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7 Spinal Cord Injury Complications & How to Manage Them

mother and daughter looking up spinal cord injury complications

Spinal cord injury complications can affect all sorts of human body systems such as your respiratory, circulatory, and endocrine systems.

Your spinal cord is responsible for conducting sensory and motor information between the brain and body.

With spinal cord injury, information can’t get through to either side, which results in loss of control over many body functions.

Most Common Spinal Cord Injury Complications

While some spinal cord injury complications can be mild and easy to deal with, others can be serious medical emergencies that need immediate attention.

Here are 7 spinal cord injury complications that often arise after SCI and the best ways to manage them in your day-to-day life.

1. Trouble Breathing

breathing-related spinal cord injury complications

Breathing problems typically result in patients with higher cervical injuries (C1-C4).

This is because motor function over your diaphragm cuts off. Your diaphragm is the primary muscle used for breathing.

These higher-level spinal cord injuries need immediate attention and often result in death due to inability to breathe.

Respiratory infections can also result in trouble breathing as mucus secretions can collect in the lungs when your coughing ability becomes weak.

The more mucus pools in the lungs, the harder it gets to breathe freely. This increases your chances of getting pneumonia, which is one of the leading causes of death in spinal cord injury patients.

It’s also possible to develop sleep apnea following an SCI, which is when your breathing becomes unstable during sleep. This causes you to snore and fail to achieve a proper night’s rest.

How to Manage:

Spinal cord injury patients with breathing problems may need the assistance of a ventilator. It will help regulate spontaneous breathing patterns.

Practicing deep breathing exercises can help expand lung volume, and coughing exercises can help reduce the amount of mucus buildup.

For sleep apnea management, you may need to use a CPAP (continuous positive airway pressure device). It will help keep your airway open while your sleeping.

 2. Circulatory System Complications

aerobic exercise is a type of physiotherapy for spinal cord injury recovery

After a spinal cord injury, you may experience neurogenic shock, which is when your blood vessels lose sympathetic tone in a process called vasodilation. Sympathetic tone must be tight to push blood from the heart to your organs.

This leads to blood pressure decreasing and blood pooling in your veins. Blood pooling can cause blood clots, which can further reduce circulation or even cause pain.

Another circulatory system complication you may experience is orthostatic hypotension, which is when your blood pressure dramatically drops after long periods of sitting or lying down.

Low blood pressure can make you feel disoriented and cause fainting.

How to Manage:

Managing low blood pressure and a slow heart rate can be as simple as keeping your head elevated while sleeping or drinking enough water.

However, in more serious cases, you may need IV fluids or powerful medications to help tighten your blood vessel or increase heart rate.

Try to do aerobic exercise a few times a week to get your heart pumping! This will help ensure that your body gets ample oxygen and nutrients.

3. Autonomic Dysreflexia

a sudden drop in blood pressure after spinal cord injury can cause loss of consciousness or dizziness

Autonomic Dysreflexia is when your autonomic nervous system (which affects involuntary functions like heart rate, blood pressure, temperature regulation, bladder, and bowel activity) overreacts to stimuli.

Anything that bothers your nervous system below your level of injury can stimulate autonomic dysreflexia. Examples include wearing pants that are too tight, a full bladder, cuts, and extreme temperatures.

Symptoms of autonomic dysreflexia include sweating, increased blood pressure, blurry vision, anxiety, headaches, or blotchy skin.

How to Manage:

Autonomic dysreflexia might be inconvenient, but it’s one of the easier spinal cord injury complications to manage.

First and foremost, when you notice signs of autonomic dysreflexia, try to sit with your legs lowered and head raised to keep blood flowing below your level of injury.

Then, try to identify what triggered the autonomic dysreflexia and undo it.

Try not to wear constrictive clothing or jewelry. Now you have an excuse to wear sweats all day!

Be sure to empty your bladder or bowels often. If you’re using a catheter for bladder management, make sure that you don’t have any bends or clogs in the tubing.

Inspect your skin daily for cuts, bruises, or any other type of skin breakdown. Try to avoid touching or adding unnecessary pressure to these areas.

Try to avoid staying out in the sun for too long. Extreme heat and sunburns can trigger autonomic dysfunction.

4. Bladder and Bowel Dysfunction

bowel and bladder spinal cord injury complications

Spinal cord injury won’t really affect your digestion, but it can cause neurogenic bowel or bladder dysfunction.

The muscles responsible for these functions can either become flaccid or spastic.

You might not be able to tell when you need to empty your bladder or bowel which can cause constipation, pain, and accidents.

How to Manage:

While drinking a lot of water can help with the fluidity of your stool, it can also make you need to empty your bladder more frequently.

Some people may need to use a catheter for bladder control.

We highly recommend eating foods high in fiber. They’ll add bulk to your stool so that it’s easier to excrete.

Implementation of a bowel program may also be helpful to regulate your bowel patterns better. You’ll learn what foods to eat, when to eat, what medications can help, and new techniques that will ease the bowel emptying process.

5. Pain

management of spinal cord injury back pain

The majority of spinal cord injury patients experience chronic pain.

There are 3 types of pain you can experience after spinal cord injury: musculoskeletal, visceral, and neuropathic pain.

Musculoskeletal pain mostly occurs when you overuse certain bones, joints, or muscles. For example, many SCI patients overuse their arms while maneuvering wheelchairs.

Musculoskeletal pain can also come from muscle spasticity, which is when your muscles tighten up and spasms occur. We’ll talk more about spasticity in the next section!

Visceral pain typically occurs near the abdominal or pelvic areas and originates from your internal organs. This kind of pain may be indicative of bowel or bladder complications.

Lastly, neuropathic pain is pain that results from nerve damage, which is why even in places where you are otherwise paralyzed, you can feel pain.

How to Manage:

Taking medication is the most common way to manage spinal cord injury pain.

This can range from taking Tylenol or Advil to using powerful medications like opioids depending on the severity of your pain.

Regular stretching can also help relieve musculoskeletal pain by loosening tight muscles.

Sometimes all your body needs is some rest, so give your muscles a break from time to time to recover.

6. Spasticity

sci spasticity management

Spasticity occurs after spinal cord injury because the connection between your brain and body gets damaged.

Because your body isn’t getting signals from the brain, it starts taking orders from the spinal cord which tells the muscles to stay tight to prevent them from getting torn.

When your muscles are continuously tight, it becomes painful and difficult to move. Spasticity can also cause spasms.

How to Manage:

Spasticity can be uncomfortable, but effective spasticity management is definitely possible.

Some people even learn to use the increased tone to their advantage to help prop themselves up.

One way to manage spasticity is to do physiotherapy that includes lots of repetitive stretching and movements. By stretching often, you’re making the muscles more limber and preventing stiffness.

If you have more severe forms of spasticity, Botox injections or oral medications like Baclofen can help temporarily relax your muscles.

7. Depression and Anxiety

management of spinal cord injury depression or anxiety

Depression is one of the most common spinal cord injury complications that arise because it requires such a significant change in lifestyle.

If not carefully managed, depression and anxiety can really harm your sleeping and eating habits.

Depression is not just feeling down; it’s a serious mood disorder that affects your energy and behavior.

Although depression is not your fault, it is up to you to take initiative and seek treatment.

How to Manage:

Luckily, depression and anxiety are spinal cord injury complications that can be treated through medication and/or psychotherapy.

Antidepressants can help regulate the neurotransmitters in your brain that affect your mood and stress levels.

In contrast, psychotherapy involves speaking to a trained professional who can help you dig deep and understand why you feel so negative. Psychotherapy can also teach you how to cope through positive reinforcement.

Living with Spinal Cord Injury Complications

Your spinal cord is a delicate bundle of nerves and damage to it should never be taken lightly.

Living with spinal cord injury complications really teaches you how to be aware of your body and requires time to adjust.

The best ways to avoid these complications is to maintain your health by eating a variety of nutrient-dense foods and exercising regularly.

While eating healthy and exercising won’t guarantee prevention of spinal cord injury complications, it will definitely help prevent the consequences of neglect.

Every day won’t be easy, but if you stay hopeful and keep going, living with spinal cord injury will get easier. Good Luck!

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