Warin,
I assume from GBS you are referring to Guillain-Barre Syndrome. Forgive
this post if I'm wrong. This demyelinating disease affects primarily the
largest nerve fibers (alpha motor neurons) but can also affect sensory
neurons as well. The cause of the severe pain in Guillain-Barre has been
long debated. It is my thought that the pain is a combination of issues.
Much of the pain seems neurogenic, as it presents as burning stabbing pain.
I've had great success using neural mobilizations to treat this, as well as
desensitizing therapy. Have you tried testing neural tension with this
person?
There also is definitely a musculoskeletal component. Contractures set in
quickly with disuse, leading to end range pain. Muscle overwork is also a
big issue, and it's very important to track the patient's strength
carefully. I muscle test every day I work with someone with GBS. If there
is a sudden loss of muscle strength that is not readily explained, I cut
back on the exercise for a day or two to see if the strength comes back. If
it does, I know for sure I've overworked the patient.
Let me know if you need any more info. I have a copy of a really good
article outlining exercise guidelines for Guillian-Barre patients.
Warm regards,
Geoff Mosley, PT, NCS
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