Medications and therapy can help prevent and treat these problems. Fitness and wellness. Weight loss and muscle atrophy are common soon after a spinal cord injury. Limited mobility can lead to a more sedentary lifestyle, placing you at risk of obesity, cardiovascular disease and diabetes. A dietitian can help you eat a nutritious diet to sustain an adequate weight.
Physical and occupational therapists can help you develop a fitness and exercise program. Drive safely. Car crashes are one of the most common causes of spinal cord injuries. Wear a seat belt every time you're in a moving vehicle. Make sure that your children wear a seat belt or use an age- and weight-appropriate child safety seat. To protect them from air bag injuries, children under age 12 should always ride in the back seat. Spinal cord injury care at Mayo Clinic.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview A spinal cord injury — damage to any part of the spinal cord or nerves at the end of the spinal canal cauda equina — often causes permanent changes in strength, sensation and other body functions below the site of the injury.
Spinal cord injuries Open pop-up dialog box Close. Spinal cord injuries Paralysis of the lower half of the body is called paraplegia. Request an Appointment at Mayo Clinic. Central nervous system Open pop-up dialog box Close. Central nervous system The spinal cord extends downward from the base of your brain. Share on: Facebook Twitter. Show references Spinal cord injury: Hope through research. National Institute of Neurological Disorders and Stroke.
Accessed July 10, Hansebout RR, et al. Acute traumatic spinal cord injury. Spinal cord injury. American Association of Neurological Surgeons. Jankovic J, et al. Spinal cord trauma. Elsevier Inc. Accessed July 20, Mayo Clinic; Abrams GM, et al. Chronic complications of spinal cord injury and disease. Rehabilitation including occupational and physical therapy can have a positive effect on the degree of paralysis. Adaptive equipment for quadriplegics and quadriplegic assistive technologies such as a speech generating device and custom environmental control unit for disabled individuals have advanced significantly through the years and offer quadriplegics the ability to communicate and perform everyday tasks such as turning on the light or changing channels on the television.
What makes the autonoME such an effective assistive technology for quadriplegics is its ability to help an individual communicate and achieve independence. If you are in the process of researching environmental control units for disabled individuals, adaptive equipment for quadriplegics, or various assistive technologies for quadriplegics, give us a call.
Our Product Reps are happy to answer your questions and demonstrate how the autonoME can transform the life of you and your loved one. Blog - Latest News. Here is a summary of the main differences: Paraplegic A paraplegic has sustained a spinal cord injury in the lower back within the T1-L5 sections of the spine.
There are medications that will help with problems that come up after injury. Medications for spasticity, infection, bowel function, bladder control and many, many others, help to keep your body functioning well and can prevent further issues.
Care always must be taken regarding medication, both prescriptive and over the counter as interactions do occur. Always report your full list of medications and have a professional monitor what you are taking to avoid interactions with the medication, supplements and food. As scientist learn more about how the nerves in your body work, connect and transmit messages, more medication treatments will be developed that will assist with nerve signaling as well as to enhance function and eventually healing.
There are surgical treatments available now that will help improve function. Surgery can be performed on peripheral nerves those in the body but not yet on central nerves those in the spinal cord or brain. Peripheral nerve surgery includes nerve releases, transfers and grafting. This area of surgery is probably the most explored. Some surgeries are approved and offered in specialty centers but not yet widespread to find locally. Hand and arm nerve surgery can improve arm function. There are also some peripheral nerve surgeries that improve lower extremity function, bowel, bladder and sexual function.
Stem cell therapies and genetic manipulation procedures are being studied by researchers to promote regeneration and recovery of function after spinal cord injury.
Many of these treatments may include surgery however, as more knowledge is gained, these treatments may become intravenously IV delivered. Stem cells and genetic engineering therapies target improved recovery of function by rebuilding damaged or lost spinal nerve circuits. While these techniques are still largely experimental, scientists ae excited about translating them to the clinic, for use either alone or in combination with other interventions for example, certain kinds of activity-based rehabilitation.
Peripheral nerve surgery is possible and is performed by specialty trained surgeons. Peripheral nerves are outside of the brain and spinal cord. Surgery to the nerves in the peripheral nervous system PNS are available which includes improving function in the cauda equina section of the lower spinal cord. These nerves can be rerouted or even split to improve function.
Therapy is used to help your brain and body learn to activate this reorganization. In the Big Idea, an FDA-approved feasibility study, 36 individuals with chronic, complete spinal cord injury are being implanted with an epidural stimulator. Investigators hope to demonstrate that epidural stimulation ES can improve functions such as cardiovascular, sexual and bladder function, as well as the ability to facilitate standing and voluntary movements.
ES raises the level of excitability in the network of nerve cells that remains intact below the level of injury; combined with appropriate sensory information, that network is able to control complicated movements. As of July , a total of 14 Big Idea research subjects had been implanted and are in varying stages of their two-year Big Idea participation. At the end, each has the option to keep the implanted stimulator or have it removed.
The Big Idea builds on a promising earlier study in which eight men were implanted with stimulators. Every study of spinal cord injury repair increases the knowledge base. More than likely, a combination of all these treatments will be used to restore function from paralysis. Activity will be needed both before and after treatment to bring the body to full recovery. Medications are used now to help people function in their daily lives but other medications specifically for recovery are being developed.
Surgery to restore nerve function is underway. We have never been so close but when you are the one waiting, it can seem like forever. Now is the time to have the most hope. Clinical practice guidelines are available to model standards for healthcare professionals and the public about rehabiliation strategies. The Paralyzed Veterans of America have a wide variety of evidence-based guidelines available free of charge.
Spinal Network has a wide range of clinical practice guidelines. The American College of Physicians. The American Academy of Physical Medicine and Rehabilitation provides a wide array of information at their website. Research into recovery from spinal cord injury is being conducted. There are many options that are being studied. These include therapies to preserve and restore function, medications and surgeries. The amount of information being currently being produced is mind boggling.
There are even options that are available today but beware, many of the treatments being pushed on the web are not proven and can cost hundreds of thousands of dollars. Participation in some of these therapies might even keep you from benefitting from successful treatments at a later time.
Most of these procedures seem to be surgical although there are unproved other treatments as well. In the past, offerings for shark tissue to be placed in your back or stem cell treatments in other countries have been advertised. People have spent large amounts of money on these types of treatments. Why are they not used as often now? Because they did not produce the results promised.
Sometimes, the failure was accounted to an inability to be able to measure outcomes and yet outcome measures are readily available and standardized around the world. Waiting for recovery has always been an issue. It is easy to be drawn into false promises. As a consumer, there is a phrase, if it appears too easy, it probably is not worth it. If someone approaches you about a quick fix treatment, you should question why the rest of the world does not know about or is not using that particular therapy.
A proven therapy will be known by legitimate researchers and provided to the entire SCI community. However, there has never been a time when so much progress has been made in the treatment of spinal cord injury. These studies as well as research into specific diseases that lead to paralysis are being shared and combined to enhance your opportunities. There is no magic answer, but options do exist. Outcomes of spinal cord injury do not rest on a medical or trauma cause.
When healthcare professionals speak about spinal cord injury, they are referring to both causes. Sometimes people think little attention is paid to medical causes because research about spinal cord injury focuses on trauma. This is because trauma often provides information about the exact time of onset and level of injury.
Medical causes do not have specific onset time as that is usually unknown. Medical causes of SCI usually begin prior to diagnosis. Level of injury can be variable in medical causes and often there are several injury points. Research of SCI from medical or trauma causes benefit all individuals with spinal cord injury.
Research of the medical causes is usually conducted under that disease diagnosis. SCI research focuses on the injury from medical and trauma sources, curbing the injury, reducing secondary effects and cure. Basic Science are experiments that take place in a laboratory. These experiments are important to demonstrate the possibility of treatment success in humans.
They cover all aspects of SCI injury and recovery from molecular physiologic processes to drug treatment. Clinical Research is performed with humans as the subjects. This can include physiologic, biologic, and psychologic studies.
Clinical research is only done when bench science has collected enough evidence to know there is basic safety for the study to be conducted with humans. Activity Based Therapy has been demonstrated as a key factor in spinal cord injury recovery both in active patterned movement as well as through internal and external functional electrical stimulation.
In this therapy, nerves are stimulated for function from an external source or implant. When the nerve is stimulated, movement of the body occurs. The efficacy of this therapy has been demonstrated through a variety of sources.
Stem Cell Transplant for improved nerve transmission is being studied. The idea is that stem cells can be converted into any cell of the body. Creating nerve stem cells for implantation in the spinal cord is a goal but this is not yet totally effective.
Currently, there is no appropriate stem cell transplant for spinal cord injury. Much progress has been made in the laboratory with animals but the translation to humans has not been made.
How stem cells will become a part of spinal cord injury treatment has not yet been established. Technology and Devices are being developed rapidly. These can include studies of implants in humans to equipment to improve function and decrease secondary complications.
An example of technology is the evolution of external electrodes for muscle movement that has evolved into microchips implanted which allow the individual to move. Further testing is underway. Devices to assist with movement for the goal of improving ability to perform activities of daily living are being developed. These include devices for hand and arm movement to allow self-feeding, grooming and toileting assistance to mobility devices to increase range over rough or sandy terrain.
Medication for spinal cord stabilization and for secondary complications are a critical part of spinal cord injury research. Neuropathic pain leads the way as a need verbalized by individuals with spinal cord injury. Controlling spasticity is a part of controlling pain. Treatment to reduce secondary damage at the time of injury and immediately following is important to reducing the outcome of SCI.
Every aspect of SCI treatment is being considered to improve quality of life. Nerve Transfers are being studied. This can include moving a nerve from one target muscle to another, grafting a nerve to a new area, splitting a nerve so it can perform more than one function.
Researchers are studying how to transplant nerves from one person to another although rejection has not yet been mastered due to the low immune system function of those with spinal cord injury.
Most successful has been nerve transfers to improve arm and hand function. Transfers in the legs and to the bladder have also been successful but less functional in the legs due to balance issues. The number of surgeons who have been educated to perform this type of surgery are few.
Phrenic Stimulation is a process that increases the diaphragm to be stimulated for effective breathing. This process reduces the need for mechanical ventilation. The number of surgeons educated to perform this surgery through a minimally invasive technique is low.
A survey performed by researchers at the Christopher and Dana Reeve Paralysis Foundation indicates 1. This number includes those with a central nervous system medical diagnosis as well as trauma.
Estimating the total number of individuals with spinal cord injury is challenging as those with SCI as a complication from medical illness do not necessarily identify as having a spinal cord injury but rather identify with their diagnosis. There are many medical diagnoses that can result in spinal cord injury.
Most individuals do not think of themselves as having a spinal cord injury but rather attribute their injury by their diagnosis. It is perfectly natural to think of disease by the medical diagnosis or cause, however, the consequences of the medical diagnosis is spinal cord injury. Other parts of the body may also be affected by the medical diagnosis especially the brain since it is part of the central nervous system.
Additional complications can be attributed to spinal cord injury. Life expectancy is only slightly reduced for those with spinal cord injury with shorter life expectancy with a higher level of injury. The most common cause of death is infection, specifically pneumonia followed by septicemia. There are many diseases that lead to spinal cord injury. In fact, that is the cause of most spinal cord injuries.
People do not often think about the consequences of disease as spinal cord injury but focus on the disease itself. Because of this, some individuals tend to overlook the SCI ramifications. With disease, spinal cord injury can progress slowly.
In trauma, spinal cord injury can develop in a second. The trajectories of disease onset compared to trauma onset are typically opposite. Disease takes time. Trauma happens in an instant. With either onset, the effects of spinal cord injury or any paralysis are life altering. Treatments have been developing for paralysis for thousands of years.
Due to the pooling of information and cooperation of scientists, coordination of research findings has been crossing diagnostic boundaries.
What is discovered in one neurologic disease has been translated into other neurologic diseases. Information from research of one diagnosis is often applied to other unrelated diagnoses with successful outcomes and certainly knowledge building. Spinal cord injury has been recorded in the hieroglyphs of Egypt. You can imagine the trauma that might have been sustained by workers of the great pyramids.
This would be one of the first recorded industrial accidents. Pictorial evidence of urinary catheterization has been recorded by these early historians.
It seems that spinal cord injury and other paralysis have been with us since the dawn of mankind. In some of the remains of the Native American culture in the United States, vertebrae bones with arrows going through them have been found. One arrow pierced vertebra can be seen at Cahokia Mounds in Southern Illinois.
This exhibited specimen is of a human vertebra with the arrow and tip through the bone. The human tissue is long gone but the injury that would have been sustained would clearly have been a traumatic spinal cord injury.
War and trauma were the common sources of SCI for years mostly because people did not live long enough to see much effect of SCI from disease. Because of the large numbers of injured soldiers from each battle, techniques to save lives were developed over time.
The more soldiers that could be saved would mean more soldiers that could return to the battlefield. One of the first rehabilitation nurses was Florence Nightingale who suggested novel treatments such as hand washing, cleanliness in providing care and pressure release treatments. Florence thought patients should be turned to avoid pressure injury about every two hours-sound familiar? We still aim for the two hour turn in hospitals today, even though scientific evidence indicates that pressure releases should be accomplished as frequently as every 10 minutes.
Fast forward to World War II. The intervention of antibiotics and field hospitals with quick treatments resulted in a significant survival of wounded soldiers. Regenerative techniques were developed to improve vascular function and spare nerve damage. Medical doctors and surgeons continued with development of treatments after the war since many soldiers lived to return home.
Today, military and other researchers continue with advancing treatments for rehabilitation care. Paralysis treatment was extensively developed with the polio epidemic in the United States. Other countries had been conducting research for neurological conditions as well. Some of these techniques were further developed for the treatment of polio.
These included providing activity to affected parts of the body, aquatic or water therapy and ventilation with iron lungs. In polio treatment centers, those affected were provided range of motion by volunteers for hours at a time. This constant movement provided the body with the necessary activity that was not being provided internally. Aquatic therapy, in warm water, relaxed muscles and provided the buoyancy to help support limbs. Moving a body part on your own might be too difficult due to gravity but the added buoyancy of the water reduced the difficulty of overcoming gravity with movement.
Another essential element for treatment was ensuring oxygenation for those who had difficulty breathing. This allowed individuals a chance to survive until enough strength was regained to participate in additional therapies. There were other treatments as well, but these were the mainstays of the program.
Whole communities would take part in providing this time intensive therapeutic treatment. One famous spa is in Warm Springs, Georgia. This was developed by President Franklin D. He continued with this therapy throughout his life. Another proponent of therapy for polio was Sister Kenny who created a novel treatment. The Sister designation was from her origin of Australia, although she did not have formal training as a nurse. Her treatment consisted of reducing spasms, so limbs could be put through range of motion.
At the time, this practice was controversial as it was not the state of the art. However, her unusual thinking changed the way treatments were conducted. A new idea was conceived: hope. There was a wave of movement that it would be possible for individuals with spinal cord injury to improve. It was due to several discoveries such as nervous system plasticity where it is acknowledged that the nervous system can adapt to injury and reroute itself.
Previously, the nervous system was thought that only one particular nerve could connect to another particular nerve. If you think of a ponytail hair do, it was thought that if the ponytail was cut, each single hair would have to be reattached to its original hair. This was the same thinking that spinal cord injury could be repaired, each nerve reattaching to its original nerve.
The concept of plasticity changed this idea. The body can adapt and adjust to injury. There were several other major discoveries about the nervous system which when combined created a new vision of recovery from spinal cord injury. The major proponent of these discoveries was Christopher Reeve who developed what is now called the Christopher and Dana Reeve Paralysis Foundation to expand and develop these new ideas about the nervous system.
His motto, Forward, indicates the need to look toward these new ideas of hope and recovery rather than to cling to old ideas that we now know did not encompass spinal cord injury recovery. Many researchers and health care professionals have embraced the new concept of recovery for spinal cord injury.
Similar therapies like those instituted for the treatment of polio have been adapted and revised for the current use. The explosion in the development of technology has been utilized to develop equipment that can replace the large numbers of people needed to deliver the therapies as well as to deliver treatments in less time allowing the recipient to have time for other pursuits in life.
As time moves on, these therapies have been refined and tested with positive results. Knowing which therapy to be provided for the best results and the length and number of treatments is being considered. Further advances in technology have allowed some of the external cumbersome equipment to be reduced to microscopic size which can actually be transplanted into the body. This is beneficial and convenient for the person with spinal cord injury. Future research will make these technologies more encompassing and available for everyone with spinal cord injury.
One of the prime features is that these technologies will benefit individuals with new spinal cord injuries and those that have injuries from years ago.
If you are looking for more information about spinal cord injury or have a specific question, our Information Specialists are available business weekdays, Monday through Friday, toll-free at from am to pm ET. Additionally, the Reeve Foundation maintains a spinal cord injury fact sheet with additional resources from trusted sources. Check out our repository of fact sheets on hundreds of topics ranging from state resources to secondary complications of paralysis. We encourage you to reach out to organizations and associations which feature news, research support, and resources, national network of support groups, clinics, and specialty hospitals.
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