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How to Care for Pressure Ulcers in Spinal Cord Injury Patients

treating pressure ulcers in spinal cord injury patients

Pressure ulcers in spinal cord injury patients are extremely common due to impaired mobility.

There are lots of different names for pressure ulcers. So if you hear the terms pressure sores, bedsores, or decubitus ulcers, know that they all refer to the same condition.

This article will explain why so many spinal cord injury patients get pressure ulcers, and what you can do prevent and manage them.

What Causes Pressure Ulcers in Spinal Cord Injury Patients?

pressure sores in sci patients

The primary reason why so many spinal cord injury patients get pressure sores is immobility.

Normally, people get the urge to move or shift positions after sitting or lying down for a long time.

Because spinal cord injury disrupts communication between the brain and body, the sensory signals that indicate there is too much prolonged pressure on a specific part of the body are not received by the brain.

When you have paralysis, you don’t necessarily feel antsy or uncomfortable.

Therefore, you’ll stay in the same position for extended periods which is a lot of pressure.

Too much pressure for too long will disrupt blood flow and deprive tissues of oxygen. This makes the skin susceptible to pressure sores.

Pressure sores are most common in areas where there the bones and skin are closely aligned like the:

  • elbows
  • tailbone
  • hips
  • heels
  • ankles
  • knees
  • back of head
  • shoulders

Stages of Pressure Ulcers

stages of pressure ulcers in spinal cord injury patients

Pressure sores are categorized into 4 stages, with stage 1 being the mildest and stage 4 the most severe.

Stage 1. A stage 1 pressure ulcer will present a change in color and/or temperature of the skin. However, the skin should still be intact.

Stage 2. Stage 2 pressure ulcers involve visible damage to the skin at the uppermost layer called the epidermis. They’ll usually appear in the form of a blister or scrape.

Stage 3. Stage 3 pressure ulcers are deep indentations that often extend into the subcutaneous layer. This is the bottommost layer of skin that is made up of fat and connective tissue.

Stage 4. Stage 4 pressure ulcers are so deep that they can involve damage to the bones, joints, or muscles.

How to Manage Pressure Ulcers in Spinal Cord Injury Patients

effective management tips for pressure ulcers in spinal cord injury patients

Managing pressure ulcers in spinal cord injury patients requires mindfulness and routine.

Let’s go over some actions you can take to prevent infections and progression of pressure sores. 

Skin Inspections

It’s important to have regular skin inspections at least once a day to spot pressure sores early and prevent them from progressing.

Keep an eye out for changes in skin color, temperature, texture, and moisture levels as they may indicate irritation beneath the surface.

One of the main goals of pressure ulcer management is to prevent the ulcer from growing and compromising the skin around it.

If you notice early signs of a pressure sore, try to avoid applying additional pressure on that area and apply topical treatments as necessary.


Make sure that areas susceptible to pressure sores are properly cushioned to avoid friction.

Consider adding padding to your wheelchair and make sure you don’t sit or lie on anything with a tough surface.

Even your own body parts can rub against each other and cause pressure sores.

For example, when you lie on your side, your ankles or knees can rub against each other.

To prevent this, try placing a pillow between your legs.


There are many reasons why poor nutrition can increase the risk of pressure sores.

For one, not eating enough can cause you to lose weight. People who are underweight have an increased risk of developing pressure sores due to skin thinning and reduced bone and muscle mass.

Our bodies need to consume essential vitamins and minerals in order to preserve integrity of the skin.

Low body weight and insufficient nutrients are linked to “slow and nonhealing wounds”.

It’s also important to make sure that you’re drinking enough water. When you’re dehydrated, the skin becomes dry and loses elasticity which increases the risk of pressure ulcers.


Generally, you should change positions at least once every two hours to relieve pressure.

Moving around is one of the best ways to promote circulation and prevent pressure sores.

Spinal cord injury patients with quadriplegia may not be able to move their bodies. Therefore, it is the caregiver’s responsibility to reposition the patient from time to time.

Spinal Cord Injuries and Pressure Ulcers

pressures sores and SCI

Due to paralysis, many spinal cord injury patients aren’t able to move as often as they’d like.

Pressures ulcers are a painful and debilitating result of being too sedentary.

This complication of spinal cord injury may be common, but it’s also very much preventable.

By performing regular skin inspections, cushioning bony areas of the skin, maintaining a healthy weight, and making an effort to be active throughout the day, you can spot pressure ulcers early or even avoid them altogether!

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