Bob VogelQ. I’m 37 and in my 14th year as a T6 complete para. Up until recently I’ve had just enough spasms to keep my leg muscles in shape, but nothing that bothered me. Within the last month my leg spasms have gone from mild to out of control — I have to Velcro them into my chair to keep them from spasming straight out.

My primary care physician checked me for UTIs, bladder and kidney stones and pressure sores, and all tests came up negative. He is at a loss as to what is causing the spasms, so he referred me to a physical medicine and rehab doctor at the center where I did my rehab — but that isn’t until next month.

Do you have any ideas as to what may be causing the spasms? What are my options for treating them? Have you heard of other people with this?
— Dani

A. Dani, it sounds like your primary care doctor is on track, including sending you to a PM&R doctor to further investigate the cause and offer treatment options.

Spasms are a double-edged sword — they help maintain muscle tone and help pump blood from the legs.  And increased spasm activity can be a valuable SCI tool to help you identify problems before they do damage — such as a leg jumping violently when your foot enters water that is too hot. But severe spasms can interfere with everything from seating and transfers to sleep.

According to Diedre Bricker of the Craig Hospital Nurse Advice hotline, a sudden increase in spasticity years after SCI is a warning sign that a stimulus is affecting your body — usually something that would be uncomfortable or painful if you had sensation in the affected area. When spasms increase, first check for obvious causes — problems with seating and positioning, a full bladder or bowel, skin irritation, pressure sores, ingrown toenails, UTI, or red or swollen limbs that may indicate a fractured bone.

If the cause isn’t found — see a physician. If possible, the best bet is to see a PM&R doc at a major SCI rehab center. Tracking down the cause of spastic