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Spinal Cord Injury and Breathing Difficulties: What’s the Link?

man with spinal cord injury and breathing problemsies

Breathing problems after a higher-level spinal cord injury are very common.

They occur because signals from the brain cannot get past the spinal cord damage, which results in loss of control over the diaphragm.

This article will expand on breathing difficulties after spinal cord injury and how to effectively manage them to improve lung capacity.

Understanding How Level of Spinal Cord Injury Affects Breathing

diagram explaining levels of spinal cord injury

The level or location of a spinal cord injury plays a significant role in determining whether breathing ability will be compromised.

Generally, patients who have higher-level cervical spinal cord injuries will experience breathing difficulties because the C3C5 spinal nerves innervate the diaphragm.

The diaphragm is an essential respiratory muscle. Lack of control over the diaphragm makes it difficult for your lungs to expand and inhale air.

Individuals with C1C4 spinal cord injuries have the greatest risk of breathing difficulties and often need ventilator assistance to sustain sufficient oxygen intake.

Those with C5 spinal cord injuries might start off using a ventilator but usually wean off it by practicing breathing exercises to improve lung capacity.

Now that you understand which levels of spinal cord injury are susceptible to breathing problems, let’s discuss potential respiratory complications.

Respiratory Complications Associated with Spinal Cord Injury

spinal cord injury and breathing difficulties caused by poor diaphragm control

Respiratory complications are the leading cause of death in spinal cord injury patients.

Breathing difficulties after a spinal cord injury can result in reduced lung volume, weak coughing, and increased risk of respiratory infections.

Common respiratory complications experienced by SCI patients include:


Pneumonia is the most prevalent cause of death in spinal cord injury patients.

The infection causes air sacs in the lungs to fill with fluid.

Symptoms of pneumonia include:

  • excessive congestion
  • pale skin
  • shortness of breath
  • fever

Often, spinal cord injury patients with breathing problems struggle to produce a strong enough cough to clear the fluid from their lungs.

Therefore, it is essential to be vigilant for pneumonia symptoms and seek early medical attention. Typically, care providers will prescribe antibiotics, antiviral medications, or antifungal medications as treatment.

Sleep Apnea

Another common respiratory complication experienced by spinal cord injury patients with weak breathing is sleep apnea.

Sleep apnea is a sleep disorder that can cause breathing to fluctuate.

During sleep, breathing becomes very shallow and the respiratory system has to work harder to maintain breathing stability.

Spinal cord injury patients with sleep apnea may repeatedly wake up throughout the night because their breathing suddenly stops.

As a result, side effects of sleep apnea include:

  • daytime sleepiness
  • anxiety
  • irritability
  • poor focus

Depending on the severity of one’s sleep apnea, a doctor may suggest multiple treatments. The most commonly advised treatment is to sleep with a continuous positive airway pressure (CPAP) device.

This non-invasive device ensures that the airways don’t collapse by providing a consistent supply of air through a mask.


Spinal cord injury patients with breathing difficulties can also develop atelectasis.

Atelectasis occurs when part or all of the lungs collapse due to airway blockages.

Blockages can be caused by lung deflation or excess fluid buildup.

Symptoms of atelectasis include:

  • chest pain or tightness
  • shortness of breath
  • increased heart rate
  • blue or gray tinted skin or lips

Spinal cord injury patients with atelectasis may struggle to inhale enough oxygen and have an increased risk of developing pneumonia or respiratory failure.

In the following section, we’ll go over everyday behaviors you can adopt to prevent the progression of breathing complications.

man with spinal cord injury and breathing problems seeking medical attention

The Best Ways to Manage Breathing Problems After SCI

One of the best ways to manage breathing difficulties after spinal cord injury is to focus on preventative treatment.

By implementing the following lifestyle changes, SCI patients can significantly reduce their risk of developing respiratory complications:

  • Avoid Smoking. Smoking is extremely harmful to the lungs and increases the likelihood of contracting respiratory infections.
  • Drink More Water. Drinking water will help thin out mucus so that it is easier to cough out.
  • Practice Breathing and Coughing Exercises. Breathing exercises will help gradually expand lung capacity. Coughing exercises will help strengthen one’s cough so that it is easier to clear the lungs of excess fluids.
  • Maintain a Healthy Weight. Those who are overweight or obese are more likely to experience breathing problems due to reduced lung capacity.
  • Exercise. Individuals with mild breathing difficulties might benefit from exercise. However, make sure to get clearance from your doctor first. Start light and gradually increase the intensity of exercise to prevent overworking the respiratory system.

These are all relatively simple behaviors that can have a significant effect on breathing ability after spinal cord injury.

Spinal Cord Injury and Breathing: Key Points

Breathing difficulties after spinal cord injury are caused by paralysis of the diaphragm.

Although respiratory complications like pneumonia, sleep apnea, and atelectasis are the leading cause of death in spinal cord injury patients, they often can be prevented by adopting healthier behaviors.  

Individuals who notice symptoms of respiratory complications following spinal cord injury should seek medical attention immediately. Early intervention is key to preventing symptoms from progressing.

Hopefully, this article helped you better understand how a spinal cord injury can affect breathing functions and what to do to prevent complications from progressing. Good luck!

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