Complications

At first, changes in the way your body functions can be overwhelming. However, your rehabilitation team will help you develop tools to address the changes caused by the spinal cord injury, in addition to recommending equipment and resources to promote quality of life and independence. Areas often affected include:

• Bladder control. Your bladder will continue to store urine from your kidneys. However, your brain might not control your bladder as well because the message carrier (the spinal cord) has been injured.

  The changes in bladder control increase your risk of urinary tract infections. The changes may also cause kidney infections and kidney or bladder stones. During rehabilitation, you'll learn ways to help empty your bladder.

• Bowel control. Although your stomach and intestines work much like they did before your injury, control of your bowel movements is often altered. A high-fiber diet might help regulate your bowels, and you'll learn ways to help control your bowel during rehabilitation.

• Pressure injuries. Below the neurological level of your injury, you might have lost some or all skin sensations. Therefore, your skin can't send a message to your brain when it's injured by certain things such as prolonged pressure.

  This can make you more susceptible to pressure sores, but changing positions frequently — with help, if needed — can help prevent these sores. You'll learn proper skin care during rehabilitation, which can help you avoid these problems.

• Circulatory control. A spinal cord injury can cause circulatory problems ranging from low blood pressure when you rise (orthostatic hypotension) to swelling of your extremities. These circulation changes can also increase your risk of developing blood clots, such as deep vein thrombosis or a pulmonary embolus.

  Another problem with circulatory control is a potentially life-threatening rise in blood pressure (autonomic dysreflexia). Your rehabilitation team will teach you how to address these problems if they affect you.

• Respiratory system. Your injury might make it more difficult to breathe and cough if your abdominal and chest muscles are affected.

  Your neurological level of injury will determine what kind of breathing problems you have. If you have a cervical and thoracic spinal cord injury, you might have an increased risk of pneumonia or other lung problems. Medications and therapy can help prevent and treat these problems.

• Bone density. After spinal cord injury, there's an increased risk of osteoporosis and fractures below the level of injury.
• Muscle tone. Some people with spinal cord injuries have one of two types of muscle tone problems: uncontrolled tightening or motion in the muscles (spasticity) or soft and limp muscles lacking muscle tone (flaccidity).

• 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.

• Sexual health. Men might notice changes in erection and ejaculation; women might notice changes in lubrication after a spinal cord injury. Physicians specializing in urology or fertility can offer options for sexual functioning and fertility.
• Pain. Some people have pain, such as muscle or joint pain, from overuse of particular muscle groups. Nerve pain can occur after a spinal cord injury, especially in someone with an incomplete injury.
• Depression. Coping with the changes a spinal cord injury brings and living with pain causes depression in some people.