Complications of Spinal Cord Injury
Because the spinal cord is critical to so many body functions, spinal cord injury can cause a wide range of short- and long-term complications. Learning to manage these complications is an important part of the recovery process.
Complications from spinal cord injuries include the following:
- Pneumonia and asthma are common long-term complications because muscles associated with breathing usually are weakened. Breathing assistance may be necessary if the nerves to the diaphragm are damaged. Medications may be used to regulate breathing issues and patients are encouraged to get an annual flu shot.
- The heart rate can slow down considerably, or increase to an alarming level following spinal cord injury. This may cause heart problems and low blood pressure that may require intravenous blood infusions.
- Autonomic dysreflexia is a condition that occurs when a stimulus (e.g., blocked catheter, skin irritation) below the injury site triggers a message to the brain that cannot be received. This causes a reflex that constricts blood vessels and results in a reduced heart rate and high blood pressure. Autonomic dysreflexia increases the risk for stroke and rarely, seizures. Sometimes this condition can be resolved if the patient changes position or the stimulus is removed.
- Blood clots are of particular concern for spinal cord injury patients, as immobility reduces blood flow through the veins. Patients often are prescribed medications to prevent clotting.
- When a patient has been sitting or lying in the same position for a long time, pressure on the skin can cause the tissue to deteriorate resulting in pressure sores (also called bedsores). If feeling has been lost in certain parts of the body, the patient may not even be aware of these sores. Patients who develop pressure sores should change positions frequently, should take measures to maintain healthy skin, and should follow a balanced diet. Patients or caregivers also should inspect all areas of the skin carefully for cuts and sores.
- Neurogenic pain (i.e. pain that originates from nervous tissue) and burning and stinging sensations are common and may even occur in limbs that no longer have movement or feeling. Using other parts of the body to compensate for paralyzed limbs (e.g., using the arms to move a wheelchair) can also cause pain. Treatment includes medications, acupuncture, surgery, and spinal or brain electrical stimulation.
- Spasms are reflexes that cause uncontrolled limb movement. Spasticity is a term used to describe spasms of increased tone. These conditions occur when nerves in the spinal cord are affected by the injury and the brain and nerves can no longer communicate and control the movements. Medical treatments are available to help reduce spasticity. In some cases, spasms are actually beneficial, as they can improve muscle tone in the affected areas and allow some patients a little stability of the limb, which can improve mobility.
- Urinary problems (e.g., urinary tract infection [UTI], kidney infection) and bowel difficulties occur when the nerves controlling these functions are damaged. The brain and body can no longer coordinate and the bladder and bowel may eliminate uncontrollably. Drinking plenty of water and incorporating more fiber into the diet can sometimes help both of these problems. In some cases, catheters and medications also are used.
- Spinal cord injuries often result in sexual dysfunction and fertility problems. Typically, these problems affect men more often than women. Doctors can prescribe medication and other treatments to increase fertility. In many cases, spinal cord injury does not affect a woman's fertility; however, pregnancy is considered high risk and should be considered only under the care of a qualified health care provider. For both men and women, specialists can provide advice for intimacy.
- Weight loss or gain can also occur, since spinal cord injuries affect diet as well as the patient's ability to exercise. Physical therapists and nutritionists can help patients maintain healthy habits through exercise and diet.
- Depression is common in patients who have sustained a spinal cord injury. During recovery, patients often feel sadness, grief, anxiety, and stress, and a caring network of qualified health care providers, family, and friends is very important. Therapists can also help patients through this difficult time.