How does a spinal cord injury affect your body? Part 1 of 4.
There really is no short answer to this question, but I’ll try my best to present this clearly, in bite-sized pieces and an organized manner.
Mobility
This is the most obvious clinical problem. Any part of the body above the spinal cord injury remains normal, while parts below the injury have no movement or altered movement. So for example, if a patient has a spinal cord injury in the neck region, he may have limited or no use of his arms and legs. But if the spinal cord injury is below the neck at a thoracic (chest) level, the upper limbs remain intact while the lower limbs have limited or no movement. While arms and legs are the most obvious body parts that lose function, trunk muscles and abdominal muscles can also have limited or no movement – this can affect a patient’s sitting, stability and posture.
Spasms
Any injury to the brain or spinal cord can cause muscle spasms or spasticity. In someone without brain or spinal cord injury, the body has a natural feedback loop that smooths out the muscle movements – enabling you to easily move your elbow or hand at will and in a controlled, even manner. The injury to brain or spinal cord makes this movement stiff and uneven, and the muscles trying to produce this movement are harder to control. There are many options for treatment for these muscle spasms depending on their severity. The Cleveland Clinic has an excellent video detailing spasms and management options – watch here.
One point I want to make here: people with brain or spinal cord injury usually have a baseline level of spasticity – they know how often spasms happen and how severe these muscle spasms are when they occur. Any increase in the level of spasticity (more severe, more frequent) should raise a red flag of warning that there’s something wrong going on in the body. It can be a new infection, pain, or even emotional distress – I’ve seen people who have more spasms when they are angry or anxious. It’s like an extra vital sign in addition to the usual fever, pulse rate, breathing/respiratory rate and blood pressure.
Skin
Parts of the body below the spinal cord injury are unable to receive signals from the brain, so they are unable to move. These parts disconnected from the brain also cannot send signals to the brain – as a result, the person cannot (or have a limitations) sense pressure, touch, pain or vibration from these disconnected parts.
Take for example someone who has a chest-level injury (thoracic area). He sits in a chair for a long time. Sitting for a long time can be uncomfortable and certain muscles can get tired. In a non-injured person, the muscles and skin of the buttocks can send signals saying “I’m uncomfortable and tired” to the brain, which makes the person shift weight or change positions. The patient with a spinal cord injury is unable to do this change in positions. Because of this, he is at risk for a pressure injury (pressure ulcer, or bed sore) from being in one spot for an extended period of time. To prevent pressure injuries, the person with spinal cord injury has to move and shift his weight every 20-30 minutes or so, and relieve the pressure for at least 30-60 seconds. You can read more about it on the Shepherd Center’s website from Atlanta, Georgia.
Part 2 will tackle problems with bowel movements, urination and sex. Part 3 will address problems with blood pressure and breathing. In part 4, you can read about overuse injuries and other issues of muscles and bones.
