Damage to the spinal cord may result from a number of different causes, for example:
- Congenital defects such as Spina Bifida
- Inflammatory problems such as meningitis or a post-viral infection
- Tumours (most commonly secondary deposits from a primary tumour in the breast, prostate or lung)
- Degenerative or de-myelinating diseases such as Motor Neurone Disease (MND) or Multiple Sclerosis (MS)
- Traumatic injury such as a road traffic accident, domestic or work-related injury, a fall from a height or a sporting injury
Non-traumatic pathologies of the spinal cord (such as MND and meningitis) do not disrupt the nerve roots of the spinal cord as the spinal column has not been ‘destabilised’.
However, high-velocity type injuries to the spinal column, particularly those with a rotational / torsional element, can lead to ligament disruption and bony injury to the spine which may overstretch or tear the spinal cord and lead to a complete or incomplete spinal cord injury. This results in disruption of the nerve roots and causes problems with sensation and /or muscle power below the level of the spinal cord injury.
Complete tears: These result in no function, voluntary movement or sensation below the level of the spinal cord injury. The paralysis affects both sides of the body equally.
Incomplete tears: These have variable effects depending upon the severity and the level of the cord injury. The individual may be able to function, move or feel one side or part of their body more than other areas.
The effects and nature of the paralysis of a spinal cord injury are entirely dependent upon the type of injury, the severity of the damage and the location of the lesion, therefore each individual may present differently. Sensory and motor changes occur below the level of the lesion and may include the following:
- Reduced sensation
- Reduced voluntary movement
- Altered position sense (proprioception)
- Muscle spasm
- Loss of bladder / bowel function
- Loss of sexual function
- Gastrointestinal problems
- Changes in blood pressure and circulation
- Difficulty breathing and coughing
Diagnosis: Any complaints of pain in the neck, between the shoulder blades, in the chest, or the lower back following a traumatic accident should be treated with suspicion of a spinal injury. More often than not, this is just a precaution as most injuries to the back and neck resulting from trauma are purely soft tissue injuries, or whiplash associated disorders. Any unconscious individuals, those who have fallen from a height or those who have sustained a road traffic accident are always considered for spinal injury. Symptoms such as reduced sensation (numbness or electric shock feeling into the limbs), altered reflexes and muscle weakness may also be suggestive of a cord / nerve injury.
Physiotherapy management: A spinal cord injury is a life-changing event for both the individual and their family, often with long-term changes to function. The specific treatment approach will depend upon the severity and the level of the spinal cord injury, but should always be goal-orientated and tailored to the needs of the individual.
Rehabilitation may include:
- Pain control
- Exercises to improve and maintain ranges of movement and muscle power
- Manual therapy techniques and stretches to reduce muscle spasm
- Moving and handling / transfers (for example: bed, chair, toilet, wheelchair, bath / shower)
- Wheelchair skills
- Assistance with chest clearance and breathing techniques (respiratory physiotherapy)
- Skin and joint care
- Balance and gait re-education as appropriate
- Advice, teaching and support to everyone involved
Physiotherapy aims to maximise normal movement and function whilst helping to prevent complications arising from the injury such as joint and soft tissue contractures, muscle spasm and compensation, and breathing difficulties resulting from reduced mobility and higher spinal cord lesions. Rehabilitation may be necessary over the long term, or until an individual with this type of injury has stabilised and reached their optimal potential.
Whether you require regular or intermittent rehabilitation sessions our specialist team at Yorkshire Neuro Physiotherapy is experienced in managing spinal cord injuries and can provide short or long-term rehabilitation as required. Physiotherapy assessment and treatment sessions can take place from within your own home or care home if this is more appropriate for you, or we can provide your rehabilitation from one of our designated clinics. It is important to us that your rehabilitation is convenient to you, carried out in a comfortable and confidential environment, with plenty of time allocated to achieving your aims and listening to and supporting your individual needs.
We often work alongside Case Managers and Solicitors if they are involved in the management of your injury, and we can provide physiotherapy reports when necessary and attend case management / care plan meetings if this is required.
If you would like to speak to one of the team and find out more about what we can offer, please get in touch.