Spasms are muscles that move without you controlling them. They are reflex actions that under normal conditions our brain stops from happening. After a SCI in the cervical or thoracic levels, that connection between the reflexes and the brain is interrupted, so the brain is unable to stop them. Anything that causes an irritation will trigger them. Touch, a full bladder or bowel, and even movement may trigger them. They are usually most active in the morning after you have been lying still for a period of time and then become less as you become more active throughout the day. Spasms can have some benefits such as helping with blood circulation. But if they become very bad they can also interfere with daily care such as getting dressed or doing transfers. They can be uncomfortable for some people.

Spasms usually begin sometime during rehabilitation when the swelling in the spinal cord goes down. They may increase over the first year, but after a year will usually level off or even decrease. If you notice a sudden and big increase in spasticity, it may mean you have an infection, are constipated or have some other medical condition and should call your doctor.

Prevention
It is not usually possible to completely stop spasms and because there are some benefits it is not always a good idea. However, spasticity may be decreased by practicing good self care, doing bowel and bladder programs, not getting pressure sores and doing daily stretching and range of motion exercises.

Signs and Symptoms
Spasms are simply movement of muscle so you will notice legs twitching or shaking. You may also feel tightening of the abdomen.

Treatment
• Using the prevention techniques above is the simplest way to manage spasms.
• Many people need medicine to control spasms, but in most cases this will not completely stop them.
• A few people have severe spasms that make it hard to take care of themselves. There are now some surgical procedures available. A relatively new procedure is having a pump inserted under the skin that continuously gives medicine to the spine. It takes a very small amount of medicine to control the spasms, however the pumps can break and would require a surgical procedure to fix .