Spinal Cord Injuries (SCI) are the most common injuries that happen around the world every year. It occurs after traumatic or non-traumatic events that result in nerve damage which influences the motor system, sensory and respiratory function.
Not just that, it also affects the bladder, bowel, and sexual function. Besides this, it also affects the individual's blood pressure, skin health, and ability to regulate temperature.
Damage to the spinal cord can be caused by fractures, compression, or disease:
Fracture of the spine can displace bone fragments, disc material, or tear into spinal cord tissue causing a spinal cord injury.
Compression of the spinal cord can damage nerve cells that carry signals to and from the brain.
Diseases of the spinal cord are rare but can cause spinal cord injury.
Types of spinal cord injury?
Spinal cord injury is classified by the level and severity of the lesion.
Level of Injury
- Paraplegia
- Quadriplegia
Severity of Injury
Complete spinal cord injury: a person with this type of injury is completely paralysed below the lesion. This paralysis is associated with an absence of pain, pressure, temperature and sensation.
Incomplete spinal cord injury: a person with this type of injury may have some loss of movement and sensation below the level of their lesion as there is only partial injury to the spinal cord.
Effects of a spinal cord injury
A person who has a complete spinal cord injury will have paralysis and loss of sensation below the level of injury.
An incomplete spinal cord injury will affect different parts of the body depending on the level of injury.
In addition to loss of mobility and feeling below the below the level of injury, individuals with an injured spinal cord will often experience other complications such as:
- Problems with bowel and bladder function,
- Respiratory difficulties,
- Loss of sexual dysfunction,
- Spasticity (increased reflexes and stiffness of the limbs),
- Neuropathic pain,
- Muscle wasting and weakness
Causes of Spinal Cord Injury
The most common causes of damage to the spinal cord are trauma which include:
- Road traffic accidents,
- Sports injuries,
- Domestic injuries,
Other causes of damage to the spinal cord are diseases such as:
- Transverse Myelitis
- Polio
- Spina Bifida
- Friedreich's Ataxia
- Multiple Sclerosis
Physiotherapy for spinal cord injury
Physiotherapy for a person with an injured spinal cord should start as soon as possible after injury. People who have suffered from a spinal cord injury benefit from specialist neurological physiotherapy.
Physiotherapy for a complete spinal cord injury
Physiotherapy for people with a complete spinal cord injury will concentrate on maintaining tissue capability increasing muscle strength and maximising potential and promoting independence. Treatment will focus on:
- Increasing muscle strength above the level of injury to reduce muscle weakness
- Maintaining muscle, tissue length and range of movement below the level of injury
- Muscle stretching below the level of injury to help lengthen tight muscles and reduce stiffness
- Regular standing to weight bear and improve function of internal organs
- Exercises to improve balance and confidence
- Teaching wheel chair skills which includes pushing and turning the chair, operating the brakes, and removing the footplates and armrests
- Breathing control and assisted coughing if appropriate to maintain a clear chest
- Teaching transfers (getting in and out of a wheelchair, bed, car, shower/bath and onto and off a toilet) to improve safety and promote independence
- Advice on orthotic devices
- Advice on positioning to help posture and prevent pressures sores
- Improving safety
- Increasing energy levels
- Reducing pain and muscle spasms
- Hydrotherapy treatment
Physiotherapy for an incomplete spinal cord injury
People with an incomplete spinal cord injury present in different ways depending on the severity of the injury. Each person therefore needs individual treatment and continuous assessment. Physiotherapy treatment will concentrate on rehabilitation and returning the individual to their previous physical level as much as possible. Treatment will improve functional abilities and focus on:
- Exercise to strengthen weak muscles
- Reducing contractures by stretching muscles that have become stiff
- Promoting normal movement
- Increasing control of movement of the arms, legs and trunk
- Promoting activities of daily living
- Exercises to improve balance
- Reduce any anxiety that you may have and regain your confidence
- Increase ability to transfer including roll/move in bed/sit/stand
- Exercise to increase stamina and reduce fatigue
- Mobilisation exercises to improve circulation and range of movement
- Advice on effective positioning to increase comfort
- Advice on orthotic devices and walking aids.
- Hydrotherapy treatment.
- Promoting independence
- Improving quality of life
A person with an injured spinal cord will have different difficulties depending on the level of lesion. Bhaskar Health and Physiotherapy will help you maximise your potential by setting individualised short and long term goals of treatment. Physiotherapy treatment sessions with our specialised physiotherapists are effective and enjoyable leading you through a graduated programme.
