine work well in low doses. In addition, avoiding lifting weight, bending forward, and applying a hot pack may help. I suggest you avoid eating oily and spicy foods.

I hope this information will help you.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply.

Is it bad that I have not seen any decrease in my numbness, tingling, and spasticity in the last six months? I expected some decrease in symptoms though it be gradual. It seems that it just changes, moves around, there are good days, bad days, etc. and the spasticity seems to have increased the more I exercise trying to get stronger. I do not have pain so I think I might not take the tablet Lyrica and just take the tablet Baclofen. What do you think? I do not think Gabapentin or Lyrica is helping with the altered sensations in anyway. My doctor thinks that I have made significant improvement since my accident, but I am worried. Kindly help.

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Yes, it is okay if you do not take tablets such as Pregabalin or Gabapentin. You can also take them as required or as per need. In case the pain is bearable, these medicines may be avoided. You may also take them on alternate days for a few days and then stop. Tablet Baclofen should certainly be continued.

I hope this information will help you.

Thank you.

Patient's Query

Hello doctor,

Thank you for your response.

Should some of these symptoms have gone away by now? Is it normal at six months to still have these nerve symptoms with not much decrease in them? I have been exercising, walking, and doing yoga. Am I making things worse? Is there anything I can do to help my recovery? Please help.

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

You are not doing anything wrong. Doing yoga and regular physical exercise will benefit you in the long run. It is common for patients to take longer than this to recover from such symptoms. Please do not worry. Carry on with the stretching exercises and daily practice of yoga.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thank you for your response.

My spasticity has gotten strong. My doctor thought it was triggered by heat, but he said a follow-up MRI of my neck should be done. Should I be worried? My injury happened about eight months ago, and I had no surgery. Is spasticity reflective of more compression, or is it a symptom of my existing injury? What could be worsening my spasticity this time? Please help.

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Worsening spasticity is more often because of the existing injury. There are few chances of progressive nerve compression after such a long time. A repeat MRI (magnetic resonance imaging) scan may be done to rule it out. Are you continuing with the medicines? I hope you have been doing physiotherapy. How would you rate it on a scale of one to 10? When are you getting the MRI done? Please let me know so that I can guide you further.

I hope this information will help you.

Thanks.

Patient's Query

Hello doctor,

Thank you for the reply.

I am getting the MRI done by next week. The tightness in my legs is pretty stiff, especially in the leg where I had a tib or fib ORIF (right leg). It is not painful, but it is uncomfortable. My walk is very stiff, and I can still bend so that I may give a score of 6 or 7. I get a few cramps. It is preventing me from walking correctly. I am taking tablet Baclofen 10 mg thrice a day, stretching each day, and walking for 20 to 25 minutes. I bought some CBD gummies but have yet to take any of them. Tablet Baclofen does not offer much relief, but stretching helps temporarily. I still go for physical therapy, but they are not really focused on my spasticity. I should not actually keep surfing the internet, but I recently browsed about syrinx.

However, I do not have those symptoms. But I feel scared to think that something like syrinx could happen after an injury, but no one mentioned that to me. My MRI taken five months back showed that I had adequate room in my spinal canal, so I did not require any surgery. It was told to me that I had arthritis, and when I whiplashed, it bruised my cord. In that accident, which happened last year, I also fractured my pelvis. I still have extreme tightness, burning, and numbness in my buttocks near the piriformis, and I have the feeling as if I am sitting on something. Also, I feel as if something is wrapping around my private parts (anus etc). Could this be causing the flare-up of spasticity, as my buttocks seem more sore lately? I am also getting a pelvic MRI done as well next week. What is your opinion on this?

Thanks.

Hi,

Welcome back to icliniq.com.

Glad to have you back.

Yes, that is right, please get the pelvic MRI (magnetic resonance imaging) also done so that we will know about the current status of your pelvic injury and recovery to date. Please continue with physiotherapy and tablet Baclofen till then. Also, please do some breathing exercises to lower your anxiety and stress levels.

I hope I have resolved your queries.

Do get back to us if you have any further queries.

Thank you.

Patient's Query

Hi doctor,

Thanks for the reply.

My cervical MRI shows no significant change from the last MRI, which is good news. My pelvis MRI showed some deformity and chronic fractures, as you see in the report. Would any of these findings cause increased spasticity, numbness in the buttocks, or a feeling like you are sitting on something that puts pressure on the anus and genius area? If so, what can be the remedy?

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

There has been no significant change in the cervical MRI (magnetic resonance imaging) scan. The findings do not explain the reason for increased spasticity. The symptoms are either related to the previous insult or a result of stress or anxiety. Please continue the physiotherapy and the same medicines, including Baclofen.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thank you very much.

The most challenging part of this recovery is the changes. Myelopathy is constantly changing. I am hoping recovery is happening even though I do not see it. As I recover normal sensations, will the spasticity eventually recover as well? Also, I do not want to go back on Gabapentin with the Baclofen, but do you think a low dose would help at all? I am not willing to take high doses because of side effects.

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Yes, the recovery will happen. Both in terms of sensations and spasticity. Gabapentin and Baclofen will work in combination in low to moderate doses. Please do not lose hope.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thanks for the reply.

I wish I could say I am not losing hope, but I still have spasticity and tingling or numbness at 11 months now. Every day is a challenge. I have some burning prickling and do not know how much more strength I have to keep pushing. I am now doing some aquatic exercises. Please give me hope that I can still recover from these horrible symptoms. I have this nerve that is so tight in my buttocks that it wraps around my genitals. My rehab doctor ordered an epidural pain injection in my lower back two weeks ago, and I think it’s making my symptoms worse. Is that possible? Maybe I irritated the sciatica nerve?

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

The symptoms should not have worsened after the epidural injection. Which suggests the procedure possibly did not work. What dose of Gabapentin and Baclofen are you taking? Physiotherapy may still help. Avoid oil massage.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thanks for the reply.

I only take 10 mg of Baclofen in the morning., 15 mg in the afternoon, and 15 mg at night. I do not take Gabapentin anymore because I am teaching, and it makes me fuzzy-headed. How high of a dose would I have to take? Can all these excitable nerves be regenerated and recovered? I have heard this. I have also been exercising in the pool, which is more exercise than usual. Will I still recover? My rehab doctor mentioned following up with the spine surgeon, but surgery was not recommended, and nothing has changed in the most recent MRI and flexion or extension X-ray. Both looked good. I have been told I have enough latency in my cord. I was told 12 to 24 months to recover gradually, and it has been 11 months. I hoped to have a normal sensation by now, or at least better. Maybe it will take more time?

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

The Baclofen dose is still low. The dose may be gradually increased to 60 to 80 mg per day. Low-dose Gabapentin may also be added. Nerve regeneration also causes similar symptoms, though not as severe. Regular exercise should be continued. Gradually, recovery will take place. It may take some more time.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thanks for the reply.

Here is a picture of my injury if you want to see it. How about a PEMF mat? What is this feeling of numbness and tightness in my buttock or lower back that feels like I am sitting on something that runs against my genitals? Is there any nerve entrapment? Or is it just part of nerve damage from injury? Will this heal as well? Is there a way to test and see what can be done? This feeling has been there since day one. I will change insurance at the beginning of the year and see if I can get a doctor who can provide better care. Does any yoga pose I should avoid?

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Oil massage does not help. PEMF (pulsed electromagnetic field therapy) is a temporary relief. This feeling is true because of nerve injury. Nerve regeneration and recovery will gradually happen. Please avoid forward bending during yoga.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thanks for the reply.

I will stop forward folds in yoga. I hope I did not hurt myself. How much Gabapentin is needed for the neuropathy in the legs and feet? I know I am anxious, but this has been hard for me to live with. I pray hard every day this will get better very soon.

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Gabapentin may be safely taken in a dose of 600 to 900 mg per day. The dose should be gradually increased. Please do not worry. It will get better with time.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thank you for the reply.

I wanted to update you and ask you some questions. The good news is I have been walking much better, and my gait is good. Spasticity presents as tightness in the legs, core, and buttocks. These areas are also numb from nerve damage. My feet are still excruciatingly scratchy. I have been able to stop most meds. I am down to about 5 mg of Baclofen a day. Of course, I feel the tightness more, and it is uncomfortable, but I don’t like being in meds. My new doctor put me on Nortriptyline for insomnia and nerve pain. I take 25 mg at bedtime. Also, if I could not sleep, he would give me Seroquel. I have been pushing myself by walking faster, stretching, staying at work longer, and going to the pool, but it comes with the cost of tightness and nerve irritation. But I think it is good to push for that neuroplasticity, right? I am going to try Feldenkrais classes for movement next week. Can you think of anything else I can try other than medications? I went to see a hand doctor for my right hand contracture, but he did not know he could do anything. Maybe FSM treatment? Finally, I am 17 months out and am disappointed I’m not farther along. Is there still a good chance that my sensation and spasticity will continue to improve?

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

That is reassuring that you have been doing well on such a small dose of medicines. Please continue to exert more physical strength and push yourself despite tightness and nerve irritation. Please also avoid any oil massage. Please take a high protein and high calcium diet. I expect you to be off medicines soon.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thanks for the reply.

I will continue to push myself as long as there is a chance of more recovery. This journey has been challenging both mentally and physically. It is easy to lose hope, which is not good. Do you have any recommendations for any topical creams for my feet? Even if it is a prescription, I can ask my doctor. Also, do you think CBD gummies are effective for nerve issues and spasticity?

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

CBD gummies should be avoided. They have little of a role in your problem. Please keep the feet moist. Even Vaseline or Soft paraffin is effective.

I hope this information will help you.

Thanks.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Abhishek Juneja
Dr. Abhishek Juneja

Neurology

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