chronic effects of spinal cord injury - problems people face
a) Health Issues
b) Social Issues
c) Mental Health Issues
d) Compounding factors for SCI
i) Drug abuse
ii) Age
iii) Obesity
a) Health issues
Neurogenic shock
•Direct injury to the cord in addition to hypotension (low blood pressure) and bradycardia (abnormally slow heart rate) can cause a neurogenic shock.
Thromboembolism
•Immobility causes venous blood to stagnate in the limbs which increases the risk of blood clotting in the veins. These clots can then travel in the blood vessels and get trapped in a narrower vessel. This is known as thromboembolism.
Pressure ulcers
•Also known as bed sores, they are a common problem in bed ridden or immobilized patients.
Heterotopic ossification
•Or ectopic (in an abnormal place or position) bone formation can start after a few weeks of injury and can limit the movement of the affected body part severely.
Pain
•In acute phase, somatic pain can be a very serious issue for the victims. In the chronic phase, chronic musculoskeletal pain may replace acute pain.
Autonomic dysfunction
•All the organs controlled by autonomic system experience dysfunction following a spinal cord injury –
•Cardiovascular system: irregular pulse, blood pressure fluctuations
•Respiratory system: irregular breathing
•Bowel movement: No control over bowel movements
•Bladder control: neurogenic bladder, inability to pass urine
•Sweating and temperature dysregulation
•Sexual dysfunction
b) social issues
Isolation and Accessibility
•Spinal cord injury forces an individual to completely change their lifestyle.
•Immobility caused by paraplegia or quadriplegia can socially isolate a person.
•Inability to stand and walk raises a number of accessibility concerns that are not easy to realise for a person without spinal cord injury.
•Climbing a single step, queues, opening a door, reaching elevator buttons etc. very trivial things become challenging for people with a spinal cord injury.
•It is therefore very important for the friends and family be empathetic of such concerns and equally important for the patients to ask for help with day to day things.
•A number of public or private buildings have facilities for people confined to wheelchairs.
•Motorised wheelchairs and other accessibility aides are also available for the patients.
•Learning how to use such tools and how to perform the daily tasks in a different way that accommodates the mobility limitations can improve the patients’ life.
•However, people living with a complete quadriplegia may not be able to utilise most of the benefits.
c) mental health issues
•It has been observed that spinal cord injury survivors commonly suffer from anxiety, shock, depression and a number of other complex mental health problems.
•This can in fact make the disease condition worse, as a positive outlook has been found to be very important while recovering from a spinal cord injury.
•People with a positive outlook and strong willpower are more likely to regain function and more likely to cope with the residual effects following a spinal cord injury.
d) Compounding factors for sCI
i) Drug Abuse
•Drug abuse is associated with spinal cord injury in a very intricate manner.
•People with a history of drug abuse are at a higher risk of injuring their spines (although, not just the spine) in accidents owing to a more risk taking and reckless behaviour.
•Withdrawal from drugs while recovering from an injury can compound the physical health further.
•Chronic pain and shock from the injury can itself become a risk factor for future drug abuse.
•However, as mentioned before, the injury itself causes a number of changes in the body and any drug abuse will likely result in an adverse outcome, potentially a grave one.
ii) Age
•People in their 20s and 60s are observed to be most commonly suffering form a SCI.
•Elderly SCI patients can have a harder time recovering as the healing process slows down with increasing age.
•Chronic complications such as arthritis, diabetes, hypertension and decline in the normal functions of the body systems can further complicate the injury.
•For many elderly patients, social support can be a serious limiting factor for rehabilitation.
iii) Obesity
•Other than the metabolic complications and chronic diseases such as diabetes and hypertension, obesity can also have direct effects on the treatment and rehabilitation.
•Obese patients require higher drug dose due to a higher body weight and that increases their chances of suffering from side effects.
•Abdominal and trunk fat can impede diagnosis and prognosis by MRI, CT and other such imaging modalities.
•Obesity can also put mechanical stress on the injured spine and delay the body’s natural healing process.