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Understanding Spinal Cord Injury Symptoms & How to Manage Them

spinal cord injury symptoms and signs

Spinal cord injury symptoms can vary quite a bit depending on the severity and level of one’s injury.

This article is going to cover some of the most commonly experienced spinal cord injury symptoms so that you know what to expect and how to prevent symptoms from worsening.

Spinal Cord Injury Symptoms

Not every spinal cord injury patient is going to experience the same symptoms, but all spinal cord injury patients will experience some form of motor or sensory impairment.

Let’s go over 15 complications that may arise following a spinal cord injury.

1. Spasticity

one of the most common spinal cord injury symptoms is spasticity


Spasticity is when muscles continuously and involuntarily contract.

The spinal cord relays messages between the brain and body.

A spinal cord injury can disrupt the delivery of these messages and result in miscommunication, which can cause muscles below your level of injury to overreact and become spastic.

While spasticity can’t necessarily be prevented, it can be managed through physical therapy, muscle relaxants, Botox injections, and surgery.

2. Muscle Weakness

experiencing muscle weakness after spinal cord injury


Those with complete spinal cord injuries may experience flaccid or floppy muscles because the spinal lesion cuts all the way across the spinal cord.

This means that all connections below the injury site are cut off, and muscle contractions cannot occur.

People with incomplete spinal cord injuries also experience muscle weakness, but typically also experience spasticity, tingling, pain, or some other sort of stimulus below their injury site.

Luckily, those with incomplete spinal cord injuries have neural pathways in the spinal cord that were sparred and are capable of neuroplasticity!

What is Neuroplasticity?

Neuroplasticity is the central nervous system’s ability to rewire itself and adapt.

Through processes of neuroplasticity like circuit regeneration and axonal sprouting, the spinal cord is capable of relearning functions affected by the injury.

The best way to activate neuroplasticity is through massed practice.

If you notice any of your paralyzed body functions returning, be sure to try to move it as much as possible.

Through neuroplasticity, the function is reconnecting to the brain through a new neural pathway.

The more repetitions you perform, the stronger that new neural pathway becomes, and the more natural the function gets.

3. Loss of Sensation

spinal cord injury symptoms like impaired sensory function

Many spinal cord injury patients that experience quite a bit of paralysis will find it difficult to coordinate their movements because they can’t necessarily feel the way their weight is being distributed.

The spinal cord consists of 2 major pathways: sensory and motor.

When you touch something, the stimulus travels up the sensory pathways to the brain, and the brain will react by sending a signal down through the motor pathways.

After a spinal cord injury where the sensory pathway is compressed, these stimuli may not reach the brain, and the brain will not react.

4. Muscle Atrophy

muscle atrophy due to spinal cord injury

Photo Credit:[email protected]:[email protected]/Preface

The best way to understand muscle atrophy is to think “use it or lose it.”

After a spinal cord injury, many patients become much less physically active.

When you don’t use your muscles, they’ll shrink. This is because the larger your muscles are, the more energy is required to maintain them.

Our bodies are incredibly adaptive, so when you don’t use your muscles, they’ll start to wear away to conserve energy.

Some muscle atrophy is inevitable, but in the long-run, physical inactivity will result in poor circulation, increased chances of injury, and decreased metabolic rate.

It’s important to be as active as you can to promote healthy bodily functions.

5. Autonomic Dysreflexia

Autonomic dysreflexia is when you experience a sudden spike in blood pressure (hypertension)

Autonomic dysreflexia can occur in spinal cord injury patients with a T6 or higher level of injury.

The autonomic nervous system is responsible for regulating involuntary functions like heart rate, blood pressure, and digestion.

Autonomic dysreflexia is when the body overreacts when stimulated below the level of injury.

It causes the blood vessels to constrict, but because the body doesn’t receive signals from the brain to relax, blood pressure increases below the level of injury.

Pretty much anything that stimulates the body below the injury site (tight clothes, skin irritations, extreme temperatures, etc.) can trigger autonomic dysreflexia.

Luckily, autonomic dysreflexia can often be treated on your own. Just identify what is causing your blood pressure to rise and avoid it. 

If you notice a sudden rise in blood pressure or any of the other signs of autonomic dysreflexia, make sure to sit upright, lower your legs, and keep your head raised to help lower blood pressure.

6. Bowel and Bladder Dysfunction

bowel and bladder dysfunction spinal cord injury symptoms

Bowel and bladder dysfunction are some of the most commonly experienced spinal cord injury symptoms.

This is because the spinal cord segments that innervate the bowel and bladder are located towards the bottom of the spinal cord.

The higher your level of injury, the more functions will be affected. For example, a cervical spinal cord injury can affect functions from the neck down, while a lumbar spinal cord injury will only affect the lower body.

Bladder dysfunction is typically managed through catheterization, bladder augmentation surgery, and medications.

Bowel dysfunction is managed through medications and following a strict bowel management program.

7. Pain

managing spinal cord injury symptoms like pain

Did you know that it’s possible to feel pain in areas of the body that are otherwise paralyzed?

It might sound like a bad thing, but it’s actually a good sign!

Pain is one of the body’s strongest receptors, and the fact that you can feel anything at all means that neural connections between paralyzed areas of the body and brain exist.

Standard pain management interventions include the use of pain-relievers. Depending on the severity of your pain, medications can range from over-the-counter pain relievers like Advil to powerful opioids.

Another treatment for neuropathic pain is electrical stimulation. It sends electrical charges throughout the body that can interrupt or block pain signals.

8. Breathing Difficulties

breathing problems spinal cord injury symptoms

The C3C5 spinal cord segments innervate the diaphragm, which is the primary muscle used for breathing.

When diaphragm function is impaired, the lungs cannot expand to their full potential. Low lung volume can prevent the body from inhaling adequate amounts of oxygen.

Respiratory complications are the leading causes of death after spinal cord injury.

When someone with a C5 or higher level of injury gets sick, their cough is not strong enough to push mucus out of the lungs.

Practicing breathing exercises will help train your lungs to expand, and coughing exercises will help strengthen your cough.

Additionally, drinking lots of water will help thin secretions so that they are easier to cough out.

9. Hypotension

experiencing low blood pressure after sci


Following a spinal cord injury, communication between your brain and body is disrupted, and the reflexes that make your blood vessels to constrict and relax may be affected.

Hypotension is when the blood vessels expand, which can cause blood to pool in the arms and legs.

This is problematic because the more blood pools, the less blood is returned to the heart, which affects overall circulation efficiency.

Adequate amounts of blood must be pumped throughout the body to fuel cellular activity. If not enough blood is circulating, then bodily functions will start to dysfunction and ultimately shut down.

Low blood pressure can cause feelings of dizziness, shortness of breath, and fainting due to reduced blood flow to the brain.

It’s important to avoid getting up too quickly, stay hydrated, take medications if necessary, and exercise to improve circulation.

10. Depression, Anxiety, or PTSD

dealing with depression after spinal cord injury

While a spinal cord injury itself won’t cause psychological problems, the lifestyle changes that occur after a spinal cord injury can take a toll on one’s mental health.

Those with very severe spinal cord injuries can lose a lot of their independence and need assistance performing activities of daily living like bathing, eating, and toileting.

Luckily, psychological disorders like depression and anxiety can be managed through medications and psychotherapy.

Medications will help regulate neurotransmitter levels in the brain responsible for mood, and psychotherapy will help identify the root of the mental distress and provide resources to cope.

11. Difficulties Sleeping

spinal cord injury symptoms that cause sleeping problems


Sleeping difficulties are more common amongst people with spinal cord injury than the general population.

The thing about sleep problems is that there’s almost always an underlying cause that is making it difficult for you to sleep throughout the night.

Sleeping problems may arise from:

  • stress
  • respiratory complications
  • pain
  • bladder problems
  • difficulties regulating body temperature
  • melatonin and growth hormone levels
  • diet
  • sleeping environment

By identifying the cause of your sleeping problems, and properly managing them, you’ll see lots of improvements in the quality of your sleep.

12. Weight Loss or Weight Gain

how to manage symptoms of spinal cord injury that cause weight fluctuations


Depending on your personality and how you react to change, you may experience weight change after a spinal cord injury.

Weight gain occurs because of physical inactivity. Many people don’t realize how much less they are moving throughout the day but continue to eat just as much as they did before their SCIs.

In contrast, some people will lose weight after spinal cord injury due to decreased bone and muscle mass. As we mentioned earlier, when you don’t use your muscles, they’ll start to shrink to conserve energy.

This kind of weight loss is not ideal and generally results in a lot of weakness. Remember, health and weight loss are not synonymous.

It’s essential to eat a balanced, nutrient-dense diet as well as make an effort to be physically active throughout the day to maintain healthy body composition.

13. Pressure Ulcers

pressure sore sci complications

Pressure ulcers are the result of sitting or lying in the same position for too long.

Normally, people start to get restless after sitting in the same position for a long time and will begin to move around.

After a spinal cord injury, many people don’t feel that the urge to move around and can stay in the same position for prolonged periods.

When this happens, too much pressure is placed on one area of the body and eventually, circulation gets cut off.

This causes the tissues to become weak and allows for pressure ulcers to develop in areas where the bones and skin are closely aligned like the elbows, tailbone, ankles, and knees.

To prevent pressure ulcers from forming, make sure that you’re:

  • shifting positions every once in a while
  • regularly inspecting the skin
  • cushioning susceptible areas

14. Spinal Shock

spinal cord injury symptoms like spinal shock can result in temporary loss of reflexes

Spinal shock occurs in the early stages following a spinal cord injury and is characterized by the complete loss of functions below one’s level of injury. This is called hyporeflexia, and the affected muscles will appear limp or floppy.

Luckily, spinal shock is a temporary condition, and functions will gradually start to return.

When they do, people often experience hyperreflexia. This is when the muscles overreact, resulting in muscle spasms.

This is completely normal and a result of the neural pathways reconnecting the muscles to the brain.

Spinal shock typically lasts between 4-12 weeks, but after this period, you’ll have a better understanding of your functional abilities.

15. Poor Body Temperature Regulation

spinal cord injury and body temperature


As previously mentioned, the autonomic nervous system is responsible for regulating involuntary body functions, including body temperature regulation.

Usually, when someone is cold, they’ll have goosebumps and start shivering. When someone is hot, the body will try to cool itself off by sweating.

After a spinal cord injury, your brain may not receive these sensory signals from the body, or brain signals may not reach areas below your level of injury. This will prevent the body from being able to regulate body temperature on its own.

Therefore, spinal cord injury patients will need to be very aware of their environment and be prepared to cool down or warm up manually.

Understanding Spinal Cord Injury Symptoms

Every spinal cord injury is unique and not everyone will experience the same symptoms.

Hopefully, this article helped you understand all the potential complications that can arise after spinal cord injury.

Now that you’re aware of what can happen, you can identify these symptoms early and prevent them from worsening, or maybe even avoid them altogether. Good luck!

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