Depending on the level of spinal cord injury, many individuals experience paralysis of the legs, which limits mobility and contributes to swelling. When the legs are less mobile and are in a dependent (low) position, such as in a wheelchair, gravity pulls fluids downward, leading to dependent edema. This is characterized by fluids pooling in the legs since they are not being pumped back upward by the weak or paralyzed muscles.

Fortunately, there are several ways to reduce edema and decrease risk of additional complications. In this article we will discuss 8 effective ways to help reduce and manage leg swelling after spinal cord injury.

How to Reduce Leg Swelling After Spinal Cord Injury

Spinal cord injury can affect many functions below the level of injury. Since the leg muscles are innervated by the lower segments of the spinal cord, all spinal cord injury patients experience some degree of weakness or paralysis in the legs. 

Regular leg movements are necessary to promote blood flow back to the heart. When movement is limited due to spinal cord injury, blood may begin to pool in the legs and cause them to appear swollen, red, and shiny. Dependent edema can increase risk of blood clots and can also cause the skin to become more fragile and prone to sores.

To decrease risk of complications, it is important to monitor swelling and take steps to reduce edema. To help with this, here are 8 tips for treating swelling in the legs after spinal cord injury:

1. Move Often

As we’ve discussed previously, blood and other fluids can begin to pool in the legs when they are not moved enough. This means frequent movement is very important to help reduce or prevent swelling.

When your mobility is limited, passive range of motion exercises can be used to promote movement without requiring active muscle function in the legs. This means you can use non-affected muscles to help move the affected ones, with or without the use of a band or other assistive device.

If your upper extremities are affected or very weak because of spinal cord injury, ask your caregiver, physical therapist, or nurse to help you move your legs. Your therapist may also be able to provide you with some techniques to help you perform passive leg movements independently.

Moving the legs using passive range of motion exercises promotes circulation and can lessen joint stiffness. This in turn can help move fluid back out of the legs to reduce edema. To help get you started, we’ve provided a link for passive range of motion exercises for spinal cord injury patients.

2. Limit Sodium Consumption

Eating excess sodium can contribute to dehydration, causing the body to hold onto fluids. This can lead to increased swelling, specifically in the feet, ankles, and legs. Since sodium can cause fluid retention, limiting your sodium intake may be a helpful strategy to reduce leg swelling after spinal cord injury.

Instead, try to consume more fresh or frozen fruits and vegetables. These foods have a high water content and are naturally low in sodium. It’s also important to monitor sodium amounts on packaged foods and to try to find foods labeled as “reduced sodium” or “no salt” added, according to the CDC.

3. Elevate Your Legs

Just like gravity pulls excess fluids to the legs, elevating your legs can allow gravity to direct fluid back to the heart. Even just 15 minutes of leg elevation can help reduce leg swelling after spinal cord injury and can be performed several times per day.

Stack a few pillows on top of each other and elevate your legs on them while you you’re laying down. It’s a good idea to have your heels hanging off the edge of the pillows to minimize the risk of pressure sores developing on your heels.

4. Drink More Water

Swelling is caused by excess fluid in the body, so it might seem contradictory to drink more water. However, dehydration can cause the body to hold onto fluid because it doesn’t know when you’re going to replenish its supply.

To avoid increased fluid retention, make sure you’re drinking enough water throughout the day so that your body doesn’t feel the need to store it for later. This can also help regulate sodium levels, further decreasing leg swelling after spinal cord injury.

5. Wear Compression Stockings

Wearing compression stockings or socks adds pressure to the legs to increase blood pressure and help to move excess fluid. This is especially true for gradient compression stockings, which have the highest compression at the foot and gradually loosen as they go up the leg, pushing fluid in the right direction.

Although low blood pressure is more common in patients with spinal cord injury than high blood pressure, it is a good idea to talk to your doctor to see if compression stockings are safe for you and your particular medical history. Your physical or occupational therapist can also help you choose compression stockings that are appropriate for your needs.

When choosing compression stockings, make sure the stockings are not too loose or too tight to ensure their effectiveness and avoid complications. Also, make sure there are no big wrinkles once the compression stockings are on. This can act as a tourniquet on your leg, making swelling worse in a particular area and putting you at risk for developing a sore or autonomic dysreflexia.

6. Massage Your Legs

Massaging your legs can help stimulate blood flow and reduce swelling. Similar to compression stockings, the additional pressure created by massage can improve circulation and helps to move the extra fluid out of your legs. This can also help with pain relief and can increase flexibility, potentially improving performance of daily activities and transfers.

To get started, try massaging your legs in an upward motion, starting at your feet and moving towards your trunk. This helps to redirect pooled fluids out of the legs and back to the heart. Additionally, it may be helpful to immediately put on compression stockings after massage to help maintain any reduction in swelling you were able to achieve.

7. Avoid Hot Temperatures

Warm temperatures can cause your blood vessels to expand (vasodilation) so that heat in your blood can get closer to the surface of the skin and evaporate to cool you off. This vasodilation creates increased fluid, which can become trapped in the legs and lead to leg swelling after spinal cord injury.

Staying cool can help promote narrowing of the blood vessels (vasoconstriction) to reduce leg swelling. Although the temperature of your environment may be out of your control, there are several ways to help stay cool and reduce leg swelling after spinal cord injury.

Some actions you can take to avoid vasodilation include:

• Staying out of direct sunlight
• Wearing light, easy-to-remove layers
• Carrying a spray bottle of water or a damp towel
• Staying hydrated

8. Get Cardiovascular Exercise

Engaging in regular cardiovascular exercise is vital to help maintain good circulation and heart health. Any movement that increases heart rate can help promote circulation throughout the body and assist with moving fluid out of the legs, decreasing leg swelling. Cardiovascular exercise can also help with flexibility, stress, cholesterol, and sleep.

Following a spinal cord injury, it may feel difficult to perform cardiovascular exercise due to decreased mobility. However, there are many ways that individuals can engage in cardio after spinal cord injury.

Different examples of cardiovascular exercise after spinal cord injury include:

• Propelling your wheelchair briskly
• Hand cycling
• Using exercise bands
• Sitting aerobics or circuit training

Talk with your physical therapist to help create an exercise plan that is appropriate for you. Additionally, it is important to keep SCI exercise guidelines in mind to avoid risk of overexertion or autonomic dysreflexia. This includes increasing exercise intensity gradually and taking sufficient rest breaks.

Inspect Your Body Regularly After Spinal Cord Injury

Since spinal cord injuries often cause impaired sensation, many SCI patients don’t notice when they are injured or their skin is irritated. Daily body inspections can help identify spinal cord injuries such as heterotopic ossification and deep vein thrombosis, which can both contribute to leg swelling.

Heterotopic ossification is when abnormal bone growth occurs in soft tissue below your level of injury. This is caused by miscommunication between the brain and body after spinal cord injury, signaling bone cells to form bone in inappropriate locations, such as within the muscles. This abnormal growth can cause swelling in the legs.

Deep vein thrombosis is when a blood clot forms due to pooling blood or physical inactivity, generally occurring in only one leg. The clot can cause leg swelling and limit blood flow back to the heart.

Frequent body inspections will help identify complications early and allow you to manage them before they progress. If you do notice signs of a deep vein thrombosis, such as single leg swelling or redness, seek medical attention immediately as this can be dangerous and life-threatening.

Understanding Spinal Cord Injury & Leg Swelling

Swelling in the legs after spinal cord injury can be caused by a combination of factors including dependent positioning, dehydration, sodium levels, and physical inactivity.

This leg swelling, or edema, can lead to complications such as skin breakdown and deep vein thrombosis. Therefore, it’s essential to manage leg swelling in order to maximize circulation and avoid complications. This can include passive movement, compression stockings, massage, elevation, and cardiovascular exercise.

We hope this article has been a helpful resource for managing leg swelling after spinal cord injury. Now that you know what actions you can take to reduce swelling, we hope you try them out for yourself!

The post Leg Swelling After Spinal Cord Injury: Why It Happens & How to Effectively Treat It appeared first on Flint Rehab.

This article will discuss the causes of muscle spasms after a spinal cord injury, the importance of a proper rehabilitation regimen, and how to promote recovery.

What Causes Spasms After Spinal Cord Injury?

The spinal cord serves as the communication pathway between the brain and rest of the body. When the body receives sensory input, such as the sensation of heat on the skin, it sends that information through the peripheral nerves to the brain via the spinal cord. Once the brain receives these sensory signals, it processes the information, and then sends the appropriate signals back down the spinal cord to tell the muscles how to react.

For example, when your hand gets close to a hot stove, your peripheral nerves will send a signal through spinal cord to the brain saying it is getting hot. Subsequently, your brain will send a signal back down through the spinal cord to tell the muscles in your arm to move your hand away.

However, when the spinal cord sustains damage, sensory information is unable to reach the brain. Because of this, the stimulus travels back down to the muscles, causing them to hyper-react, which can result in muscle spasms.

To further illustrate this, reconsider the example above. In this example, the hand was getting gradually warmer, and information regarding the hot stove reached the brain, was processed, and was thoughtfully responded to.

However, this reaction changes when you touch something that burns you. Instead of the sensory information travelling through the spinal cord to the brain for consideration and then back to the muscles, the nervous system realizes there needs to be a faster reaction.

Therefore, when the signal that your hand is being burned reaches the spinal cord, the spinal cord initiates a muscle reflex, sending a signal directly back to the muscle to jerk away. A similar process may occur to individuals following spinal cord injury.

If sensory information is unable to reach the brain due to a lack of neural connections in the spinal cord, signals can be sent back to the muscles, resulting muscle spasms.

Muscle spasms may also occur if the body enters a state of spinal shock after injury due to swelling within the spinal cord. Spinal shock refers to the temporary loss of functions and reflexes below your level of injury (the lowest region of the spine where movement and sensation are intact). 

This inhibits the muscles’ ability to contract and causes them to become loose and floppy. When swelling is reduced and proper blood flow is restored, movement and sensation may gradually return, causing hyper-responsive reflexes that result in jerky muscle spasms.

Involuntary muscle contractions, or spasticity, can also appear in the form of jerky muscle spasms and prolonged stiffness in the muscles. Some movement is better than no movement, and although muscle spasms can be uncomfortable and even painful, they can indicate a positive sign of spinal cord injury recovery.

Why Muscle Spasms in Paralyzed Legs Can Be a Sign of Recovery

Individuals may experience paralysis after a spinal cord injury. The chances of this occurring depend on the severity (or completeness) of the injury. In a complete spinal cord injury, the spinal cord is fully severed, meaning there are no existing neural pathways below the level of injury. However, incomplete spinal cord injuries have spared neural pathways because the spinal cord is only partially severed.

Although paralysis usually means there are no existing motor or sensory signals below the level of injury, muscle spasms in paralyzed legs or other parts of the body after an incomplete spinal cord injury can indicate that there are some neural connections remaining.

This is great news for recovery because the pathways can be rewired with the help of neuroplasticity, the nervous system’s ability to heal and rewire itself. Neuroplasticity strengthens existing neural pathways and creates new ones to help restore communication between the brain and muscles. 

It is best activated through high repetition of therapeutic exercise, or massed practice. The more a muscle is exercised, the more the nervous system will strengthen its neural connections and restore function. Thus, there is hope for individuals with muscle spasms in paralyzed legs and an incomplete spinal cord injury to potentially regain movement, especially through passive exercise.

How Muscle Spasms After Spinal Cord Injury Can Be Helpful

The presence of muscle spasms can signify functional improvements which can prevent the development of other complications of a spinal cord injury, including autonomic dysreflexia and pressure sores. Autonomic dysreflexia is characterized by sudden changes of autonomic function such as blood pressure and heart rate, and is triggered by irritating (noxious) stimulation below one’s level of injury. 

Pressure sores are also likely to occur due to immobility and loss of sensation, which make it difficult for survivors to know when the skin is becoming irritated. Fortunately, when muscle spasms appear below the level of injury, it means that some communication exists and there is potential to receive sensory stimuli.

In this light, muscle spasms after spinal cord injury can be viewed as a sign of recovery and a stepping stone towards regaining movement and sensation, which can help avoid further complications.

Additionally, muscle spasms increase muscle tone in the legs which can help individuals prop themselves up to stand, transfer in and out of a wheelchair, and even walk. Muscle spasms can also help prevent muscle atrophy (shrinking of the muscles) and promote blood circulation throughout the body.

Top Spinal Cord Injury Muscle Spasm Treatments

While there are various ways to manage muscle spasms after spinal cord injury, it’s important to also use them as a stepping stone towards recovery. Muscle spasms indicate that there are existing neural connections, but the nervous system needs your help to strengthen those connections and restore function.

Spinal cord injury muscle spasm treatments can include:

1. Prescribed Medication

Muscle spasms after spinal cord injury can be painful depending on the severity. Muscle relaxants are often prescribed to help reduce pain and symptoms of spasticity. This type of medication typically works by altering the chemical balance in the central nervous system and temporarily inhibiting muscle spasms. Muscle relaxants can be locally injected or taken orally for a more general effect. Effects often wear off within a few hours.

While medication is helpful, it does not treat the root cause of muscle spasms after spinal cord injury, which is the disruption in signals between the spinal cord, brain, and muscles. Fortunately, communication can be restored through rehab exercises.

2. Rehab Exercises

Therapeutic exercises help stimulate the nervous system and activate neuroplasticity (rewiring of the central nervous system). Exercising consistently also helps reduce the excitability of hyperactive muscles. The more you practice a skill, the more the nervous system will strengthen its neural connections.

Rehab exercises can be done actively on your own, or passively with the assistance of your unaffected limbs or therapist. Your therapist may also recommend stretching exercises to help manage muscle spasms. Lengthening spastic muscles can help reduce spasms and expand range of motion. Your therapist can also provide you with a variety of exercises to safely practice at home.

3. Home Therapy Program

Having a proper home exercise program for spinal cord injury is crucial during recovery. The best way to heal the spinal cord and reduce muscle spasms after an injury is to promote neuroplasticity as much as possible. While many survivors attend 1-2 therapy sessions a week, it is often not enough to achieve your goals and see improvements. Therefore, practicing therapeutic exercises at home is essential. To help you stay motivated to achieve high repetition of therapeutic exercises you can use interactive neurorehab devices like FitMi.

FitMi is a gamified neurorehabilitation device designed to improve full-body mobility. It provides you with various therapeutic exercises based on your ability level. FitMi helps you stay motivated to achieve massed practice by keeping track of your progress and unlocking more challenging exercises as you improve. The more you practice in between your therapy sessions, the higher the chances of reducing muscle spasms after spinal cord injury.

4. Orthotic Devices

Sudden, jerky movements caused by muscle spasms can sometimes cause you to hit nearby objects, increasing your risk of injury. To help control the movements, therapists may recommend wearing orthotic devices such as braces or splints. These can help hold your body in place to prevent spastic muscles from contracting further. Orthotics can also help mildly stretch tight muscles for continuous muscle lengthening.

5. Botox Injections

Botulinum toxin, or Botox, is a nerve block that is directly injected into spastic muscles. These injections help provide temporary relief of neuropathic pain and muscle spasms, usually ranging from 3-6 months. However, similar to medication, Botox does not address the underlying cause of muscle spasms after spinal cord injury.

Therefore, it’s important for individuals to take advantage of reduced spasticity during this period and focus on achieving high repetition of therapeutic exercises to activate neuroplasticity and promote recovery.

6. Surgery

Another type of spinal cord injury muscle spasm treatment is surgery. However, surgery should only be considered once all other options have been exhausted due to its highly invasive nature. For example, one procedure involves implanting an intrathecal baclofen pump into the spinal column.

Baclofen is a commonly-prescribed medication for spasticity. With an implanted pump, a small dose can be directly administered into the spinal fluid to relieve spasticity. Other procedures like a rhizotomy involves nerve incisions to denervate the spastic muscles.

Treatments for muscle spasms may include a combination of different methods. Be sure to consult with your doctor if you are interested in more invasive procedures. They can provide you with treatments that are safe and suitable for you.

Managing Muscle Spasms After Spinal Cord Injury

Muscle spasms after spinal cord injury occur due to the disrupted communication between the brain, spinal cord, and body. They can be uncomfortable, painful, and interfere with your ability to perform your daily activities.

Fortunately, there are many ways to effectively manage the effects of muscle spasms including medication, orthotic devices, or Botox injections. To treat the root cause of muscle spasms after spinal cord injury, it’s important to establish a proper home exercise regimen. Consistently practicing therapeutic exercises is the best way to stimulate neuroplasticity and promote healing. 

We hope this article helped you understand why muscle spasms after a spinal cord injury occur, and how they can be a good sign of recovery.

The post Muscle Spasms After Spinal Cord Injury: Understanding Signs of Recovery appeared first on Flint Rehab.

The type of paralysis after spinal cord injury depends on the severity and level of injury. In order to receive proper treatment for spinal cord injury paralysis, an accurate diagnosis must be obtained. Timely management of paralysis is important in order to prevent further complications.

This article will discuss the causes of spinal cord injury paralysis, how to lower the risk of complications, and increase the chances of restoring movement in the muscles. Use the links below to jump straight to any section:

• Causes of spinal cord injury paralysis
• Is recovery possible?
• Complications of spinal cord injury paralysis
• Importance of passive exercise
• Recovery methods

Causes of Spinal Cord Injury Paralysis

The spinal cord is responsible for the transmission of messages between the brain and body. Communication is necessary in order to coordinate movement,  control motor function, and respond to sensations. When messages get disrupted by damage from a spinal cord injury, it can result in weakness in the muscles or paralysis.

Paralysis can be temporary or permanent depending on the severity of your spinal cord injury. Spinal cord injuries can either be complete or incomplete. With a complete spinal cord injury, the spinal cord is fully severed and there are no spared neural pathways. As a result, movement and sensation below the level of injury do not exist.

With an incomplete spinal cord injury, the spinal cord is partially severed meaning there are intact neural pathways remaining. This increases the chances of restoring movement and sensation, as functions can be rewired through the neural pathways that remain.

The level of injury refers to the lowest region of the spinal cord where sensation and motor control exist. It determines the areas of your body where you may experience paralysis.

For example, individuals with a cervical spinal cord injury may experience quadriplegia (also known as tetraplegia), meaning they have paralysis in all four limbs. Survivors with a low-thoracic spinal cord injury may experience paraplegia, or paralysis in the lower limbs (legs). 

Additionally, depending on the characteristics of the injury, muscles affected by paralysis may be either spastic or flaccid. These refer to increased or reduced muscle tone, respectively, and can occur in both the upper or lower extremities.

Is it Possible to Recover from Spinal Cord Injury Paralysis?

The chances of recovering muscle functions affected by paralysis mostly depend on your type of spinal cord injury. With a complete spinal cord injury, the spinal cord cannot heal or rewire itself because there are no intact neural pathways remaining. Therefore, the chances of recovery from spinal cord injury paralysis are much higher for an incomplete spinal cord injury since some neural pathways are left intact.

This is due to the process of neuroplasticity, or the central nervous system’s ability to adapt and rewire itself by sprouting new axons (connections) and reorganizing neural circuitry. With the help of neuroplasticity, existing neural pathways can be strengthened to improve function and new connections can be created. 

Neuroplasticity in the spinal cord is best activated through high repetition of exercises, or massed practice. Practicing therapeutic exercises stimulates the central nervous system and helps it understand the demand for that specific task. The more repetitions you perform, the stronger the neural pathways for that skill become, maximizing your chances of recovery from paralysis.

Although the chances of recovering muscle function are much higher for incomplete spinal cord injuries, it’s also possible to regain functions if an incomplete injury is misdiagnosed as a complete injury because of spinal shock.

After an injury your spinal cord can enter a state of spinal shock where all reflexes and sensorimotor function below your level of injury are temporarily lost. This causes the muscles to feel limp which can lead many survivors to believe they have a complete spinal cord injury.

Spinal shock can last anywhere between a few weeks to several months. However, as swelling and inflammatory processes in the spinal cord go down, individuals with incomplete spinal cord injuries may notice certain functions and reflexes gradually improve.

However, it is important to note that recovery from paralysis may include more than just regaining muscle function. For those with complete spinal cord injuries, recovery can be pursued by maximizing your unaffected muscle function and using compensatory techniques to make up for abilities that are lost. For example, those with paraplegia may initially be unable to care for themselves, but can recover independence in their daily activities by using adaptive equipment, such as a leg lifter, hand controls for driving, and a shower chair.

Therefore, recovery should always be pursued regardless of the prognosis in order to maximize the chance of recovery.

Complications of Spinal Cord Injury Paralysis

Loss of muscle function can create many challenges for everyday life, but it can also lead to further complications if not managed properly. Common complications of spinal cord injury paralysis may include:

Pressure Sores

Developing pressure sores, or pressure ulcers, is a major risk of paralysis after spinal cord injury. Studies have shown that 23-30% of spinal cord injury survivors experience pressure sores, especially in bony areas such as the hips, knees, ankles, shoulders, elbows, and tailbone.

A lack of muscle function due to paralysis, often paired with sensation deficits, may result in individuals remaining in certain positions for long periods of time. This adds pressure to the skin, which can inhibit proper blood circulation, causing tissues to die.

If left untreated, this tissue breakdown can enter deeper areas in your body such as the bone, leading to infection and even death. Therefore, it’s especially important for survivors with spinal cord injury paralysis to reposition themselves often and constantly examine their skin for any signs of breakdown.

Osteoporosis and Muscle Atrophy

Individuals with spinal cord injury paralysis may also develop osteoporosis (weakened bone density) or muscle atrophy (shrinking muscles) due to lack of movement. Bones and muscles are strengthened by bearing weight and exerting energy through everyday movements. Without movement, the muscles can lose their function.

The body is extremely energy efficient. Though it takes more energy to move larger muscles, if you don’t use them they can shrink due to an imbalance between protein synthesis and protein degradation. Weak bones and muscles can increase the risk of serious injury by creating an unstable framework.

This instability can make you more susceptible to falling and fracturing your bones. Keep in mind the ‘use it or lose it’ concept to remember how important it is to continue moving your affected muscles after a spinal cord injury.

Bladder and Bowel Dysfunction

Another complication of spinal cord injury is the loss of bladder and bowel control. Paralysis is often accompanied by impaired sensation, which can make it difficult to sense when your bladder or bowel needs to be emptied.

If not managed properly, bladder and bowel dysfunction can result in frequent accidents. To prevent unwanted accidents, some management techniques include catheterization (or other forms of manual waste removal), prescribed medication, maintaining a consistent evacuation schedule, and possibly surgery. Consult with a doctor to find the appropriate treatment for you.

Spinal cord injury paralysis can increase the risk of further injury. To prevent paralysis from worsening or developing serious complications, survivors must engage in rehabilitation exercises to stimulate the nervous system and promote movement.

The Importance of Passive Exercise for Spinal Cord Injury Paralysis

Exercise is the most effective way to stimulate neuroplasticity after a spinal cord injury, promote blood flow, and encourage movement. However, with paralysis it can be challenging to perform active exercises.

Fortunately, passive exercises are just as effective and do not require you to move your body independently. Passive exercises are performed with the assistance of your unaffected limbs or with the help of a therapist or trained caregiver.

Passive exercise allows your affected muscles to be moved for you. Even if you have limited or no mobility due to paralysis, passive exercises help stimulate neuroplasticity and send signals to the nervous system. 

Performing passive range of motion exercises can also help promote proper blood flow, maintain range of motion in the joints, and minimize the risk of complications. With time and consistent practice, you can increase your chances of recovery from spinal cord injury paralysis.

Recovery Methods for Spinal Cord Injury Paralysis

Various types of therapy, such as physical therapy and occupational therapy, help survivors achieve high repetition of exercises in their affected limbs. Whereas physical therapy exercises focus on improving functional mobility, occupational therapy exercises focus on improving performance with the activities of daily living.

Occupational therapists are especially helpful in introducing compensatory technique for those with complete spinal cord injuries, so that they can pursue recovery even if they are unable to regain muscle function.

Both PT and OT are essential to help improve paralysis after spinal cord injury. Unfortunately, therapy sessions are not always covered by insurance, leaving survivors to only practice 1-2 times a week. While this is helpful, 1-2 therapy sessions per week is not nearly enough to achieve massed practice.

To stay focused and engaged in between your outpatient sessions, it’s important to have a suitable home exercise program for spinal cord injury. Your therapist can create a rehabilitation plan that is suitable and safe for your ability level. They can also train a caregiver to safely help you practice exercises passively if you cannot do so on your own.

For an added boost of motivation, you can use home therapy devices such as MusicGlove and FitMi. MusicGlove focuses on improving hand function and FitMi focuses on improving full-body mobility. Both provide exercises that can be done passively or actively from the comfort of your own home.

Exercise is undoubtedly the best way to manage paralysis after spinal cord injury. However, depending on the severity, some survivors may benefit from other types of treatment as well. This can include a combination of:

• Prescribed medication
• Botox injections (for spastic paralysis)
• Exoskeletons
• Electrical stimulation
• Advanced nerve surgery

Some treatments are more invasive than others. Be sure to consult with your doctor first to obtain a proper diagnosis of your paralysis.

Understanding Spinal Cord Injury Paralysis

Spinal cord injury paralysis can be permanent or temporary depending on the severity and whether the injury was complete or incomplete. Finding effective management techniques for paralysis is important in order to prevent further injury and complications.

The best method for managing paralysis and encouraging neuroplasticity is through passive exercise. High repetition of passive exercises can stimulate the nervous system and promote movement and sensation.

We hope this article helped you understand how you can maximize your chances of recovery from spinal cord injury paralysis.

The post Spinal Cord Injury Paralysis: How to Maximize Your Chances of Recovery appeared first on Flint Rehab.

This article will discuss what causes changes in sensation after spinal cord injury, how it can sometimes be a sign of recovery, and effective management techniques.

What Causes Tingling and/or Numbness After Spinal Cord Injury?

Loss of sensation is one of the most common secondary effects of spinal cord injury. When we touch or feel something, sensory information travels through the spinal cord to the brain. After this information is processed, the brain then sends signals back down to the body. These signals from the brain often stimulate a movement-based reaction, such as moving away from a hot stove.

However, when a spinal cord injury interrupts this process, it can be difficult for sensory information to reach the brain to be processed and responded to appropriately. When this occurs, individuals may experience complete loss of sensation below the level of injury. Alternatively, individuals may retain some sensation, but it may be impaired, causing tingling or altered sensations (paresthesia).

When a loss of sensation occurs, it is often referred to as numbness. Many people report feeling numbness after a spinal cord injury, since the nerves responsible for sending sensory signals to the brain are often damaged or disrupted.

The inability to process sensory stimuli can make it difficult to protect your body from any potentially harmful stimuli. Therefore, complete or partial loss of sensation after a spinal cord injury can increase the risk of further injury.

While this can be concerning, the presence of tingling after spinal cord injury is not always a negative sign. Let’s take a look at what impaired sensation after spinal cord injury could mean.

What Does Tingling After Spinal Cord Injury Mean?

When a survivor begins to feel tingling after spinal cord injury, it can actually be an indicator that at least some sensory communication exists. Thus, tingling in the arms or legs after spinal cord injury can be viewed as a positive sign of recovery because it shows that at least some sensory stimuli is reaching the brain.

While complete numbness may indicate a more serious condition, tingling in certain parts of the body below the level of injury can indicate that the neural pathways in that muscle are being restored – which is great news for recovery!

Restoring sensation, movement, and function following a spinal cord injury is heavily dependent on the level of injury, intensity of rehabilitation, and whether the injury was complete (spinal cord fully severed) or incomplete (spinal cord partially severed). Usually, individuals with incomplete spinal cord injuries have higher chances of recovery because there are unaffected neural pathways within the spinal cord remaining. 

In fact, tingling is only possible with an incomplete SCI, because complete SCI survivors have no feeling below the level of injury. Therefore, it’s important to continue training the areas where you may feel even the slightest sensations to maximize the chances of recovering sensation. 

Through specific therapies, you can help strengthen the spared neural pathways in the spinal cord that relay sensory information to the brain. Thus, if you are experiencing tingling in your affected limbs after an incomplete SCI, try to think of it as a sign of hope for recovery.

Managing Changes in Sensation After Spinal Cord Injury

Different types or rehabilitation methods can help minimize numbness and tingling after spinal cord injury. It’s important to note that these are management techniques that can help with the symptoms, but they may not address the root cause.

Management techniques for numbness after spinal cord injury can include:

Avoiding Triggers for Autonomic Dysreflexia

Survivors who experience loss of sensation after a spinal cord injury (especially those with a T-6 level injury or higher) are at risk of developing autonomic dysreflexia. This is a condition in which the autonomic functions of the body overreact or produce involuntary actions.

Individuals with autonomic dysreflexia after a spinal cord injury may experience:

• Abnormally high blood pressure
• Irregular heart rate
• Severe headaches
• Nausea or vomiting
• Difficulty breathing or chest pain

Numbness after an SCI can increase the chances of triggering autonomic dysreflexia because it becomes more challenging for individuals to notice sensory stimuli below the level of injury, such as a full bladder or tight clothing.

Therefore, understanding and avoiding potential triggers is essential to lowering the risk of autonomic dysreflexia. This can include wearing loose clothing, avoiding extreme temperatures, evacuating your bladder regularly, checking catheters, and inspecting the skin routinely for pressure sores and bruises.

Safety Tips

If you are experiencing numbness after spinal cord injury, being aware of your surroundings can help you stay safe and prevent further injury. As previously mentioned, loss of sensation can put you at a greater risk for potentially harmful stimuli. Therefore, it’s important to keep the following safety tips in mind: 

• Keep a lookout for sharp objects
• Be extra careful when cooking and minimize the use of stoves, microwaves, or any other household appliance
• Use a thermometer to check the temperature of shower or bath water (the safest temperature is 100°F), and lower the hot water heater temperature to no higher than 120°F
• Reposition yourself or ask a caregiver to assist you in repositioning often (at least every 2 hours) to lower the risk of pressure sores or ulcers.

Pressure sores are a common result of impaired motor control and sensation. This is because sensation provides the urge to move after being in one position for a prolonged time, and motor control allows the body to move. When either function is impaired, the skin becomes vulnerable to ulcers. Thus, it’s extremely important for you or a loved one to ensure your body is frequently moved.

Maximizing Neuroplasticity, Especially in Early Recovery

During the first 6-9 months after injury, the spinal cord enters heightened levels of neuroplasticity, the central nervous system’s ability to rewire itself. Neuroplasticity allows existing neural pathways in the spinal cord to be strengthened and new pathways to be formed, allowing for better communication between the brain and body. The better the communication, the more the brain will be able to receive sensory information and process that stimuli, potentially reducing tingling and/or numbness. 

Large improvements may initially be seen through “spontaneous recovery,” but a plateau in gains often occurs about 12-18 months post injury. However, this does not mean recovery completely stops. It continues as long as rehabilitation is pursued actively. Rehabilitation can include a variety of therapies and management techniques, which is crucial to maximize the chances of full recovery after spinal cord injury.

Sensory Reeducation

When individuals with incomplete spinal cord injuries begin to feel some sensation returning, sensory reeducation can help stimulate neuroplasticity. Sensory reeducation typically involves stimulating areas of affected sensation with items of differing textures. Rubbing the affected area with the hand, a soft blanket, or a washcloth can provide differing inputs to help stimulate communication within the nervous system.

Sensory reeducation techniques may be utilized with the eyes open or closed, and may also include attempting to localize a sensation to a certain area of the body. Consult with your occupational therapist to learn more about sensory reeducation.

Acupuncture

Though there is minimal research available for its effectiveness in specifically treating numbness and tingling, studies have shown that acupuncture can help relieve neuropathy, which includes weakness, numbness, and pain from nerve damage (commonly felt in the hands and feet). Some individuals with numbness after spinal cord injury may also experience neuropathic pain, making acupuncture an attractive way to help manage symptoms. 

In fact, studies showed that SCI survivors who received one treatment of acupuncture daily for 6 days had significant reductions in pain and numbness. A more targeted approach is known as electroacupuncture where a small electric current is passed through pairs of acupuncture needles. While electroacupuncture usually focuses on improving movement after SCI, it can potentially help with sensation, especially if your injury was incomplete. The best way to find out is to try, just be sure to consult with your doctor or therapist beforehand.

Electrical Stimulation 

Lastly, a management technique that may help with numbness and tingling after spinal cord injury is electrical stimulation. There are many different types of electrical stimulation available, and it’s essential to talk to your therapist to discuss which options are suitable for you. They can also provide any necessary training on how to use an at-home e-stim device. 

For example, during Transcutaneous Electrical Nerve Stimulation (TENS), electrodes are placed on the surface of the skin to stimulate the muscles and nerves. While no studies have directly found a link between TENS and numbness after spinal cord injury, the option could be worth exploring to help stimulate neuroplasticity. TENS has also been shown to help with neuropathic pain.

Understanding Numbness & Tingling After Spinal Cord Injury

Many survivors experience numbness and tingling after spinal cord injury. While loss of sensation can raise concern and increase the risk of autonomic dysreflexia and other complications, tingling may actually be a sign of recovery. Tingling indicates that there is at least some neural activity remaining, which increases the chances of recovery through neuroplasticity. 

Talk to your therapist to discuss which options are most suitable for you, such as electrical stimulation or electroacupuncture. We hope this article helped you understand tingling and numbness after spinal cord injury, and the most effective management techniques to overcome these effects.

The post Numbness & Tingling After Spinal Cord Injury: What It Means & How to Promote Recovery appeared first on Flint Rehab.

Understanding the effects of a spinal cord injury can help you or your loved one take necessary precautions to minimize the risk of complications. This article will discuss the potential spinal cord injury secondary effects, along with effective management techniques to help promote recovery.

How the Spinal Cord is Affected After Injury

The primary functions controlled by the spinal cord are movement and sensation. Thus, damage to the spinal cord can result in various motor impairments such as paralysis or changes in sensation like numbness.

The effects of spinal cord injury that survivors experience differ depending on the severity and level of the injury. These can be determined by using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Also known as the ASIA exam, this classification tool involves testing sensory and motor functions at each level of the spinal cord to determine which functions remain intact, and which are affected.

Since specific areas of the skin and sets of muscles are connected to specific levels of the spinal cord, this exam is able to identify the level of injury (the lowest section of the spinal cord where movement and sensation are intact). Higher levels of injury affect functions in the upper (and often lower) body, while lower levels affect functions only in the lower body.

The ASIA exam also helps to identify the severity of a spinal cord injury. In a complete spinal cord injury, the spinal cord is completely severed. Therefore, since there are no spared neural pathways, there is a total loss of all motor control and sensation below the level of injury. 

Conversely, in an incomplete spinal cord injury, survivors may have some preserved sensory and motor functions in the areas below the level of injury. This is due to the spinal cord being only partially severed, with some spared neural pathways remaining. During recovery, these spared neural pathways can utilize neuroplasticity, the central nervous system’s ability to rewire itself, to improve functions.

The effects of a spinal cord injury can be rehabilitated with traditional therapies as long as the injury was incomplete. When an injury is complete, rehabilitation will focus on learning compensation techniques to help promote as much independence as possible.

Generally, the less severe a spinal cord injury, the higher the chances of improving function. To understand the rehabilitation process, it first helps to know what potential spinal cord injury secondary effects may arise.

Potential Effects of Spinal Cord Injury

Spinal cord injury secondary effects may develop shortly after the injury or later on during recovery. To prevent these effects from worsening and becoming more serious complications it helps to know what potential spinal cord injury secondary effects may occur and why they may arise. 

Be sure to seek emergency medical care if you or your loved one experience any new or recurrent symptoms.

Here are some of the most common spinal cord injury secondary effects:

1. Limited Mobility

In order for movement to occur, the brain needs to send messages down through the spinal cord to the rest of the body. When this flow of messages is interrupted after a spinal cord injury, it can cause weakness or paralysis in the limbs. More specifically, it can cause paraplegia (paralysis of the legs) or quadriplegia (paralysis of the arms and legs), depending on the level of injury. 

To improve motor control and restore mobility, it’s essential to stimulate neuroplasticity, which is best activated through high-repetition of exercises, or massed practice. Practicing a movement consistently helps strengthen its neural pathways. Your physical or occupational therapist can provide a rehabilitation plan suitable for your ability level with exercises that focus on improving mobility.

2. Loss of Sensation

Another common effect of spinal cord injury is impaired sensation. When we touch something, sensory information travels from the body, through the spinal cord, and to the brain. The brain then processes that information and sends signals back down to the body to create a movement-based reaction, if necessary. 

When a spinal cord injury disrupts this process, it can result in the inability to process sensory stimuli, causing a lack of sensation, numbness or tingling. Loss of sensation can make it difficult to protect your body from potentially harmful stimuli.

For example, wearing mittens when taking a plate out of the oven helps protect your hands from the heat. If you remove the plate without mittens, sensory nerves will transmit a message to the brain through the spinal cord saying the plate is too hot. The brain then sends a signal through the spinal cord to the muscles to initiate a reaction. This reaction helps prevent your body from serious burns or severe pain.

When the spinal cord is injured, it may be difficult to relay the information to your brain or initiate a reaction. Therefore, if you struggle with sensation deficits after spinal cord injury, it’s important to be extra cautious while cooking or doing any other activity that may increase the risk of accidents.

3. Pain

Chronic pain effects approximately 65% of individuals with spinal cord injuries. Neuropathic pain stems from damage to the nervous system, potentially affecting areas that have been paralyzed or otherwise affected by your injury. This may occur due to a disruption in the flow of sensory signals through the spinal cord to the brain, causing these signals to be misinterpreted as pain.

Treatment may vary depending on the severity of the pain and can include prescribed medication such as non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and opioids. Electrical stimulation and physical therapy may also be recommended. Speak with your doctor to obtain a proper diagnosis and treatment according to your unique needs.

4. Autonomic Dysreflexia

A secondary effect that most commonly occurs in individuals with a T6 level injury or higher is autonomic dysreflexia, or a sudden overreaction of the autonomic nervous system. The autonomic nervous system controls the regulation of involuntary body functions such as breathing, heart rate, blood pressure, body temperature, and digestion.

Uninterrupted neural communication is necessary for the autonomic nervous system to function properly. Following a spinal cord injury, however, the transmission of messages between the brain and body may be disrupted. As a result, the autonomic nervous system can overreact to stimuli. 

There are various factors that can trigger autonomic dysreflexia including a full bladder or constipation, extreme changes in temperature, tight clothing, and skin irritation. Survivors with autonomic dysreflexia may experience sweating, high blood pressure, blurry vision, headaches, blotchy skin, or anxiety.

This spinal cord injury effect can progress quickly, therefore it’s important to know the triggers and address them as soon as possible. For example, you can empty the bowel and bladder at regularly scheduled intervals and avoid wearing clothes that have sharp items on them like zippers or studs.

5. Loss of Bladder and Bowel Control

Bowel and bladder dysfunction can occur when signals from the brain cannot pass through the damaged areas of the spinal cord and reach the bowel and bladder muscles. Loss of bladder and bowel control are common secondary effects because they are regulated by the lowest regions of the spinal cord, making them more susceptible to damage.

Proper bladder and bowel movement are necessary to flush out waste and toxins. When not treated appropriately, loss of bladder and bowel control can result in complications such as constipation, fecal and urinary incontinence, autonomic dysreflexia, and urinary tract infections. 

Lack of sensation and impaired reflexes in the body following a spinal cord injury can also make it challenging for individuals to know when to use the bathroom, increasing the risk of urine and waste-related accidents, as well as the development of pressure sores.

While there are management techniques you can try, it’s important to work closely with your doctor and therapist to establish a proper bladder and bowel regimen. They may recommend using catheters, which are inserted into your body to manually empty the bladder. They can also prescribe medication such as laxatives to help ease your bowel movements. Additionally, natural methods, such as drinking water and eating high-fiber foods, can help with the fluidity of your stool.

6. Breathing Difficulties

High level cervical and thoracic injuries may result in breathing difficulties. The diaphragm is a large, dome-shaped muscle, and is the primary muscle responsible for respiration. When the diaphragm becomes impaired, especially after high-level cervical injuries (C1-C5), survivors may experience breathing difficulties. 

While not as vital, the intercostal muscles located between the ribs also play a role in respiration, and may be affected in a T3-T5 spinal cord injury. Symptoms of impaired respiratory muscles include shortness of breath, heart palpitations, nausea, and abdominal pain.

Damage to the diaphragm can also cause diaphragmatic palsy (weakness of the diaphragm muscle), increasing the chances of respiratory infections. For example, when survivors cannot produce a strong enough cough to clear excess mucus/fluid in the lunges, it can lead to pneumonia, a serious complication of spinal cord injury.

Difficulty breathing can lead to death, therefore it’s crucial to take note of these effects after a spinal cord injury and seek immediate medical attention.

7. Spasticity

Another common secondary effect of a spinal cord injury is spasticity, or involuntary muscle stiffness. Spasticity is caused by disrupted signals between the brain and the areas below the level of spinal cord injury. When spinal reflexes activate a muscle contraction, signals from the brain telling the muscle to relax may not be able to get through, resulting in prolonged contraction.

Individuals with spasticity may experience stiff movements or jerky muscle spasms. When not managed properly, spasticity can cause additional complications such as limited range of motion, contractures (extreme joint stiffness), and body distortions. Therefore, it’s important to work with a physical or occupational therapist if you experience this effect after a spinal cord injury.

8. Clonus

After a spinal cord injury, reflexes can become hyperexcitable to stimulation and cause a condition known as clonus. Clonus refers to involuntary rhythmic shaking of the limbs after spinal cord injury, particularly when the limb is stimulated.

Although it most commonly occurs in the ankles and feet, survivors may also experience it in different areas depending on the level of injury. This can include the calves, knees, wrists, triceps, and biceps.

Studies have shown that clonus typically develops about 2 months after a spinal cord injury and can concurrently be present with spasticity. If not properly managed, severe clonus can disrupt your sleep, cause daytime fatigue, and make it difficult to perform self-care tasks.

9. Sexual Dysfunction

Sexual functions may be affected by a spinal cord injury due to impaired sensation, and it affects men and women differently. While men are still able to get erections and women are still able to get pregnant, the level of arousal and pleasure during intercourse may be affected. Talk to your doctor or a therapist with specialization in this area for treatment ideas.

10. Sleep Apnea

Spinal cord injury secondary effects may also consist of sleeping disorders such as sleep apnea. Sleep apnea is a condition characterized by unstable breathing (breathing starts and stops) during sleep. As a result, individuals may wake up multiple times throughout the night, interfering with a full night’s rest. Individuals may experience excessive snoring as well as daytime fatigue.

A continuous positive airway pressure device (CPAP) supplies pressurized air into your airways while you sleep. This machine can help treat sleep apnea and other respiratory difficulties. Consult with your doctor if you are unable to sleep well during the night after sustaining a spinal cord injury.

Management Techniques for the Effects of Spinal Cord Injury

The spinal cord injury effects listed above all have something in common: they are the result of miscommunication between the brain, spinal cord, and rest of the body. Fortunately, the spinal cord can rewire itself via neuroplasticity in spared neural pathways.

Spared neural pathways are seen in incomplete spinal cord injuries as opposed to complete spinal cord injuries where the spinal cord is fully severed. In order to activate neuroplasticity after an incomplete SCI, individuals must repeatedly practice weakened or affected movements.

Think of the phrase “use it or lose it!” Neuroplasticity is occurring all the time, not just after the injury. It can promote or impede recovery based on your dedication to the rehabilitation process. The more you practice a function, the higher the chances of improving and restoring that function.

To help manage spinal cord injury effects you can engage in the following types of therapy:

• Physical therapy: Physical therapy focuses on improving mobility by promoting high repetition of therapeutic exercises to encourage neuroplasticity and functional movement patterns. This can include a variety of exercises for paraplegia and quadriplegia, depending on your level of injury. Physical therapists can address mobility-related concerns such as pain and spasticity, too.
• Occupational therapy: Occupational therapy focuses on helping survivors adapt to their ability level and maximize independence after spinal cord injury. Therapists can provide exercises that mimic daily activities such as bathing and eating. Adaptive equipment may also be recommended for those with complete and incomplete injuries to make tasks easier.
• Speech therapy: Speech therapy is especially helpful for high-level spinal cord injuries that cause respiratory effects. Speech-Language Pathologists can provide exercises that focus on managing secretions and increasing diaphragm strength.

While therapy helps treat the root cause of the secondary effect, you can also use compensation techniques to help reduce some of the symptoms. For example, medications such as baclofen can help with spasticity and orthoticscan help promote proper musculoskeletal alignment and mildly stretch tight muscles.

Consult with your therapist to find the most effective compensation techniques for you. Your therapist can also provide you with a home exercise program to keep neuroplasticity stimulated between therapy sessions.

Overcoming Effects of a Spinal Cord Injury

The effects of a spinal cord injury depend on the level of injury. For instance, high level cervical injuries may result in quadriplegia while lower level injuries may result in paraplegia. Rehabilitation is crucial to address any secondary effects and reduce the risk of further complications.

The best way to promote recovery is to stimulate the central nervous system through high-repetition of exercises. Survivors must engage in massed practice to improve mobility, sensation, and restore as much overall function as possible. We hope this article helped you understand the types of spinal cord injury secondary effects that may arise, and encouraged you to seek immediate medical care if needed.

The post Effects of a Spinal Cord Injury: Understanding the Aftermath appeared first on Flint Rehab.

Thus, it’s important to be aware of the potential complications of spinal cord injury and seek emergency medical attention if new symptoms arise.

This article will discuss what potential spinal cord injury complications can occur and what the underlying causes may be. It will also explore management techniques that can help improve overall health and promote recovery.

Use the links below to jump straight to a particular complication of spinal cord injury:

• Lack of Blood Circulation
• Pain
• Contractures
• Bowel and/or Bladder Dysfunction
• Pneumonia
• Atelectasis
• Bloated Stomach
• Scoliosis
• Pressure Sores
• Osteoporosis
• Heterotopic Ossification
• Weight Gain/Weight Loss
• Leg Swelling
• Sleep Problems
• Depression & Anxiety

What Are the Complications of Spinal Cord Injury?

To prevent spinal cord injury complications from worsening, it helps to understand what they are and how they can occur. It’s especially important to note the risk factors that can increase the chances of developing certain complications.

Be sure to seek emergency medical care if you or a loved one experience any new signs or symptoms after spinal cord injury.

Here are some of the most common spinal cord injury complications that may occur:

1. Lack of Blood Circulation

The spinal cord is responsible for transmitting messages that control movement and sensation throughout the body. When a spinal cord injury affects movement, it can result in paraplegia (paralysis of the legs) or quadriplegia (paralysis of the arms and legs), potentially creating the need for a wheelchair.

When spinal cord injury survivors are unable to move independently and do not participate in regular exercise, stretches or therapy, the lack of physical activity can cause blood to pool in the arms and legs.

As a result, this can disrupt blood vessel tone, and when your blood vessels relax too much, there isn’t enough pressure to efficiently push blood back to the heart. Individuals with poor blood circulation may experience low blood pressure, cold feet, lightheadedness, dizziness, or weakness.

2. Pain

Pain is among the most common complications of spinal cord injury. Specifically, untreated secondary effects of spinal cord injury can result in musculoskeletal and/or visceral pain.

Musculoskeletal pain involves pain in the bones, joints, ligaments, tendons, and muscles. It can stem from unmanaged spasticity (tightness of the muscles) or excessive use of muscles and joints. It can also be caused by dependency on the unaffected areas of the body.

For example, an individual who uses on a manual wheelchair may rely primarily on their arms and shoulders to move around after a spinal cord injury. However, the arm and shoulder muscles are not designed to carry the weight of the full body, and thus the muscle strain from overworking these muscles can result in musculoskeletal pain.

Although less common, spinal cord injury survivors can also experience visceral pain, or internal organ pain. Visceral pain is usually caused by urinary or bowel dysfunction, and individuals generally feel aching or cramping around the abdomen.

A physical therapist is a great resource for treating and preventing musculoskeletal pain after spinal cord injury. Alternative remedies such as acupuncture, massage therapy, and rest may also help reduce pain. You can also talk to your doctor about possible medication for pain depending on the severity.

3. Contractures

A contracture refers to the tightening of affected muscles, ligaments, and tendons. This often occurs when spasticity has not been managed properly, and typically results in limited joint motion and pain. Contractures occur in approximately 66% of individuals with SCI, and may develop in the early stages of spinal cord injury or later in recovery. 

Survivors may experience neurally mediated contractures due to unmanaged spasticity, or non-neurally mediated contractures that occur due to immobilization, particularly when muscles remain in shortened positions. For instance, knee flexion contractures usually result from the loss of knee extension for long periods of time.

Contractures not only limit joint mobility but they can also interfere with daily-life activities. Fortunately, physical therapy interventions such as stretching and passive movements can help manage contractures. Working with your physical therapist is essential to receive a variety of stretching and passive exercises for contractures tailored to your ability level.

4. Bowel and/or Bladder Dysfunction

Proper bowel and bladder functioning is necessary to remove waste from the body. When the spinal cord cannot transmit signals to the bowel and bladder muscles, it can lead to bladder and/or bowel dysfunction.

When the bladder muscles are not working, individuals may experience incontinence or be unable to empty the bladder appropriately. If not addressed, bladder dysfunction can cause a variety of more serious complications, including urinary tract infections, kidney stones, and bladder cancer.

Furthermore, when affected bowel functions are not managed properly, other serious complications such as constipation and bowel incontinence may occur. Lack of bowel management can result in additional problems, including abdominal pain, hemorrhoids, anal fissure, and other diseases.

Fortunately, there are ways to help your body get rid of waste and restore proper bowel and bladder functions after a spinal cord injury. This can include lifestyle changes such as increasing your water intake, maintaining a high-fiber diet, performing consistent catheterizations, and using a regularly scheduled bowel management program.

Additionally, medication may be prescribed to help manage complications such as laxatives to promote bowel movement. Be sure to consult with your doctor before taking any medication to see if they are safe for you.

5. Pneumonia

After a spinal cord injury, survivors may not be able to cough strongly enough to get rid of fluids in the airway. This is common after high-level spinal cord injuries, like a C5 (cervical injury), which can result in loss of control over the diaphragm muscle. 

When the diaphragm is impaired, it can make it difficult to breathe and cough, which is an important mechanism to clear the airway. Eventually this can lead to respiratory infections such as pneumonia.

Pneumonia occurs when one or both lungs fill with fluid and become infected. Treating pneumonia generally consists of antibiotics, but alternatives such as respiratory muscle exercises during physical therapy may also be recommended by your doctor.

6. Atelectasis

High level spinal cord injuries can also result in other lung complications such as atelectasis, the complete or partial collapse of the lungs due to blocked airways. Atelectasis is often asymptomatic until it affects larger portions of the lungs. When it occurs, survivors may experience shortness of breath, coughing, and chest pain.

Deep breathing exercises as well as using a ventilator or CPAP machine may help increase lung volume. Additionally, coughing exercises can help provide strength to effectively remove mucus from the lungs and help prevent pneumonia.

7. Bloated Stomach

When bowel and bladder dysfunction or an impaired diaphragm are not treated properly, it can cause a bloated stomach. Stomach bloating after spinal cord injury occurs due to gas or water retention in the body. This is an uncomfortable sensation that can make you feel heavy and may even be painful.

To reduce gas and water retention and promote a healthy digestion you can try adjusting your diet, drinking more water, and increasing physical activity when possible. You can also try a bowel program for spinal cord injury to help manage and keep track of stomach bloating.

8.  Scoliosis

Another spinal cord injury complication that may occur is scoliosis, a condition in which the spine curves to the side. Although scoliosis typically occurs during adolescence, adults can develop it after traumatic events like a spinal cord injury.

Maintaining good posture while sitting or walking after a spinal cord injury can be difficult, especially when control over the core muscles is impaired. Individuals who continuously compromise their posture and slouch or lean to the side can develop neuromuscular scoliosis if left untreated.

9.  Pressure Sores

When most people sit or lay in the same position for an extended period, they start to feel pressure in certain areas of the body and automatically shift positions. However, after a spinal cord injury, survivors may not feel the excess pressure due to impaired sensation and may not feel the need to move for long periods of time.

Too much pressure for long periods of time can disrupt adequate blood flow and deprive tissues of oxygen, making the skin susceptible to pressure sores, especially over bony areas of the body. When treatment is neglected, it increases the risk of additional complications including pain and serious infections. Fortunately, the earlier pressure ulcers are identified, the easier they are to treat. 

Additionally, there are ways to minimize the progression of pressure sores. This includes inspecting your skin daily, especially at bony points such as the tailbone, sit bones, ankles, knees, and hips. 

You can also ask your caregiver or loved one to provide “pressure reliefs” to reposition your body every two hours when lying in bed or every 30 minutes when sitting up in your wheelchair.

10. Osteoporosis

As previously mentioned, when a spinal cord injury impairs motor control survivors may become less physically active. Lack of physical activity can increase the chances of developing more serious complications, such as osteoporosis.

Osteoporosis occurs when your bones break down faster than the rate at which they are reforming. This causes your bones to become weaker, less dense, and more likely to fracture. Without regular weight-bearing on the affected areas, bone density can decrease, reducing bone strength.

To help lower the risk of osteoporosis after spinal cord injury, make sure you have sufficient calcium and vitamin D in your diet. These nutrients are essential for building and maintaining bone strength. 

Another way to reduce the risk of osteoporosis is to gradually add more weight-bearing exercises into your routine to help build bone density. You can also ask your doctor about medications that can help slow down bone breakdown.

11. Heterotopic Ossification

While osteoporosis involves too much breakdown of bone, some complications can occur from the opposite direction: excess bone tissue. Heterotopic ossification, for instance, is an abnormal bone growth in your soft tissues surrounding the joints. This typically occurs below the level of injury, oftentimes in the hip area.

Nearly 20% of spinal cord injury survivors, typically those with more severe injuries, experience heterotopic ossification. This may result in pain and reduced range of motion in the affected areas.

For this spinal cord injury complication, survivors may need prescribed medication. Additionally, if the bone growth prevents joint motion or other bodily functions, it will need to be surgically removed. Other options such as physical therapy or radiation therapy can also be explored.

12. Weight Gain/Weight Loss

Both weight gain and weight loss are common complications of spinal cord injury.

Survivors may lose weight shortly after spinal cord injury due to the decreased levels of physical activity that result in loss of muscle mass (muscle atrophy) and decreased bone density. To help lower the risk of weight loss, it’s important to participate in weight-bearing exercises when possible.

On the other hand, less physical activity also means your body is not using as much energy as it did pre-injury. In order to avoid the complication of weight gain, try to remain active and  be mindful of your post-injury diet. Be sure to eat balanced meals and avoid crash dieting. You need plenty of vitamins and minerals, like calcium, to promote recovery and prevent further complications.

13. Leg Swelling

Edema, or swelling, is another spinal cord injury complication caused by the buildup of excess fluid in the body. Leg swelling after spinal cord injury is particularly common in individuals with paraplegia or quadriplegia. Limited mobility decreases blood flow, resulting in excess fluid gathering in the tissues.

Leg exercises, such as passively or actively moving your legs, as well as keeping the legs elevated when possible, can help increase circulation and reduce leg swelling. If your legs become weighted down and difficult to move due to swelling, resistance bands or leg lifters can provide extra assistance to help you move your legs more swiftly.

To help manage leg swelling with paralysis you can also try wearing compression stockings, massaging your legs, and managing sodium intake. Working with a physical or occupational therapist who is certified in lymphedema treatment may also help you manage leg swelling.

14. Sleep Problems

Sleeping after a spinal cord injury is essential to allow the body to heal. However, sleep disturbances after a spinal cord injury may occur due to a variety of factors. 

For example, after a spinal cord injury you may struggle with regulating your body temperature, resulting in body temperature dysregulation. Individuals may then feel too hot or cold while sleeping causing them to wake up throughout the night. Sleep disturbances may also be increased by pain, obesity, anxiety, and medication side effects. 

There are some management interventions that can help improve your quality of sleep. Effective interventions depend on the primary factors contributing to sleep disturbances. These may include cognitive-behavioral therapy to help identify and reduce anxiety or stress levels, medication for pain, and managing your weight.

15. Depression & Anxiety

A spinal cord injury can bring about sudden changes in daily activities and quality of life, which can be difficult to cope with. Without proper support, survivors may struggle with anxiety or depression after spinal cord injury.

If you or a loved one struggle with depression or anxiety it’s important to reach out to friends, family members, or support groups. You can also speak to your doctor about medication if you are interested. Psychotherapists in particular are another great resource and can provide more insight on psychological care.

How to Treat Spinal Cord Injury Complications

Every spinal cord injury is unique, and the complications that may arise also vary for every survivor. Fortunately, rehabilitation therapy and compensation techniques can help you manage spinal cord injury complications.

For example, to help reduce musculoskeletal pain due to spasticity, you can try physical therapy. With physical therapy exercises, you can improve mobility by activating neuroplasticity (the central nervous system’s ability to rewire itself). As the central nervous system begins to rewire itself and improve communication between the muscles and central nervous system, spasticity may reduce.

While some physical therapy exercises can be challenging depending on your ability level, there are other types of exercises that do not require you to exert as much energy. 

For example, rather than using your own strength to move, passive range of motion exercises involve a therapist or caregiver moving your body for you. These exercises encourage the joints to move through their full range of motion, minimizing joint tightness and preventing stiffness.

Occupational therapy focuses on helping survivors maximize independence after spinal cord injury. Exercises focus on attaining the skills needed to complete daily activities such as eating and dressing. Occupational therapists may also encourage survivors to use adaptive equipment to make tasks easier. 

Speech therapy can also be helpful, especially for high-level injuries that cause respiratory complications. Speech-Language Pathologists can provide guidance and exercises focused on increasing diaphragmatic strength and managing secretions.

Other methods such as medication can help provide temporary relief from musculoskeletal and visceral pain, as well as respiratory infections and mental health conditions. Consult with your doctor before taking medication because some can cause adverse side effects and may not be ideal for long-term use.

Creating new lifestyle habits after spinal cord injury, such as adopting a healthy diet and being physically active, can help lower the risk of developing complications and may be beneficial to your overall health. 

To maintain a well-balanced diet, try to consume nutrient-dense foods that are rich in fiber. This can help increase bulk in your stool and regulate bowel movements. Staying hydrated and drinking plenty of water can soften the stool to help prevent constipation and temperature dysregulation.

Overview of Spinal Cord Injury Complications

Learning how to cope with spinal cord injury complications such as osteoporosis, constipation, pain, and weight loss can require time and patience. Fortunately, you can reduce the chances of developing certain complications by seeking timely treatment. 

Thus, it’s important to take note of any new or recurrent symptoms and seek emergency medical attention if you are experiencing new spinal cord injury complications. We hope this article has helped you understand the potential complications that may arise after a spinal cord injury and how to take the proper precautions.

The post Spinal Cord Injury Complications: How to Manage Potential Symptoms appeared first on Flint Rehab.

The answer is no, at least not directly. Cognitive function is only affected by a spinal cord injury with a co-occurring traumatic brain injury (TBI).

This article will explore the connection between SCI, TBI, and memory. It will also discuss management techniques you can use to cope with memory loss.

Can a Spinal Cord Injury Cause Memory Loss?

The simple answer is no. Spinal cord injury will affect motor and sensory functions relayed via the spinal cord, but it will not cause memory loss because this ability is housed in the brain. Memory is a cognitive function and cognitive functions are regulated by the brain, not the spinal cord. 

The spinal cord connects the brain to the rest of the body. It serves as the communication pathway between the two and is mostly responsible for movement and sensation. This is why the primary effects of a spinal cord injury affect movement and sensation.

However, some complications of spinal cord injury can also affect cognitive functions. For example, if a survivor experiences fatigue or pain after spinal cord injury, that may affect cognitive function and result in challenges with memory. The link is not direct, but these factors can contribute to memory loss after spinal cord injury.

It’s also important to look at the nature of the accident that caused the spinal cord injury. Sometimes, a spinal cord injury occurs alongside a traumatic brain injury, which can affect cognitive functions such as memory. In fact, studies show that about 59% of spinal cord injury survivors simultaneously experience a TBI. For example, in a car accident, hyperextending your neck is categorized as a spinal cord injury, but hitting your head on the car window is a traumatic brain injury.

Ultimately, a spinal cord injury alone cannot cause memory loss, but other complications or a co-occuring TBI can contribute. Fortunately, there are ways to help manage your memory and improve cognitive function.

Managing Memory After SCI

When a spinal cord injury and traumatic brain injury occur at the same time, the severity of both injuries will impact the secondary effects the survivor may experience.

For instance, after a TBI some survivors are able to maintain long-term memory but struggle with short-term memory. This means it can be less challenging to recall things from the past, but more difficult to retain new information. This occurs when pathways in the brain have been affected by an injury.

Fortunately, cognitive functions can be improved through neuroplasticity, the brain’s ability to rewire itself. Neuroplasticity is best activated through high repetition of activities. For example, the more a skill is practiced, the more the brain recognizes its importance and strengthens the existing pathways for it and/or creates new ones. Therefore, it’s important to practice as much as you can to promote recovery. This is true for memory as well. Reviewing names or numbers will improve your ability to recall them.

Working with an occupational and/or speech therapist is extremely helpful. They can provide a cognitive rehabilitation plan suitable for your ability level. Additionally, there are various cognitive exercises you can do at home in between therapy sessions to stay engaged and activate neuroplasticity. 

Particularly to address memory after spinal cord injury, you can try:

• Writing things down
• Setting reminders on your phone
• Getting adequate sleep
• Reducing stress
• Getting rid of distractions

To keep yourself motivated and engaged in consistent therapy, you can use the CT Speech and Cognitive Therapy App. This app provides access to over 100,000+ cognitive rehabilitation exercises to help improve memory and other skills.

Cognitive rehabilitation is particularly helpful if memory challenges are the result of a TBI. If you have not sustained a TBI but still struggle with memory after spinal cord injury, talk to your doctor or therapist to see if there are underlying issues. For example, if you struggle with pain or fatigue, your doctor might be able to help, and that can help improve overall cognitive function including memory.

Last but not least, be patient with yourself. The chances of improving memory increase with time and consistent practice.

Addressing the Connection Between SCI and Memory Loss

Spinal cord injury is complex and multifaceted. It affects movement and sensation depending on the level of injury. While SCI can directly affect movement and sensation, it does not cause memory loss alone.

Instead, only a spinal cord injury with a co-occurring traumatic brain injury can cause a variety of cognitive difficulties including impaired memory. Fortunately, memory and other cognitive functions can be improved through neuroplasticity.

We hope this information helps you understand the link between spinal cord injury and memory loss, and encourages you to engage in cognitive therapy.

The post Can a Spinal Cord Injury Cause Memory Loss? The Correlation Between SCI and Cognitive Function appeared first on Flint Rehab.

While tachycardia is not very common among spinal cord injury survivors, it’s potentially life-saving to be aware of the symptoms so that you can help someone seek appropriate medical treatment. This article will teach you everything you need to know about spinal cord injury and tachycardia.

Symptoms of Tachycardia

Tachycardia involves a resting heart rate over 100 beats per minute, which is above normal. If you’re experiencing tachycardia after spinal cord injury, it’s crucial to speak to your doctor immediately or seek emergency medical attention. Unmanaged tachycardia puts stress on the heart and increases the chance of life-threatening medical events such as a stroke or heart failure.

Symptoms of tachycardia that every spinal cord injury survivor and caregiver should know include:

• Dizziness
• Lightheadedness
• Anxiety
• Headache
• Tightness in the chest
• Shortness of breath
• Fainting

Your doctor can recommend the best treatment should you ever need urgent medical attention for tachycardia. While the best treatment will vary from person to person, the ultimate goal is to slow down the resting heart rate and get it back to a normal rhythm.

All caregivers who interact with individuals with spinal cord injuries should be aware of tachycardia (and other potential complications of spinal cord injury) and know the symptoms.

To understand the cause of tachycardia after spinal cord injury, let’s look at how the autonomic nervous system works and how an injury to the spinal cord can affect it.

Causes of Tachycardia After Spinal Cord Injury

The autonomic nervous system sends messages throughout the brain, spinal cord, and body to regulate functions such as heart rate, respiration rate, digestion, and more.

Just like specific areas of the brain control different functions, specific segments of the spinal cord control different functions too.

In regards to spinal cord injury and tachycardia, we’re interested in the T1-T5 levels of the thoracic spinal cord (the upper back area). These segments control heart rate (among many other things).

After a spinal cord injury, the connections in the spinal cord become disrupted; and as a result, areas below the level of injury may no longer effectively send or receive communication from the brain. Therefore, a spinal cord injury at or above the sixth thoracic vertebra (T6) can impact heart rate.

In other words, because the T1-T5 segments of the spinal cord control heart rate, individuals with cervical or high-thoracic spinal cord injury may sustain cardiac dysfunctions such as tachycardia, where the resting heart rate is over 100 beats per minute. (Average heart rate is 60-100 beats per minute.)

While tachycardia is more common in people with spinal cord injury levels T6 and higher; tachycardia itself is rare after a spinal cord injury. Instead, the more-common cardiac dysfunction is bradycardia, which involves a resting heart rate below 60 beats per minute.

Bradycardia vs Tachycardia After Spinal Cord Injury

The link between bradycardia (slow resting heart rate), tachycardia (fast resting heart rate), and spinal cord injury involves both the sympathetic and parasympathetic nervous systems. These branches of the autonomic nervous system work synergistically by counteracting each other.

• Sympathetic nervous system: This is your fight-or-flight response. When activated, it increases functions like heart rate, alertness, and blood pressure.
• Parasympathetic nervous system: This is your rest-and-digest response. When activated, it slows down your heart rate, stimulates digestion, and relaxes the blood vessels.

When a spinal cord injury damages the sympathetic nervous system, the individual may experience neurogenic shock. During neurogenic shock, the damage to the sympathetic nervous system results in unopposed parasympathetic stimulation. In other words, the body’s relaxation response takes over without restraint. When this happens, the fight-or-flight response cannot oppose the rest-and-digest response.

For individuals with cervical or high-thoracic spinal cord injuries, resting heart rate may slow down because of an overpowering parasympathetic response, potentially resulting in bradycardia. This is what makes tachycardia less common.

Tachycardia as a Secondary Effect

Because tachycardia is rare, it’s worth looking into two more conditions that may contribute to tachycardia after spinal cord injury: 1) autonomic dysreflexia and 2) complications when treating bradycardia.

When Autonomic Dysreflexia Contributes to Tachycardia

Autonomic dysreflexia, a potential complication of spinal cord injury, describes a reflex action that causes the autonomic nervous system to overreact when it encounters a potentially damaging (noxious) stimulus below your level of injury.

Normally, a noxious stimulus like touching a hot stove triggers the fight-or-flight response to reflexively move away from the hot surface. After a spinal cord injury, however, the message of pain or irritation may not reach the brain appropriately and the body may enter this reflexive, heightened state for a prolonged period of time.

Of the many symptoms of autonomic dysreflexia, tachycardia is one of them. Furthermore, autonomic dysreflexia occurs in about half of individuals with spinal cord injuries at the T6 level and higher, which is the same population at risk of tachycardia. Therefore, spinal cord injury survivors can help manage tachycardia by carefully avoiding triggers for autonomic dysreflexia such as a full bladder.

Learn more about the triggers for autonomic dyreflexia »

Tachycardia as a Complication When Trying to Treat Bradycardia

Sometimes treatment for bradycardia (lower-than-normal resting heart rate) can “overcorrect” for the condition and cause tachycardia (higher-than-normal resting heart rate) as a complication. Bradycardia treatment, which may involve medication, focuses on increasing heart rate. When the dose of treatment is too high or the body acts adversely to it, resting heart rate may increase too much and cause tachycardia.

For this reason, it’s important for all spinal cord injury survivors and caregivers to be aware of the symptoms of tachycardia, even if they are being treated for bradycardia.

Understanding Tachycardia After Spinal Cord Injury

Tachycardia occurs when resting heart rate rises above 100 beats per minute. When it remains in this above-normal state, the heart is put under potentially-fatal stress.

While tachycardia is rare after a spinal cord injury, it can be a complication of autonomic dysreflexia, which occurs in almost half of individuals with cervical and high-thoracic spinal cord injuries. Because of this risk, survivors should learn about autonomic dysreflexia and take great care to avoid triggering it.

As you can see, attention and awareness can help save a life. We hope this guide has helped you better understand spinal cord injury and tachycardia.

The post Spinal Cord Injury and Tachycardia: Understanding Above-Normal Resting Heart Rates appeared first on Flint Rehab.

In fact, depending on the cause and severity of quadriplegia, some individuals may be able to recover mobility in their affected muscles.

To help you understand what quadriplegia is, this article will discuss its:

Causes of Quadriplegia
Types of Quadriplegia
Signs and Symptoms of Quadriplegia
Risks Associated with Quadriplegia
Quadriplegia Recovery Outlook
Quadriplegia Treatment

Causes of Quadriplegia

Quadriplegia refers to paralysis of the arms and legs caused by neurological damage. It can occur following a variety of neurological conditions including spinal cord injury and cerebral palsy.  

Most commonly, quadriplegia is associated with high-level spinal cord injuries. It is the result of damage to the cervical region of the spinal cord. The spinal nerves in the cervical region branch into various peripheral nerves that transmit signals between the brain and the upper extremities.

Additionally, because messages to and from the brain cannot pass through spinal cord damage, functions below the level of injury (including in the trunk and legs) are also affected. As a result, individuals with quadriplegia due to spinal cord injury experience weakness or paralysis, as well as changes in sensation, in the arms, trunk, and legs.

Common causes of quadriplegia include:

• Motor vehicle accidents
• Falls
• Contact sports
• Gunshot wounds
• Acts of violence
• Stroke in the brainstem
• Lack of oxygen in the brain
• Infection in the central nervous system
• Traumatic brain injury
• Cerebral palsy
• Spinal cord injury
• Multiple sclerosis
• Amyotrophic lateral sclerosis
• Guillain-Barré syndrome
• Transverse myelitis

The following section will discuss various types of quadriplegia associated with different neurological conditions.

Types of Quadriplegia

Depending on the severity of a neurological injury, individuals may experience varying types of quadriplegia.

After a spinal cord injury, individuals may experience:

• Incomplete quadriplegia results from a spinal cord lesion that partially transects the spinal cord. Consequently, some neural pathways that connect the brain to areas below the level of injury are left unaffected by injury. This type of quadriplegia results in varying amounts of preserved function below the level of injury. As a result, individuals with incomplete spinal cord injuries may be able to feel sensation and/or control movements in some areas below their level of injury.
• Complete quadriplegia results from a spinal cord lesion that completely transects the spinal cord. In other words, all neural pathways at the level of injury are affected and messages are unable to be communicated between the brain and the areas below the level of injury. Individuals with complete quadriplegia experience complete loss of motor control and sensation below their level of injury.

Additionally, quadriplegia can result from damage to the brain. Individuals with cerebral palsy (CP) may experience quadriplegia in the form of:

• Spastic quadriplegia is a type of CP caused by damage to the motor cortex. Individuals with spastic quadriplegia experience spasticity (high muscle tone) in their arms, trunk, and legs. It can even affect the muscles in the face and impact an individual’s ability to eat and speak. However, spasticity is most severe in the arms and legs. This typically results in stiff movements through the entire body.
• Ataxic cerebral palsy is a type of CP caused by damage to the cerebellum. As a result, individuals with this type of quadriplegia typically experience poor coordination and balance as well as low muscle tone throughout their entire bodies.
• Dyskinetic cerebral palsy is a type of CP caused by damage to the basal ganglia and/or thalamus. Individuals with this type of quadriplegia experience fluctuations of high and low muscle tone throughout their entire bodies. As a result, they may seem as if they are constantly moving; however, these movements are uncontrollable.

Now that you understand the various ways quadriplegia caused by neurological injury can present itself, let’s discuss how it may affect an individual’s day-to-day life.

Signs and Symptoms of Quadriplegia

Paralysis in the arms, torso, and legs can impact your everyday life in a variety of ways. Depending on the severity of the neurological injury, individuals may experience a wide range of secondary complications associated with quadriplegia.

Signs and symptoms of quadriplegia include:

• weakness or paralysis
• loss of sensation
• bowel and bladder dysfunction
• sexual dysfunction
• breathing difficulties
• poor trunk control (which may influence posture and balance)
• pain, numbness, or tingling below the level of injury
• spasticity (involuntary muscle contractions)

Because quadriplegia affects the majority of the body, individuals may require the help of a caregiver to perform everyday activities such as grooming and feeding.

Additionally, many individuals with quadriplegia need assistive mobility devices such as wheelchairs to increase mobility. Those with more severe weakness or paralysis may find a power wheelchair more helpful while those with milder motor impairments may be able to utilize a manual wheelchair.  

The following section will address complications that individuals with quadriplegia have an increased risk of experiencing.

Risks Associated with Quadriplegia

Often, individuals with quadriplegia have an increased risk for additional complications due to their limited mobility.

Risks associated with quadriplegia include:

• the development of pressure sores
• weight gain
• muscle atrophy
• poor circulation
• swelling of the arms and legs
• cold hands and feet
• respiratory complications
• osteoporosis
• autonomic dysreflexia
• social isolation
• depression

Many of these risks are associated with a lack of physical activity. Therefore, it is important for individuals with quadriplegia to work with their caregivers to ensure they are moving around throughout the day. Even light exercise or stretching can help prevent the progression of these complications and promote better functioning of the body.

Home exercise programs like FitMi home therapy can help motivate individuals to be more active and practice movement throughout the day. If the individual has severe weakness or paralysis, their caregiver can move their body through the exercises for them. While the individual may not be actively performing the exercises, the movement will still be able to promote circulation and stimulate the spinal cord.

Up next, we’ll discuss whether it is possible to recover from quadriplegia.

Quadriplegia Recovery Outlook

Damaged neurons in the brain and spinal cord are unable to regenerate. However, areas of the central nervous system unaffected by injury have the ability to recover affected functions by utilizing neuroplasticity.

Neuroplasticity is the central nervous system’s ability to make adaptive changes to its neural circuitry based on the behaviors we repetitively practice. Therefore, the more you practice a function weakened by injury, the more you stimulate the central nervous system and reinforce demand for those functions. This encourages the brain and/or spinal cord to rewire functions affected by injury to unaffected regions and strengthen them.

Generally, the milder your injury, the better the recovery outlook. However, as long as individuals have spared neural pathways, there is potential to recover or at least improve functions affected by quadriplegia.

Although those with complete spinal cord injuries resulting in quadriplegia are unable to utilize neuroplasticity to improve their motor and sensory functions, they can still learn various adaptive techniques to become as independent as possible. The following section will discuss various treatment interventions that utilize neuroplasticity to help individuals with quadriplegia improve their mobility and functional independence.

Quadriplegia Treatment

Treatment for quadriplegia may consist of a variety of interventions. Furthermore, depending on the cause and severity of an individual’s quadriplegia, various treatments may be recommended. Generally, a combination of multiple interventions provides the most effective results.

Below, we’ll discuss some of the most effective ways to address quadriplegia.

Physical Therapy

Physical therapy for quadriplegia focuses on helping individuals strengthen weakened or underused muscles and maintain full range of motion through targeted exercises. A physical therapist will teach individuals the most effective exercises to stimulate neuroplasticity in the central nervous system.

A physical therapist may also recommend orthotics such as braces and splints to promote correct musculoskeletal alignment and assist with mobility.

Occupational Therapy

Occupational therapy for quadriplegia focuses on helping individuals become as functional as possible, primarily through activities of daily living. An occupational therapist will work with individuals with quadriplegia and their caregivers to teach them the most effective ways to perform everyday activities such as transferring, bathing, and grooming.

This may involve learning how to use adaptive tools, such as a universal cuff, or adaptive techniques like tenodesis. Tenodesis is a natural movement that all of our bodies make. When you bend your wrist forward, the hand should open up. Likewise, when you extend the wrist (bend it backward), the fingers should curl in. Learning to utilize a tenodesis grasp can help individuals with quadriplegia become more independent.

Speech Therapy

Individuals with quadriplegia often experience oral motor impairments that affect their ability to chew, swallow, and speak. Additionally, individuals with spinal cord injuries at the C5 level or above may experience breathing difficulties due to impaired innervation of the diaphragm. A speech therapist can help individuals with quadriplegia improve their oral motor functions, communication skills, and breathing.

Home Programs

While participation in rehabilitative therapies is an excellent way to promote recovery and increase independence, continuing to practice skills learned in therapy at home is essential to optimize your results. Many therapists will provide you with a list of exercises or activities that you can work on daily at home to continue making improvements even outside of therapy sessions. Your therapist may also encourage your caregiver to accompany you to your therapy sessions occasionally so he or she can learn the best techniques to use with you at home.

Psychotherapy

Individuals with quadriplegia may develop mental health problems such as depression or anxiety due to feelings of isolation, lack of support, or difficulties adjusting to life with paralysis. Working with a psychotherapist can help individuals with quadriplegia better understand their negative feelings and find more effective ways to cope.

Medications

Individuals with incomplete quadriplegia or quadriplegia that results from damage to the brain often experience involuntary muscle contractions known as spasticity. Spasticity can significantly restrict movement and affect an individual’s ability to participate in physical and occupational therapy.

To reduce spasticity, therapists may recommend Botox injections or muscle relaxants to temporarily relieve high muscle tone. This creates a window of opportunity for individuals to practice therapeutic activities and exercises without the interference of spasticity. Often, some of the improvements made while spasticity is controlled are maintained even after the effects of the medication wear off due to neuroplasticity.

Surgery

Individuals with severe spasticity after spinal cord injury that do not respond to other forms of treatment may benefit from surgery. However, the surgery will differ based on the individual. For example, surgery for spasticity may involve manually lengthening of the muscles and tendons, the implantation of an intrathecal baclofen pump, or selective incisions of nerves that cause hyperactive muscle contractions.

Support

Individuals with quadriplegia may struggle to feel accepted, supported, or understood. Friends and family may benefit from educating themselves about their loved one’s condition and being mindful about what to expect or potential complications that may arise. Often, just being there to spend quality time with your loved one and listening to them can make a huge difference.

Another helpful way for individuals with quadriplegia to find support is to join a support group. There, they can speak to others who are also going through a similar journey.

Quadriplegia: Final Thoughts

Quadriplegia describes paralysis of the arms, trunk, and legs resulting from damage to the brain and/or spinal cord. Despite affecting so many muscles in the body, many individuals with quadriplegia learn to effectively manage their paralysis. Some even learn to improve their mobility by promoting neuroplasticity through repetitive, task-specific practice.

We hope this article helped you understand what quadriplegia is and how to manage it.

The post Quadriplegia (Tetraplegia): Causes, Types, Treatment, and Recovery appeared first on Flint Rehab.

While it can be frightening to experience spinal shock after spinal cord injury, it can also be comforting to find out that your injury may not be as severe as it initially seemed and that there is potential for functions to return.

To help you understand what spinal shock is, this article will discuss its:

• Causes
• Signs and symptoms
• Duration
• Treatment

What Causes Spinal Shock?

While the underlying mechanisms of spinal shock have yet to be fully understood, it’s suggested that spinal shock is caused by swelling following damage to the spinal cord. Generally, swelling peaks at about 3-6 days post-injury.

Immediately following SCI, the body attempts to heal itself by activating an inflammatory response. This triggers an outbreak of biochemical reactions in an attempt to protect and stabilize the spinal cord. However, these processes are harsh and can cause secondary damage in the form of cell deaths, inflammation, swelling, and reduced blood flow.

Swelling of the spinal cord can further restrict blood flow, which disrupts the delivery of oxygen and other essential nutrients to tissues.  As a result, autoregulation (the ability to maintain a constant blood flow) below the level of injury becomes impaired. Our bodies need blood to fuel cellular activity. Without sufficient amounts of it, cells may be damaged and the body can start to dysfunction.

Due to the complete loss of motor control and reflexes below the level of injury during spinal shock, it is possible to mistake an incomplete spinal cord injury for a complete one. It isn’t until the swelling subsides that functions innervated below the level of injury may begin to return. Make sure to speak with your medical team about whether they believe you are in spinal shock or not.

In the following section, we’ll discuss the signs and symptoms of spinal shock.

Signs and Symptoms of Spinal Shock

Depending on the amount of time that has elapsed since their initial injury, individuals tend to experience various signs and symptoms of spinal shock. Additionally, the more severe the spinal cord injury, the greater the risk of experiencing spinal shock.

Signs and symptoms of spinal shock include:

• Loss of reflexes
• Loss of motor control
• Low blood pressure (if the SCI occurs at the T6 level or higher)
• Decreased heart rate (if the SCI occurs at the T6 level or higher)
• Flaccid paralysis
• Urinary retention
• Fecal incontinence
• Spasms/ increased muscle tone
• Loss of sensation

Generally, individuals with spinal shock go from one extreme to the other. Initially, they experience flaccid, limp muscles and an absence of reflexes below their level of injury. Then, symptoms transition to a state of hyperreflexia, where the muscles become extremely reactive to stimulation.  

Outlined below is a quick overview of the 4 phases of spinal shock:

• Phase 1: areflexia (absent reflexes)/hyporeflexia (below normal reflexes), flaccid paralysis, loss of sensation
• Phase 2: initial reflex return
• Phase 3: early hyperreflexia (overactive reflexes)
• Phase 4: spasticity/hyperreflexia

In the following section, we’ll discuss the duration of spinal shock.

How Long Does Spinal Shock Last?

Depending on the severity of the injury, spinal shock can last for days to weeks. The average duration of spinal shock is 4-12 weeks.

If a patient has no motor control or sensation following SCI, a physician usually checks for a bulbocavernosus reflex, and/or anal reflex. If the anal sphincter does not contract with stimulation, it indicates that spinal shock is present.

While an official consensus has yet to be reached, many define the conclusion of spinal shock as the return of the bulbocavernosus reflex, the recovery of deep tendon reflexes (such as the knee-jerk response), or the return of reflexic detrusor activity (contractions of the bladder wall).

Even after an individual is no longer in spinal shock, they will likely continue to experience spasticity. However, they will now have a better understanding of which sensory and motor functions are affected by their SCI.

Up next, we’ll discuss whether it is possible to minimize the effects of spinal shock.

Spinal Shock Treatment

Early medical intervention is crucial in the treatment of spinal cord injuries. By stabilizing the spinal cord as quickly as possible, the individual’s medical team may minimize the progression of swelling and other secondary processes that contribute to spinal shock. This helps reduce overall damage to the spinal cord.

As a temporary outcome of spinal cord injury, spinal shock should resolve on its own. Once swelling of the spinal cord starts to die down, blood flow should be restored and individuals may experience a gradual return of reflexes, sensation, and motor control below their level of injury.

The return of any sensation, motor control, or reflexes below the level of injury is an excellent sign of recovery. It indicates the SCI is incomplete, meaning that neural connections between the brain and areas innervated below the level of injury exist. Those spared neural connections are capable of using neuroplasticity (the central nervous system’s ability to adapt and reorganize itself) to potentially recover affected functions.

The most effective way to promote neuroplasticity after spinal cord injury is through highly repetitive and task-specific practice of affected movements. Continuously practicing weakened functions will help reinforce demand for them and encourage the spinal cord to make adaptive changes.

By participating in an intensive rehabilitation program, individuals can learn effective exercises and activities to promote neuroplasticity, maximize their mobility, and regain their functional independence.

Understanding Spinal Shock: Key Points

If you’re experiencing a complete loss of reflexes, sensation, and motor control below your level of injury, ask your physician about spinal shock. Often, some functions may return as swelling subsides and blood flow is restored.

We hope this article helped you understand that the initial outcomes of a spinal cord injury are not always permanent and with time, functional outcomes may improve.

The post Spinal Shock: Causes, Symptoms, Duration, and Treatment appeared first on Flint Rehab.