What other health issues may be present in the hospital?
Authors: SCIRE Community Team | Reviewer: Arlene Aspinall and Tova Plashkes | Published: 17 February 2017 | Updated: ~
Spinal cord injury affects many of the systems of the body, which can result in many different health issues. The following conditions are common after injury and may need to be addressed during acute care.
Autonomic dysreflexia
Autonomic dysreflexia
is a sudden increase in blood pressure that can happen in people with injuries at T6 and above. It may also result in headache, sweating above the injury, and dry pale skin below the injury. While this condition is more common in later stages, it can also happen early after injury. Treatment involves putting the person into an upright position and removing anything irritating or painful below the injury. If this does not reduce blood pressure, medications are used to quickly lower blood pressure. If the condition is not recognized and treated, blood pressure can remain elevated and this can be life threatening.
Bladder problems
Bladder problems can cause leaking of urine, inability to fully empty the bladder, or overfilling of the bladder. Bladder problems are managed through the use of catheters, medications, bladder routines, electrical stimulation, and surgeries.
Bowel problems
Bowel problems can cause symptoms such as constipation, difficulty controlling bowel movements, and accidental leakage. Bowel problems are managed by developing a regular routine that may include the use of medications, special diets, hands-on methods of emptying the bowels, and surgeries.
Breathing problems
Breathing problems may occur after injury depending on the level and completeness of the injury. Many people with cervical and thoracic
complete injuries
have impaired muscles for independent breathing and coughing. People with breathing problems may use a ventilator or other supports to help with breathing.
Movement problems
Movement problems can result in paralysis or weakness of muscles below the injury. Movement and mobility training can include exercise, transfer training, wheelchair skills training, practicing daily living tasks, practicing walking (after an
incomplete
injury, where possible), electrical stimulation, and many other potential treatments, beginning as early as acute care and continuing long-term.
Pain
Pain is common after SCI and usually begins within the first six months after injury. Controlling pain in the early stages is an essential part of acute care. Treatment can include a variety of different types of medications based on the type of pain. Other types of treatments for pain include exercise, talk therapies, massage and heat, electrical modalities, and surgical treatments.
Spasticity
Spasticity
includes muscle spasms, involuntary jerking movements, and overactive reflexes. It can interfere with daily activities, make walking difficult, and contribute to other conditions like pain,
contractures
, and pressure sores. Treatment of spasticity includes the use of medications like Baclofen as well as other treatments like positioning, stretching, electrical stimulation, and surgery.
Depression
Depression is a common disorder involving low mood, a loss of interest or pleasure in daily life, sleep difficulties and other mental and physical symptoms. Depression is the most common mental illness among people with SCI and can affect adjustment after injury, function, and quality of life. Treatments like talk therapies, medications, and exercise programs may be used to address depression. Note that a person who has just had an SCI may experience many emotions such as fear, grief, anger and sadness. This is often a natural part of the process of coming to terms with an SCI, and does not necessarily indicate depression.
Orthostatic hypotension
Orthostatic hypotension
is a drop in blood pressure that happens when a person moves from lying into an upright position. It can cause light-headedness, dizziness, fainting, and blurred vision. Medications and other treatments like abdominal binders, pressure stockings, and controlling fluid and salt intake may be used to prevent changes in blood pressure.
Malnutrition
Malnutrition can happen because many of the medical treatments used in the hospital can make it difficult to eat normally. For example, a tube in the throat is often necessary to help breathing right after an injury and during surgery. In order to prevent malnutrition, a feeding tube may be inserted through the nose or the wall of the stomach, which supplies liquid food directly into the stomach. Despite this, the body often does not have enough fuel to heal and is missing essential nutrients and electrolytes. Poor nutrition can lead to poor healing and increased chances of other problems like pressure injury and infection.
