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7 Complications of Paraplegia and How to Overcome Them

complications of paraplegia

Complications of paraplegia can arise immediately after spinal cord injury, years later, or anytime in between.

Any injury that doesn’t involve the cervical region of your spinal cord (the first 8 nerve roots) will result in paraplegia.

People with paraplegia will have full control of their heads, neck, shoulders, arms, and hands, but depending on their level of injury, may lack trunk and leg control.

The higher your level of injury, the more functions will be affected.

This article will go over 7 common complications of paraplegia and how to manage them.

Let’s start!

Complications of Paraplegia

It’s important to be aware of potential complications that may arise with paraplegia so that you can try to prevent them or be prepared when they do occur.

Here are 7 common complications of paraplegia you may experience:

1. Spasticity

dealing with spasticity and paraplegia

Spasticity is the continuous contracting of muscles.

It occurs because SCI disrupts the communication between your brain and body; therefore, your muscles aren’t receiving signals from the brain to relax.

Having spasticity in your legs can result in jerky, uncontrolled spasms.

Some negative consequences of spasticity include pain and sleeping difficulties.

Believe it or not, you can use spasticity to your advantage. The increased tone can be utilized to help with transfers and standing.

Spasticity management consists of muscle relaxants like Botox or baclofen, and in severe cases, surgery.

Nonpharmacological spasticity management involves physical therapy, regular stretching, and wearing braces that help lengthen muscles and maintain range of motion.

2. Muscle Atrophy

muscle atrophy due to spinal cord injury
Photo Credit: CNX Anatomy and Physiology

After moderate to severe spinal cord injury, people usually become very physically inactive and stay confined to their wheelchairs.

Muscle atrophy is when your muscles shrink from disuse.

Using your legs becomes a lot more difficult when they’re paralyzed; however, it’s important to make an effort to move them throughout the day to prevent severe atrophy.

Muscle atrophy can increase your risk of injury, reduce circulation, and slow down your metabolic rate.

Consider performing passive range of motion exercises to stimulate the muscles and increase your joint range of motion.

3. Bowel and Bladder Dysfunction

complications of paraplegia bowel management

One of the most common complications of paraplegia is bowel and bladder dysfunction.

After spinal cord injury, patients may be unable to feel when their bladders are full or when they need to empty their bowels.

Additionally, they may not be able to control the contracting or relaxing of their urethral or anal sphincters, so accidents or physical discomfort can occur.

Bladder dysfunction can be managed through catheterization, electrical stimulation, medications to relax bladder muscles, Botox injections, and bladder augmentation surgeries.

The best way to manage bowel dysfunction is to adopt a bowel management program.

SCI patients will be able to better time and predict their bowel movements through scheduling and medications.

4. Autonomic Dysreflexia

anxiety complications of paraplegia

Autonomic dysreflexia will occur in higher-level thoracic spinal cord injuries (T6 and up).

The autonomic nervous system is responsible for involuntary body functions like temperature regulation, heart rate, and blood pressure.

Autonomic dysreflexia is basically the body overreacting to sensory stimuli.

Symptoms of autonomic dysreflexia include:

  • A sudden rise in resting blood pressure
  • Feeling anxious
  • Headaches
  • Blurry vision
  • Sweating
  • Blotchy skin

Causes of autonomic dysreflexia include extreme temperatures, skin irritations, and a full bladder. Anything that makes your body feel slightly uncomfortable like tight clothes or jewelry can cause it.

Therefore, it’s best to wear non-restricting clothes, inspect your skin daily, check your catheter for bends, avoid extreme heat or cold, and ultimately just try to stay as comfortable as possible.

5. Pressure Sores

pressure sore sci complications

You know that restless feeling you get when you sit or lay in the same position for too long?

After spinal cord injury, you may not be getting those urges to move around.

Pressure sores or pressure ulcers are the result of too much pressure on an area of skin for too long.

They typically occur in areas of the body where the bones and skin are very close together like the elbows, shoulders, hips, knees, and ankles.

The best ways to prevent pressure sores are by:

  • Performing daily skin exams
  • Moving around every once in a while
  • Avoiding moisture buildup
  • Using cushions to pad susceptible areas

6. Pain

dealing with pain is one of the most common complications of paraplegia

About 40-60% of all spinal cord injury patients develop neuropathic pain at or below the level of injury.

Depending on what neural circuits are spared, neuropathic pain will vary. Some people describe feeling pins and needles while others may feel burning or stabbing sensations.

Management of neuropathic pain varies depending on the occurrence and severity of pain.

Medications will vary from ibuprofen to antidepressants to anticonvulsants to opioids.

The stronger the medication, the greater the risk of side effects.

Other treatment interventions include electrical stimulation and alternative medicines like acupuncture, massage therapy, and marijuana.

People with paraplegia may also experience musculoskeletal pain above their level of injury from increased dependence of the arms.

For example, you might overexert your arms when moving around in a wheelchair for too long.

Luckily, this type of pain is more bearable and is usually treatable by resting overused bones, muscles, or joints.

7. Deep Vein Thrombosis

Deep vein thrombosis is a spinal cord injury side effect in which blood clots form due to lack of movement.
Photo Credit: staff (2014). “Medical gallery of Blausen Medical 2014”

Deep vein thrombosis is when there’s a blood clot in your arms or legs due to a lack of movement.

It can cause swelling, aching, and poor blood flow in the legs.

If part of the clot travels up to the lungs, it can block an artery and cause a pulmonary embolism.

Treatment for deep vein thrombosis typically consists of blood thinners to prevent the formation of additional blood clots.

Only in very serious cases of deep vein thrombosis will thrombolytic drugs be used to break up clots.

Another treatment intervention is to surgically insert a filter into the vein to prevent the clot from traveling to the lungs.

Living with Complications of Paraplegia

best management of paraplegia and it's complications

While living with paraplegia might appear overwhelming at first, you’ll soon find out that you can still do a lot of daily tasks and fun activities on your own.

Because people with paraplegia have fully functional arms and hands, they can still be very independent.

By learning to adapt and exploring new ways to do all their favorite things, many people with paraplegia can work, go to school, play sports, and drive all on their own.

So don’t let complications of paraplegia keep you down. Depending on the severity and level of your spinal cord injury, you may not even experience them.

It’s always a good idea to be knowledgeable about your condition so that you’re not taken by surprise and are well-prepared to manage its complications.

Good luck!

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