The Spinal Cord is a tubular extension of the brain that runs downward through a canal in the vertebrae carrying messages between the brain and the rest of the body for movement and sensation. There are three major areas of the spine:
The cervical spine refers to the seven bones of the neck. The thoracic spine refers to the twelve bones of the back – all the bones that have ribs attached to them. Finally, the lumbar is what is referred to as the “lower back” which is located below the rib bones.
The spinal cord starts at the base of the brain and usually ends between the lowest portion of the thoracic spine or the higher portion of the lumbar spine. At each level, the spinal cord gives off spinal nerves. After the spinal cord ends, those spinal nerves become much longer and drape down into the lumbar spine and continue to exist at each level. These draping nerves resemble a horse’s tail and are thus referred to as the cauda equina (the Latin translation for “horse’s tail”).
Spinal cord injury occurs when something interferes with the function or structure of the cord. This can include consequences of a medical illness or trauma resulting in overstretching the nerves, a bump, the bones of the vertebra pressing against the cord, a shock wave, electrocution, tumors, infection, poison, lack of oxygen, cutting, or tearing of the nerves.
Symptoms of a spinal cord injury vary; they depend on the type, location, and severity of the injury. An entire loss of muscle control and feeling is called a complete spinal cord injury. When some muscle control is maintained and sensation is still present, this is called an incomplete spinal cord injury. Injuries that occur higher up, the spinal cord usually result in more severe symptoms. Immediate signs of a spinal cord injury include:
- Loss of muscle function
- Numbness, tingling, or loss of feeling
- Trouble breathing
The severity of a spinal cord injury depends on which part of the spinal cord itself is damaged. In basic terms, the higher up the spinal column, and therefore closer to the brain an injury occurs, the more likely it is to affect mobility and feeling. Spinal cord injuries sustained to lower parts of the vertebral column generally have less of an impact on a patient’s feeling, movement, and voluntary control. While individual outcomes may vary, the following are the two general levels of spinal cord injury:
Complete spinal cord injury – A complete spinal cord injury results in the total loss of all voluntary motor and sensory functions below the primary level of injury. This affects both sides of the body equally. Close to 50% of all spinal cord injuries are considered complete. It is important to note that just because there is a total absence of motor and sensory function, this does not necessarily mean all nerves across the injury site have been damaged; there may be some axons still intact, they are simply no longer functioning properly because of the injury. This may not seem like a big distinction, however, it can mean a great deal of difference for paraplegic or tetra-legit patients undergoing spinal cord injury rehabilitation.
Incomplete spinal cord injury – Unlike a complete spinal cord injury, for incomplete spinal cord injuries, the spinal cord’s ability to carry messages to and from the brain is not completely lost. This means that the patient may have some faint sensation and/or movement below the level of injury to the spinal column. However, the sensation of movement is somewhat random; patients may have more functioning on one side of the body than another, or have a feeling in limbs or extremities that they cannot move. With current advances in treatment for spinal cord injuries, this type of injury is gradually becoming more common.
Who Gets It?
Although a spinal cord injury is normally the result of an accident and can occur to anyone, certain factors can predispose an individual to an increased risk of sustaining a spinal cord injury. Spinal cord injuries affect a huge number of men. Females account for only about 20% of traumatic spinal cord injuries throughout the population. A patient is most likely to suffer a spinal cord injury if he or she is between the ages of 16-30. The average age at the time of injury is 43 years old. That being said, falls can cause most injuries when an adult is at an elderly age.
Diving into too-shallow water or playing sports without wearing the proper safety gear or taking proper precautions can also lead to experiencing spinal cord injuries. Motor vehicle crashes are the biggest leading factor of spinal cord injuries for people under 65 years of age. Lastly, a relatively minor injury can cause a spinal cord injury if a patient has another disorder that affects the bones and joints, such as arthritis or osteoporosis. Spinal cord injury can also happen during childbirth if a doctor intervenes with labor forcefully. When the mother is having trouble delivering her baby, it is up to her doctor to cooperate. However, if they pull too hard on a baby’s head, neck, or shoulder, or end up twisting the spine too far, they may cause permanent damage.
How Does It Affect You? How Serious Is It?
High-speed collisions can result in damage to the neck and spine that also affects the spinal cord, especially when a victim is involved in an accident with a larger vehicle, such as a truck; this type of serious injury is more likely to be at high risk. Spinal cord damage can also occur in situations where accidental victims have less protection for their neck and head – for example, car accidents or collisions involving pedestrians, cyclists, or motorcyclists may cause this form of injury.
Medical malpractice of multiple types can also lead to spinal cord injury. If a surgeon is not professionally careful, they might make a mistake while positioning or moving a patient that damages their spinal cord. Anesthesiologists can also increase a patient’s risk of spinal cord damage if they are not careful when administering medications. There is no healing of the spinal cord, meaning once they make this mistake, even immediate action cannot undo the damage to the patient. Failure to treat the infection can also lead to permanent spinal cord injury and even paralysis.
Recommended Treatment & Rehabilitation
Before treatment is initiated, first off, a doctor will diagnose your spinal cord injury. They will keep you immobilized during tests at a hospital. Possible tests are an X-ray, computerized tomography scan, or Magnetic Resonance Imaging (MRI). These tests take pictures of the vertebrae to show if there is any damage. Your doctor will also perform a neurological exam. This helps determine how severe the spinal cord injury is. They will see how much muscle control you have and whether or not you can feel sensations. All of these tests diagnose the level and completeness of your injury.
After diagnosis, a group of doctors will later choose the best treatment options for your spinal cord injury. In the short term, medicine can help reduce swelling of the spinal cord injury. Methylprednisolone is a cortisone or steroid medicine. It is given right away as it can help reduce damage to your nerve cells. In most severe cases, you may need surgery to stabilize your spine or remove bone or tissue that is pressing on your spinal cord. Your doctor will put you in traction to keep your head and body still during a surgical procedure. Below are long-term treatment options with several benefits. They help prevent blood clots, muscle shrinkage, calcium loss, and thinning of your skin. Long-term treatments include:
- Medicine – Certain medicines and injections can help control some spinal cord injury symptoms as well as manage pain.
- Physiotherapy – In some cases, physiotherapy can help with muscle function. It consists of stretching, strengthening, and muscle training. It can provide flexibility, control, coordination, and strength.
- Occupational therapy – This type of therapy can help you re-learn daily tasks, such as bathing, dressing, cooking, and writing. Your body may have forgotten how to do these tasks since the injury. It also provides education to prevent future health problems.
In addition, researchers have shown that exercise improves respiration, muscle strength, circulation, body composition, self-esteem, self-confidence, depression, anxiety, and independence. It also helps to prevent secondary complications (such as urinary tract infections, pressure ulcers, and respiratory infections), reduce the risk of diabetes, improve the immune system, reduce blood clotting, and reduce constipation. Whilst every spinal cord injury will result in different functional outcomes, all spinal cord injury patients must practice leg exercises to maintain their health. Even if you are completely paralyzed in the legs and cannot voluntarily move them, exercise is essential to minimize the risk of any secondary complications. Those with more severe paralysis in the legs should practice a passive range of motion exercises with a physiotherapist or caregiver. In contrast, those with some control in the legs should try to perform these leg exercises on their own and adjust as needed. Some of these exercises include the following:
Straight leg raises – Straight leg raises will help incomplete spinal cord injury patients develop their quads and hip flexors. Firstly, lay on a mat with one knee bent and the other straightened. The toes of your straightened leg should be pointed up towards the ceiling. Afterward, lift the straightened leg in the air as high as you can and gently bring it down. Perform this procedure 10 times and then switch sides. Keeping one leg bent will help stabilize the body. It is also necessary to straighten both legs and lift them at the same time for a more challenging experience.
Seated marching – Seated marching is a great leg exercise for incomplete spinal cord injury patients who still have some movement because it allows them to practice walking motions without placing any pressure on the joints. To get started, sit at the edge of your seat with both feet planted on the ground. Then finally, alternate lifting your knees, one at a time.
Heel raises – Heel raises will help spinal cord injury patients practice shifting their weight from their heels to the balls of the feet. This mimics the movements made when taking steps. Sit at the edge of your seat with feet planted on the floor. Then, slowly lift the heels. You should feel your calves tighten and your ankles extend.
Alternative & Homeopathic Treatments
Natural remedies for spinal cord injury recovery may be an alternative and complementary approach to conventional treatments. Although the effectiveness of natural remedies cannot be guaranteed, a major benefit is that they are relatively affordable and have minimal side effects. Natural remedies are typically used to relieve complications like pain, fatigue, anxiety, and poor sleep quality. These are all fairly common side effects of spinal cord injury, which make natural remedies worth considering. Below are a few home remedies to try at ease:
Massage therapy – The first natural remedy to relieve symptoms for spinal cord injury patients is massage therapy. Due to limited mobility after a spinal cord injury, individuals may experience poor circulation. Blood carries oxygen and other essential nutrients throughout the body, so efficient circulation is necessary to promote overall health. One major benefit of massage therapy is that it stimulates blood flow, which increases the body’s ability to absorb oxygen into the tissues. It also relaxes the muscles and relieves tension, which will help reduce pain and improve the range of motion.
Yoga – After a spinal cord injury, you may feel disconnected from your body. Yoga is a natural alternative that focuses on joining the mind and body through deep breathing, meditation, and postures. Adaptive yoga modifies the positions so that individuals with spinal cord injuries can safely participate. It helps lower cortisol levels in the brain, which can help reduce feelings of depression, anxiety, and stress. A clear mindset may also contribute to a good night’s rest. Over time, yoga may help individuals with spinal cord injuries improve their stability, strength, flexibility, and posture.
Chiropractic treatment – Another major natural remedy for spinal cord injuries is chiropractic treatment. It involves manipulating the alignment of the spinal column to alleviate pressure, promote circulation, and reduce pain. The spinal cord is a delicate bundle of nerves, and especially after a spinal cord injury, the spinal column needs time to heal. Additionally, every spinal cord injury is unique and stabilizes at its own rate. Therefore, it is essential to consult with a doctor about how long after a spinal cord injury it is safe to try chiropractic treatment.
Aromatherapy – Aromatherapy is the use of plant extracts in the form of essential oils to improve health and wellbeing. It involves inhaling or applying essential oils onto the skin, which stimulates physiological responses in the nervous and immune systems.
Acupuncture – Lastly, another popular remedy used by many patients with spinal cord injury is acupuncture. It involves placing thin, hair-like needles into specific points on the body to improve energy flow.