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Most spinal cord tumors are benign, or noncancerous. Nevertheless, these tumors may compress or invade nerves in and around the spinal cord, causing pain, weakness in the arms and legs, or loss of bowel or bladder control. Also, spinal cord tumors and some treatments to eliminate them, such as surgery and radiation therapy, can cause erectile dysfunction in men or a loss of sensation in the genitals in women.
NYU Langone’s Rusk Rehabilitation has a team of physical and occupational therapists who can help you regain your mobility and sensation after treatment for a spinal cord tumor. Our rehabilitation medicine physicians, also known as physiatrists, coordinate the rehabilitation program and offer treatments to improve bowel and bladder function and sexual function, and to reduce pain caused by spinal cord compression or instability of the spine.
Rehabilitation therapies begin while you are in the hospital and continue on an outpatient basis.
Our physiatrists can prescribe medication to relieve pain and other symptoms, such as bladder or bowel problems, that may be caused by a spinal cord tumor and treatments such as surgery or radiation therapy.
Our physiatrists may administer steroid injections, which reduce inflammation and temporarily relieve pain from muscle spasms that can occur after surgery or radiation therapy. Prescription pain medications can help control more severe or chronic pain caused by a spinal cord tumor for a limited amount of time. However, these medications can cause side effects, such as drowsiness and increasing tolerance, which may lead to dependence.
Botulinum toxin, also known as Botox®, is an injectable medication used to stop muscle contractions that can provide a temporary alternative to prescription pain medications. Botox inhibits the release of neurotransmitters, chemical messengers produced by nerve cells that transmit pain signals to the brain. Most people tolerate these injections, which may be given every 6 to 12 weeks.
Bethanechol is a medication that may be used in people who have nerve damage that prevents the bladder from emptying completely. This medication increases bladder muscle tone and contractions, easing urination.
Before prescribing this medication, our physiatrists collaborate with NYU Langone urologists, who perform urodynamic testing, which involves filling the bladder with saline and observing how well the bladder and sphincter muscles are working. These tests can help to determine the extent of the nerve damage caused by a spinal cord tumor.
For people with more severe or permanent nerve damage, bethanechol may be used in combination with intermittent catheterization, in which a thin, flexible tube is inserted into the urethra to drain urine from the bladder. Our rehabilitation specialists can teach you and any caregivers you may have how to perform this technique at home.
Laxatives and Enemas
Our doctors may prescribe laxatives, such as stool softeners, bulk-forming agents, and stimulant laxatives, to promote regular bowel movements after treatment for a spinal cord tumor. These medications can be taken by mouth or in suppository form. Doctors may also recommend enemas containing sodium phosphate and saline to periodically flush waste out of the intestines.
Physical and Occupational Therapy
Rehabilitation medicine experts in spinal cord dysfunction from Rusk Rehabilitation evaluate your level of spinal cord function before prescribing physical and occupational therapy. Our physical and occupational therapists use exercises and other techniques to decrease bladder and bowel straining and improve the muscle coordination needed to perform everyday activities.
One technique, called neuromuscular training, involves breaking down simple tasks, such as picking up a book, into several individual movements used to accomplish the task, like moving the shoulder and opening and closing the hand. Practicing each of these movements several times, and then reassembling them into the intended task, can help to improve strength and muscle coordination.
Our therapists also provide exercises to strengthen your upper and lower extremities, trunk, and spine; decrease pain; and improve endurance and balance. Rusk Rehabilitation offers a variety of specialized equipment and programs, including hydrotherapy, which involves doing strength exercises in water to reduce pressure on nerves in the back, to help you regain mobility. These exercises can help prevent falls and other injuries and speed recovery from treatment.
Occupational therapists can help you resume everyday activities such as bathing, going to the bathroom, and getting dressed. Our occupational therapists show you how to perform exercises safely and use devices that can help you function independently.
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