During even the earliest part of the acute care hospital stay the rehabilative process may be initiated. A physical therapist may perform passive range of motion exercises by moving the arms and legs. A foot board or other device may be used to prevent foot drop. Regular turning of a paralyzed patient is essential to prevent bedsores or decutiti. Pain of joints and muscles can be treated with pain medications, but the patient will often feel unusual sensations of their skin and throughout their body as damaged sensory nerves undergo healing generating abnormal signals.
When the patient has recovered from medical complications, such as breathing difficulty and infections, and some muscle strength has returned, treatment in an acute care hospital is usually no longer required. However, most patients will still require some continued rehabilitation care, especially physical and occupational therapy.
EMOTIONS During the early part of the illness, especially for those who require artificial respiration, events can be quite frightening. Most patients were previously fit and healthy, so finding themselves suddenly paralyzed, in pain and quite helpless can be emotionally upsetting. Patients that are ventilated may not be able to communicate verbally, but can hear and understand what is going on around them, this can be quite frustrating. The feeling of utter helplessness, hopelessness, thoughts of possible death, thought of permanent disability and even loss of earnings can be emotionally overwhelming. It is helpful to both patient and family to understand that their is a good chance of recovery. Explanations of care and activities help alleviate anxiety as well as visits by family and friends who will show caring and provide moral support. The patient on a respirator may feel less frustrated if a method for communicating with others is provided.
Depression often occurs throughout recovery as the patient doesn’t feel hopeful for the future at this stage. It is not uncommon to take anti-depressants, which help with nerve pain & depression. It is also helpful to contact a previous patient that has been through similar & recovered. This helps the patient to have hope for their own recovery.
PHYSIOTHERAPY It is very important that you receive good rehabilitation & physiotherapy. Muscles waste away very quickly while inactive or lying in bed for long periods. It can be extremely exhausting for the patient to do even the most simple of excercises, but they have to be careful not to overdo exercise at it could set them back. Before recovery begins, caregivers move the patient's arms and legs to prevent stiffness. After symptoms subside, the rehabilitation team will prescribe an active exercise routine to help regain muscle strength and independence. Training with adaptive devices, such as a wheelchair or braces, give the patient mobility.
HYDROTHERAPY Whirlpool therapy (hydrotherapy) may help relieve pain & be useful in retraining the movement of affected limbs. The warm of the water & buoyancy also help with pain. MASSAGE Massage can be effective in relieving pain & increasing blood circulation. Acupressure & acupuncture can also be beneficial
PAIN A number of GBS patients suffer with muscle & joint pain which can be treated with over-the-counter analgesics such as aspirin or panadol. If necessary, stronger pain medication (eg. acetaminophen or codeine) may be prescribed. Muscle spasms can be controlled with relaxants such as diazepam (Valium).
The later stages of rehabilitation, lingering sensation problems can be treated with tricyclic antidepressants or anticonvulcants such as Gabapentin (Neurontin).
Corticosteroids, which often effectively treat symptoms of autoimmune disorders, actually worsen Gullain-Barre Syndrome and should not be used. They are sometimes used to treat CIDP.
There are some natural forms of pain relief that may also help such as soaking in heated water, a bath, spa or heated hydrotherapy pool. Massage proves effective on a short term basis as well as acupuncture. Mild exercise can also help. (Dont overdo it)
There are many other forms of pain treatments - please ask your doctor.