Spina Bifida Physiotherapy Management - What You Need to Know

Originally Published Nov 15, 2021

Spina bifida is a complicated birth defect that affects the spinal cord and, sometimes, its surrounding nerve endings. As you can imagine, spina bifida can cause a plethora of health problems, both physical and neurological.

Here, we’re going deeper into what spina bifida is, its causes and symptoms, as well as how spina bifida physiotherapy management can help in its treatment.

What is Spina Bifida?

Spina bifida occurs due to a birth defect where the spinal cord doesn’t close completely during the early stages of the pregnancy. When this happens, the bones of the spine are unable to effectively protect the spinal cord.

The result often causes damage to the spinal cord itself or damage to the nerves surrounding the spinal cord.

What Causes Spina Bifida?

Unfortunately, the causes of spina bifida are mostly unknown. We know that spina bifida occurs in the womb during pregnancy as a birth defect although it’s unclear which aspects of genetics or which environmental factors might be at play.

What Are The Symptoms Of Spina Bifida?

Depending on the size and location of the opening in the spinal cord, spina bifida causes a range of symptoms. Generally, spina bifida presents itself as physical and/or mental disabilities ranging from mild to severe.

Some common symptoms of spina bifida include:

• Inability to move the lower body due to paralysis and weakness of the spinal cord or its surrounding nerve endings
• Poor bowel and bladder control
• Skin issues
• Orthopaedic issues
• Learning disabilities
• Attention problems
• Other neurological complications

Since messages from the brain use the spinal cord to send signals to all the nerves in our body, spina bifida can affect pretty much every process controlled by our nervous system, depending on which area of the spinal cord was affected.

Meet Andrew: Spina bifida doesn't stop him from enjoying life to the fullest Being unique is better than being perfect Meet Andrew, one of the most charismatic, compelling, and positive people you will ever come across. Andrew was born with Spina Bifida 56 years ago. His mother was told that Andrew would be lucky to make it past the age of 6. When Andrew received his NDIS plan, it was a life-changer for him. Andrew is doing activities he never thought possible thanks to the supports funded in his NDIS plan. Andrew has been cruising around Australia, to even skiing and of course you'll' be able to witness here in his story throwing some serious left and right jabs with our Mobile & In-Home Exercise Physiologist Gabby. Now driven to achieve more in life and with the help and support from Gaby and other supports, Andrew will continue to become more independent and a healthier version of himself.

Does spina bifida cause pain?

Yes, spina bifida often causes pain. However, the type of pain associated with spina bifida often varies. Pain experienced by those with spina bifida often include:

• Headaches caused by tension, migraines, Hydrocephalus or issues with a shunt
• Visceral pain associated with organ problems
• Age-related pain that is associated with degenerative conditions that affect the spine, joints or muscles

A slightly better way to put it is that spina bifida is often associated with pain that is sometimes related to other conditions. However, it is common for those with spina bifida to experience pain -- acute, chronic or both at the same time.

What Are The Spina Bifida Classifications

There are a few different kinds of spina bifida that cause varying symptoms.

• Occult Spinal Dysraphism (OSD)
• Spina Bifida Occulta (SBO)
• Meningocele
• Myelomeningocele

Let’s break these down:

• Occult Spinal Dysraphism (OSD)
  • Usually causes a dimple and red spots on the lower back, along with tufts of hair or small lumps
  • Only a small spinal defect causes minor issues like skin conditions and issues with the tissue just below the skin
  • If nerves were affected, OSD can also affect growth in children
• Spina Bifida Occulta (SBO)
  • Not visible on the back and often referred to as “hidden” spina bifida
  • Caused by a small gap in a few of the spinal vertebrae
  • Occurs in about 15% of the population causing no symptoms
  • However, if the nerves were affected, SBO can affect neurological symptoms
  • Can cause what’s called a “tethered cord” if the spinal cord is pulled during growth
• Meningocele
  • Occurs when the protective coating of the spinal cord, called meninges, protrude through an open part of the spine
  • Nerve damage is uncommon
  • Minor disabilities may be present
• Myelomeningocele
  • The most severe classification of spina bifida, also known as myelodysplasia
  • Occurs when the meninges and spinal nerves protrude through an open part of the spine
  • Nerve damage and severe disabilities are common
  • 90% of children with myelomeningocele also have hydrocephalus, or excess fluid in the brain with often requires surgery
  • Issues with motor control, learning, and mobility may be present

Treatment For Spina Bifida | Spina Bifida Physiotherapy Management

Physiotherapy might not be the first treatment method you think of when it comes to spina bifida, but, in fact, physiotherapist management is an important health care partner for patients with spina bifida, as well as their family members and carers.

Physiotherapists can help children and adults with spina bifida by helping them gain and maintain mobility and overall, to function at their best throughout every stage of life

Physiotherapists will also work alongside your other healthcare providers such as orthopedists and occupational therapists for a more holistic treatment plan that expands into every aspect of your life.

What Is A Spina Bifida Physiotherapy Assessment?

When someone with spina bifida first begins working with a physiotherapist, an assessment might include:

• Asking about birth and developmental history to help get an understanding of where they might fall on a normal development progression
  • When could they hold they head up, roll over, crawl, or walk?
• Asking about general health
  • Have they been sick or in hospital? When was their last GP visit?
• Addressing parental concerns and about what the parents hope to accomplish in the treatment plan
• A physical examination to measure their height and weight, observe movements, balance, and coordination, and complete a tactile exam of muscle strength, flexibility, and tone
• A motor skills examination to test motor development while sitting, crawling, walking, and hand use. The exam might also look at vision, language skills, and other developmental milestones.

Spina Bifida Treatment with Physiotherapy

Once you have completed an assessment as part of your spina bifida physiotherapy management, a customised treatment plan can begin either at a clinic or on the go, bringing mobile physio services to you at home or at school.

Some physiotherapy spina bifida treatment plans include:

• Infant positioning needs
• Parent and family education during infancy
• Early intervention to provide physiotherapy techniques to encourage the healthy development of strength, balance, and motor skills while teaching parents to incorporate these techniques into their daily lives
• School-based physiotherapy to work with children with spina bifida on school-related motor skills and tools to help with any neurological deficiencies
• Providing the appropriate equipment to help children and adults with spina bifida including braces, walkers, and wheelchairs
• Prevention of other possible issues including obesity through the encouragement of fitness-based activities to promote long-term health and wellbeing

Again, your physiotherapist will often work in tandem with other healthcare providers to take a holistic approach to spina bifida treatment. And, just as important as working with the patient is educating the parents and carers as well -- an important part of the process that physiotherapists can also provide.

How to Find a Spina Bifida Physiotherapist

When it comes to spina bifida physiotherapy management to help treat spina bifida, there are few things to keep in mind.

• Choose a physio with experience in paediatrics or developmental disorders.
• Go with a board-certified physio that you know you can trust.
• Make sure the physio you choose is comfortable working with other healthcare professionals to be sure all of your child’s doctors are on the same page.
• Get recommendations from friends and family to help make your decision.
• Start with a physiotherapy consultation to see what they can offer.
• Go to a clinic that’s convenient for you, whether it’s on your way home from picking up the kids at school or they offer mobile services that come to you.

Managing Spina Bifida can be challenging, but with the right approach and guidance, people living with this condition can lead fulfilling and active lives. Physiotherapy is an essential part of Spina Bifida management, helping individuals improve their mobility, strength, and overall function. At Physio Inq, our team of experienced physiotherapists can provide specialized care and support for individuals with Spina Bifida, and if you are on an NDIS plan, you can access our physiotherapy services. We also offer occupational therapy, speech pathology, and exercise physiology services to help individuals with physical disabilities live as independently as possible. If you or a loved one has Spina Bifida, don't hesitate to contact Physio Inq today to learn more about our services and how we can help or alternatively you can call our support team on 1300 731 733.