Other Conditions Treated at IRR
The IRR provides rehabilitation services for patients with general, geriatric, orthopaedic, and complex rehabilitation conditions. The conditions we treat include:
- amputation
- arthritis
- balance disorders
- cerebral palsy
- incontinence
- joint replacement
- multiple sclerosis
- Parkinson’s disease
- sports injuries
- weakness after surgery
Additionally, the IRR offers specialty services focused on prosthetic rehabilitation, spasticity, adult spina bifida, and regenerative injection therapy (prolotherapy).
Adult Spina Bifida
Initially, spina bifida was considered primarily a pediatric specialty. But, because of advanced care and treatments, persons with spina bifida are living longer and face unique challenges.
Specific health concerns for adults with spina bifida include:
- shunt failure
- pressure sores
- seizures
- scoliosis
- bowel and urinary tract infections
- lymphedema
- bladder stones
- renal failure
- fractures
- shoulder injuries
Through the Office of Vocational Rehabilitation of the Pennsylvania Department of Labor and Industry, UPMC offers a spina bifida adult treatment clinic . The clinic includes a physical exam as well as assessments of health care problems related to the individual’s disability, assessment and ongoing nutritional counseling, and screening for urologic and gastrointestinal issues. Psychosocial assessment and coordination of care with outside agencies is another integral part of the clinic.
Contact us
UPMC Mercy
1400 Locust St.
Building D Suite G103
Pittsburgh, PA 15219
Phone: 412-232-8903
Spasticity Evaluation and Treatment Center
Spasticity is a disorder in the motor system where certain muscles do not relax and are always contracted. The UPMC Spasticity Evaluation and Treatment Center brings together experts from the fields of physical medicine, neurological surgery, orthopaedic surgery, occupational and physical therapies, and assistive technology to determine the most effective course of treatment.
Patients first are seen at the center in the Kaufmann Medical Building. After evaluation, the spasticity team will determine the appropriate treatment location.
The evaluation team includes a physician and a physical therapist. A video recording of movement is made during the evaluation. This tape is referenced throughout the course of treatment; both patient and team have found this to be a valuable tool in tracking the effectiveness of different types of treatment.
The intensity of spasticity, the muscle group affected, and the types of activities that are impacted are evaluated. All treatment regimens developed by the team are specific to the patient’s goals and needs. If evaluation leads to appointments with other specialists, the Spasticity Center team coordinates all referrals. The center’s team communicates with the patient’s primary care provider, summarizing the evaluation and outlining treatment options.
Spasticity Treatment
Treatment options for spasticity and related conditions, such as dystonia and tremor, have advanced in recent years. Reducing spasticity is a main goal of the center.
The most common oral medications for treating spasticity are:
- Baclofen. This restricts the influx of calcium into the neural receptors and it increases the influx of potassium. The effect is a decrease in the number of messages the nerve cells transmit.
- Diazepam. This medication reduces spasticity by depressing the central nervous system.
- Dantrolene sodium. This is unique because it affects muscle fiber rather than nerve fiber. It reduces the release of calcium that usually occurs after muscle action.
- Tizanidine. This medication prevents the release of the amino acids glutamate and aspartate. Those amino acids can excite nerve cells.
One non-oral treatment that has been very successful is the use of botulinum type A and type B injections. Botulinum injections are more commonly known as BOTOX and when used in minute amounts have proven effective in paralyzing the spastic muscles. Injection sites are carefully determined using an electromyogram that measures electrical activity in muscles.
In severe cases of spasticity, baclofen is administered through a pump that has been surgical implanted in the patient’s abdomen. This treatment has been found to be very effective in treating spasticity in the lower extremities.
Phenol is a type of alcohol that can block transmission in nerve cells. When injected in a very small amount, the phenol can prevent the transmission of too many nerve impulses – without causing a debilitating lack of control or sensation.
Contact us
Kaufmann Medical Building, 11th floor
3471 Fifth Ave.
Pittsburgh, PA 15213
Phone: 412-648-6324
Regenerative injection therapy
Regenerative injection therapy (RIT) or prolotherapy is an interventional technique for treatment of chronic pain around joints, ligaments, and tendons. Used in the treatment of chronic musculoskeletal pain arising from posttraumatic and degenerative changes in the connective tissue, RIT is commonly used to treat injuries such as chronic strains/sprains, tennis elbow/golfer’s elbow, rotator cuff injuries, neck pain (whiplash), back pain, sacroiliac joint dysfunction and chronic tendinosis.
A solution that causes local inflammation is injected in very small amounts near the tendon or ligament. This irritant causes localized inflammation and, after the inflammation resolves, the tissue heals and is more stable. These solutions are benign and often include dextrose for growth factor stimulation, but the inflammatory signals that result cause a more vigorous growth response.
To find out more about the UPMC Department of Physical Medicine and Rehabilitation’s use of RIT, contact us:
Kaufmann Medical Building, 11th floor
3471 Fifth Ave.
Pittsburgh, PA 15213
Phone: 412-648-6324