Chronic Spinal Cord Injury: Understanding the Long-Term Effects of SCI

Is recovery from a chronic spinal cord injury possible?

After an SCI, the microenvironment surrounding your spinal cord becomes very hostile due to inflammatory responses.

Over time, these inflammatory responses will calm down and become less reactive. Your spinal cord injury will transition from an acute phase of recovery to a chronic one.

This article will help you understand what to expect during the chronic phase of recovery from SCI.

Understanding Chronic Spinal Cord Injury

Here are 7 important things to understand about chronic spinal cord injury recovery:

1. Acute SCI Transitions Into Chronic SCI

‘Acute’ and ‘chronic’ are terms that pertain to the amount of time since the traumatic event and the condition of the spinal cord.

An acute spinal cord injury refers to the early stages following a spinal cord injury. During this stage, the spinal cord is very vulnerable and requires immediate medical attention.

This is also when the spinal cord is most receptive to changes during recovery. Therefore, most patients experience positive outcomes during rehabilitation within the first few months following their injury.

In contrast, a chronic spinal cord injury refers to the period after, where the spinal cord has become more stable. During this phase, recovery may occur at a slower rate, and you’ll have a more realistic overview of your functional abilities.

It’s essential to work on minimizing damage during both the acute and chronic stages of SCI to optimize quality of life and chances of recovery.

2. Recovery is Still Possible During the Chronic Phase of SCI

Many refer to chronic spinal cord injuries as the “period when neurorecovery has plateaued.”

While recovery during the acute phase typically focuses on preventing secondary complications, recovery during the chronic phase tends to involve assistive techniques that help you become more efficient in your day-to-day life.

It’s important to understand that recovery after incomplete spinal cord injury is possible even years after your injury.

While recovery may appear to slow down or reach its limit, undamaged areas of your spinal cord are always capable of adapting through neuroplasticity.

3. Neuroplasticity is Key to Recovery

Your spinal cord is capable of neuroplasticity, which refers to its ability to rewire itself through spared neural pathways.

As long as you stimulate these pathways, there is potential to and recover functions affected by spinal cord injury.

During the chronic phase, it may appear as if your recovery has plateaued and that your mobility is as good as it’s ever going to get.

However, that’s often not the case! The rate of your recovery may slow, but as long as you’re practicing those movements, you’re promoting your spinal cord’s ability to adapt.

4. Complications Can Occur

Depending on how you adapt and manage life after spinal cord injury, you may experience various secondary complications.

Common secondary complications of chronic SCI include:

• Bowel and bladder dysfunction
• Neuropathic pain
• Spasticity
• Muscle spasms
• Poor body temperature regulation
• Sexual dysfunction
• Excessive sweating
• Muscle atrophy
• Osteoporosis

Everyone experiences spinal cord injury differently. Your physical activity levels, diet, pre-existing health conditions, and level of injury will play a significant role in whether you experience any of these secondary conditions or not.

5. Physical Therapy is Critical for Recovering Movement

The best way to manage chronic spinal cord injury is to participate in intensive physical therapy.

Daily movement is essential for promoting neuroplasticity, maintaining circulation, and strengthening your musculoskeletal system.

The intensity in which you practice the exercises you learn at physical therapy is essential for a successful recovery.

The goal is to stimulate the spinal cord through repetition. The more you repeat, the more your spinal cord will understand that there is a demand for that function and rewire itself.

Thousands of repetitions are necessary to promote neurological change after SCI, so be sure to do your part and also practice those exercises at home.

6. Adaptive Tools Can Help You Become More Independent

Patients are more likely to progress at a slower rate once their injury has reached the chronic state of recovery.

By this stage, most patients should have a good idea of what functions they can and can’t control.

Adaptive tools like wheelchairs, reachers, adaptive utensils, and transfer benches will help patients become more independent. Typically, individuals will learn how to use these tools in occupational therapy and should only be used as needed. As you slowly recover more mobility, you should wean off adaptive tools and challenge yourself to try tasks without them.

7. Orthotics Can Help Manage Muscle Spasms

At some point along their recovery, patients may experience spasticity and painful muscle spasms that affect their day-to-day activities.

Orthotics like braces, casts, and splints will help promote musculoskeletal alignment and mildly combat involuntary movements.

Interestingly, many individuals with SCI learn to take advantage of changes in muscle tone by using it to assist with transfers. Orthotics can help provide extra support to ensure that limbs are stable and won’t collapse with increased pressure.

Living with Chronic SCI

Living with chronic SCI definitely can require a lot of changes. Your body may not function exactly like it used to, but that doesn’t mean you cannot improve.

Many patients improve their mobility with consistent movement and intensive physical therapy after SCI. The more you practice, the more neural stimulation occurs.

Hopefully, this article helped you understand that recovery during the chronic stage of SCI is possible. Good luck!

Featured images: ©iStock.com/demaerre/kzenon/LSOphoto/Jelena Danilovic/halfpoint