As a trial lawyer in Atlanta, Georiga, representing clients who have  spinal cord injuries,  both paraplegia and quadriplegia, I have  become familiar with effects of such injuries about which most people know nothing. Among those are muscle spasticity and autonomic dysreflexia. Of course, this incomplete and over-simplified post cannot constitute medical advice, only an expression of awareness of the problem and the types of things that must be communicated to a jury at trial to help them understand.

Following a spinal cord injury,  nerve cells below the level of injury become disconnected from the brain at the level of injurdue to scar tissue  in the structure of the damaged area of the spinal cord, blocking messages from below the level of injury reaching the brain. When an injury occurs to the spinal cord, the body goes into spinal shock, and this may last several weeks. During this time changes take place to the nerve cells which control muscle activity.

Once spinal shock wears off,  natural reflexes reappear. In an abled boded person, a stimulus to the skin is sensed, and a  signal is sent to the brain through the spinal cord. If the stimulus is perceived not to be dangerous, an inhibitory signal is set down the spinal cord, and cancels the reflex from moving the muscle.

In a person with a spinal cord injury this inhibitory signal is blocked by the damage to the cord, and the reflex continues with a contraction of the muscle.

Muscle spasms can occur any time the body is stimulated below the level of the spinal cord  injury. When a muscle is stretched, or there is a painful stimulus below the level of injury, the sensations can produce the reflex causing the muscle to contract or spasm.

Many stimuli can trigger spasticity, but some are more common.  A bladder or kidney infection,  skin breakdown, and lack of  regular range of motion exercises can increase  spasticity.

The best way to manage or reduce  spasms is to perform a daily range of motion exercise program, and avoid bladder infections, skin breakdowns, or injuries to the feet and legs. There are three primary medications used to treat spasticity, baclofen, Valium, and Dantrium. All have some side effects and do not completely eliminate spasticity.

Spasticity is not all bad, however. It can be a warning sign to identify pain or problems in areas where there is no sensation. For example, sometimes people know when a urinary tract infection is coming on by the increase in muscle spasms. Ironically, it may also help to maintain muscle size and bone strength and blood circulation in the legs.

A surgical procedure called a radiofrequency rhizotomy is sometimes indicated in the treatment of severe spasticity. Another treatment of severe spacticty is the implantation of a Baclofen Pump.

As I mentioned above, none of this is medical advice. But if you are going to trial to recover damages sufficient to fund a life care plan for a spinal cord injury, it is important to have a lawyer to understands  the multiple effects of spinal cord injury well enough to communicate it effectively to a judge and jurors who never heard of muscle spasticity.

The Shigley Law Firm  represents plaintiffs in wrongful death and catastrophic injury (including spinal cord and brain injuries) in cases statewide in Georgia, and in other states subject to the multijurisdictional practice and pro hac vice rules in each state.  Ken Shigley was designated as a "SuperLawyer" in Atlanta Magazine and one of the "Legal Elite" in Georgia Trend Magazine. He is a Certified Civil Trial Advocate of the National Board of Trial Advocacy, and has been chair of both the Southeastern Motor Carrier Liability Institute and the Georgia Insurance Law Institute. He particularly focuses on cases arising from truck and bus accidents and defectively manufactured productsClick here for a free consultation with no obligation.