Spinal Cord Injury
The spinal cord is an extension of our brain down our spine and it is made up of thick bundles of nerves. These are the nerves that carry messages from our brain to the rest of our body telling it what to do. Not only do these messages help us move our bodies, but they also control vital functions like breathing, bowel, bladder control, and blood pressure.
When there is any injury to the spinal cord, the communication from our brain to the rest of our body is disrupted. This can often result in loss of movement or sensation from the injury level and below.
Spinal cord injuries can be caused by a traumatic event or an infection or disease.
How will a spinal cord injury affect me?
Given that everyone is different, it is vital to remember that loss of movement and sensation will vary substantially from person to person.
The higher up the spinal cord that is damaged, the more sensation and movement will be lost.
If you damage your spinal cord in your back, you will become a paraplegic. Paraplegia will affect the movement and sensation in your legs and possibly stomach and chest, too.
If you damage your spinal cord in your neck, your result will be tetraplegic. Tetraplegia will affect movement in all four of your limbs as well as your stomach and chest area.
During your injury you may hear the term a “complete or incomplete injury”. These two terms reference your type of spinal injury.
This will mean that the ability of your spinal cord which sends messages to and from your brain is not completely lost. You will have some movement and sensation below the level of injury. With early medical intervention and physiotherapy, there is always a very good chance of recovering some function after your injury.
This will mean that there is a total lack of any motor function or sensation from below the level of injury. The absence of motor function or sensation below the injury area does not mean there are no remaining intact nerves, as people have made progress with this type of injury in the past. It does mean, however, that your physiotherapy goals may be somewhat limited.
In both the above injuries, the quicker the muscles start working again after a spinal cord injury, the better your recovery chances.
What are the early signs and symptoms of a spinal cord injury?
There are various signs and symptoms that you may have injured your spinal cord.
- Loss of movement
- Loss of any sensation if touched
- Loss of any sensation to feel heat or cold on your body
- Loss of bladder or bowel control
- Pain or a stinging pain that is caused by damage to the nerve fibres in your spinal cord
- Problems breathing, coughing or clearing your lungs of secretions
- Difficulty in balance and walking
- Extreme pressure and pain in your neck, head, or back
- Numbness in your hands, fingers, feet, or toes
How is a spinal cord injury diagnosed?
If you have been taken to hospital with a suspected spinal injury your doctor will test for sensory function and movement. They will also take a clear medical history to understand how the incident took place. This is often followed by emergency diagnostic tests such as X-rays and CT and MRI scans.
The scans will show the doctors how severe your injury is. After a few days when some of the swelling has gone down, your doctor will be able to do a more comprehensive neurological examination to determine the severity of your injury.
Common causes of spinal cord injuries
There are so many injury causes. These are the most common:
- A fall
- An act of violence
- Sports of all kinds
- Motor vehicle accidents
- Bicycle accidents
- Medical and surgery complications
- Falling objects
Different types of spinal cord injury
After diagnostic tests and neurological examinations, your doctor may be able to let you know what type of spinal injury you have sustained. The most common ones are:
- Tetraplegia – this injury is as a result of damage to the cord at the cervical spine and normally the most severe, with varying degrees of paralysis of all limbs. Your movement will be compromised along with your bladder and bowel function and your breathing. The higher up the cervical spine the injury is the more severe your symptoms will be
- Paraplegia – this injury is a result of damage to the lower half of the spine. Your movements will be restricted in your legs
- Triplegia – this injury causes a loss of sensation and movement in one arm and both legs. It is typically the product of an incomplete spinal cord injury
Can you recover from a spinal cord injury?
There is no answer. Everybody is different and every injury is different. Though many people with spinal cord injuries do regain some degree of function, some do not. When you first have a spinal cord injury diagnosis, there will be degrees of swelling of the spinal cord. As the swelling goes down, this may change your symptoms and you can regain certain functions of your body.
Can physiotherapy help you with a spinal cord injury?
As everyone’s injuries are so different and complex, the problems that are associated with spinal cord injury are varied. Physiotherapy treatment can help with the following:
- Muscle weakness or paralysis
- Reduced ability to clear chest secretions
- Loss of balance and mobility
- Loss of functional movement
- Poor posture
- Pain and spasms
- Muscle stiffness
When you first see your physiotherapist, they will discuss your injury and give you a full physical assessment and assess where you need most help. Some suggestions include:
- Stretching to maintain muscle and tendon length and to reduce muscle spasms
- Splinting regimes to avoid muscle shortening and contractions
- Flexibility and strengthening to the whole body
- Weight bearing exercises with or without machinery to assist
- Breathing exercises to maximise your lung function and prevent any chest infections
- Working on your posture and balance
- Functional activities that will improve everyday movements like sitting up, rolling over, and standing up from a sitting position
- Advising on any equipment to use indoors or outdoors
- Referring you to an Occupational Therapists for certain equipment prescription
We will do whatever we can to get you on the fastest route to recovery. Some of the treatment methods we use include:
- Strengthening exercises
- Myofascial trigger point release
- Cross-friction massage
- Stretching and range of movement exercises
- Functional exercises