Spinal Cord Injury

Spinal cord injury can be caused by trauma or pathology. Depending on the cause and extent of the damage, paralysis can be parital or total below the level of the injury.

Role of the Physiotherapist

Education: Understanding how and why you are experiencing symptoms such as spasm, pain or weakness can help you to treat and cope with these more easily. Your therapist can help you understand and manage any symptoms or translate information about your injury/illness.

Program: Generally, an ongoing exercise program is needed to maintain or continue to improve range, strength and comfort. Your therapist can be part of this ongoing program, or teach you how to achieve this independently.

Assistance: Some activities or exercises are difficult to complete independently, at first a therapist can assist with exercises and movements, or teach family and carers how to help you.

Equipment: Get the right equipment for the task. Sometimes, just using the right tool can make a difficult job much easier. Your therapist can help you navigate the equipment available.

Weakness

The most obvious and common symptom after spinal cord injury is the lack of movement in the limbs and trunk below the level of the lesion. Although this is not the same as weakness caused by rest or lack of exercise, some of the same training principles can be applied. In the case of partial transection of the spinal cord, a physiotherapist will demonstrate and assist with an exercise program adapted to allow the person to "strengthen" the working muscles and neural pathways available. This in turn improves movement and function.

Spasticity

Spasticity is a complex secondary complication after spinal cord injury which results in the tightening of muscles in the affected limbs. Once the source and causes have been identified, spasticity can be managed with regular positioning, stretches and sometimes medication or splinting. Spasticity can sometimes disguise or impede available movement and function, so these can improve when the spasticity is controlled.

Sensory Changes

Less visible are changes to the sense of touch, pressure, joint position etc.

This makes it difficult to detect where a limb is or what it is pressing on.

A lack of sensation can leave a person at risk of burns, pressure sores or other injury, as well as affecting function.

A physiotherapist can give advice about prevention of secondary injuries.

Pain

Pain after spinal cord injury is extremely common and has many causes. It can be secondary to weakness, lack of movement, joint stiffness and spasticity. Or pain can be a direct effect of the nerve injury.

Physical and electrophysical treatments are available under the guidance of your physiotherapist.

Difficulty functioning

Whether it is in returning to work or just getting to the toilet, the physical problems caused by spinal cord injury can affect your ability to function as you did before.

Physiotherapists can work with you to adjust the environment, the approach to a task or tailor your treatment to improve the strength or movement needed to achieve your goals.

For example, if you transfer with the use of your arms or a slide board at home, but you want to transfer to a car or a different seat at work, your physio can assess the environment and help you find the right equipment or techniques to make it possible.

High Cord Lesions and Respiratory Function

The therapy role:

Chest assessment
Supported Cough
Education
Positioning
Respiratory Nurse referral and liaison
Suction