The effects of a spinal cord injury (SCI) can last a lifetime and vary hugely from one person to another and between injuries. The impact an SCI has on a person’s life and health depends on the extent of the damage and the area of the spine affected. An SCI can have a spectrum of effects ranging from very minimal altered sensation, or reduced function that does not require any significant changes to lifestyle, through to being paralysed and dependent on a ventilator.
The variation in SCIs means that it’s difficult to answer broad questions without assessing an individual’s situation, but there are some frequently asked questions about living with a spinal cord injury that can be addressed:
Why do spinal cord injuries cause paralysis?
The nerves that extend from your brain down the spinal cord and out to all parts of the body are what give your brain sensation feedback and control over movement. Some of the functions that this nerve-brain feedback loop are those that people can control themselves, like being able to move your fingers, and some of them are automatic, like breathing or controlling your temperature. If the spinal cord is damaged then the signals at that point are interrupted and the brain loses some or all control over control and sensation from that point down – broadly speaking, a back injury below the arms will affect the legs, bowel, bladder and sexual function; a neck injury will affect these plus the arms and possibly speech and breathing.
What is autonomic dysreflexia?
Some spinal cord injuries may make it difficult for someone to recognise early signs that something isn’t right with their body. Some of the most common problems people may experience without having any awareness of it include constipation, urinary retention, or anything that people without a spinal cord injury would experience as pain.
Without a pathway relaying information about problems in the body to the brain, these problems can become severe and may cause rising blood pressure and general feelings of illness. This is called autonomic dysreflexia (AD).
People with a SCI at T6 or above are most at risk of autonomic dysreflexia as they can experience significant problems with the bladder, bowels, and many other parts of the body without any sensation of them. The rise in blood pressure and other general effects on the body that this can have can cause serious problems and should be treated as a medical emergency and the cause of the AD found.
Can spinal cord injuries cause chronic pain?
The effects of an SCI can lead to long-term musculoskeletal or neuropathic pain, and some SCI can cause spasms or cramping muscles. It’s important to remember that pain is one of the symptoms that spinal cord injury specialists are very experienced in helping to control. It may be possible to identify and treat the underlying cause, and pain can usually be managed well with a combination of physiotherapy, massage, and medication, and other techniques that neurology teams and pain specialists can help with.
What bowel problems might I encounter after a spinal cord injury?
Continence problems and constipation are two of the most common complaints after an SCI, and they both require some management. Having an SCI can make a person unable to control their bowels and unable to sense the need for a bowel motion. An SCI can also affect the natural (unconscious) function of the bowel. The aim of good bowel management after SCI is to reduce the risk of incontinence or constipation. This can involve the use of laxatives, and suppositories or other bowel movement stimulants to encourage regular emptying of bowels at convenient, manageable times of the day.
