Spasms are muscle movements that occur involuntarily. Normally, the brain prevents these reflex actions from happening. After a spinal cord injury (SCI) in the cervical or thoracic levels, the connection between the reflexes and the brain is interrupted, and the brain may be unable to stop them. Anything that causes an irritation will trigger spasms: touch, a full bladder or bowel, pressure sores, and even movement. Spasms are usually most active in the morning after you have been lying still for a while. They decrease as you become more active throughout the day. Spasms can have some benefits. They help keep muscle tone and improve blood circulation. If they become very bad, however, they can make it hard for to perform daily care such as getting dressed or transferring. They can also 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 and after a year will usually level off or even lessen. An unusual increase in spasticity may be a sign of infection, constipation or some other medical condition; call your doctor if you notice a change.
How to prevent spasms
As long as spasms do not interfere with function, it is usually not necessary to treat them medically. There are some things that can be done at home to help:
• Follow bladder and bowel programs.
• Avoid pressure sores.
• Do daily stretching and range of motion exercises.
• Take care of health in general.
How to recognize spasms
• Spasms are muscle movements. You may notice: legs twitching or shaking
• Tightening of the abdomen.
What to do about spasms
• For many people using the simple techniques listed above will manage spasms. Others will require additional help, especially if the spasms make it hard to take care of daily needs. In this case prescription medicines may be helpful.
• Medicines are usually taken by mouth but are sometimes are given through a device that pumps medication directly into the space around the spinal cord.
• These pumps are inserted surgically under the skin and are often able to control spasms with only a very small amount of medicine.
• The goal of these treatments is to reduce spasms enough so they do not interfere with a person's life and ability to function.
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