Spinal Cord Injury

What is a spinal cord injury?

The spinal cord is a long, strong bundle of nerves that connects your brain to the rest of your body. It is the “relay station” that provides information to your brain about the environment, and then carries out commands for movement from the brain. For example, if you step on something sharp, the sensory neurons in your foot will send a message to the spinal cord, which then relays that message to the brain. Your brain receives this message of “sharp!” and quickly sends the signal back down the spinal cord to “pick up your foot.” You jump away from the sharp object even before you can even say “ouch!”, all thanks to your spinal cord!

A spinal cord injury (SCI) can result after damage to any part of the spinal cord or nerves at the end of the spinal canal (also known as the cauda equina, or horse’s tail). This damage can be caused by a number of things: trauma, stroke, infection, tumours, or congenital abnormalities. Motor vehicle accidents are the leading cause of SCI in younger people, while falls account for a higher percentage in people over 65. Regardless of the cause of damage, the result is the same: a change or interruption in the ability to relay information from the brain to the body. This can occur at any level of the spinal cord and can be complete, with a total interruption of signal conduction: this would result in a complete loss of feeling and movement below the level of the damage. An incomplete injury would mean that some signals are still able to travel past the injured area of the cord, but there may be a change in strength or altered sensation (numbness, tingling, or pins and needles). Other symptoms can include changes in bowel and bladder function, muscle twitching or spasm, or difficulty breathing and coughing.

These changes may be temporary or permanent; sometimes the body can repair the damaged connections, and sometimes they can be too injured to recover. Unfortunately, the spinal cord is not very good at healing itself – it is not like a broken bone or skin abrasion. Although we do know it is possible to see some neuroplasticity at the level of the cord, it has less ability to change than we see in the brain. The only way to know how much function someone may regain after their SCI is to wait and see- and to work hard at rehab in the meantime! Incomplete injuries usually respond more readily to therapeutic intervention, when the nerve signals may be able to find alternate pathways along the damaged cord. Although not impossible, it is rarer for complete SCI to achieve recovery of movement and sensation. 

What can be done for SCI?

Therapy for SCI can include strengthening and range of motion exercises, instruction in alternate movement patterns, education to prevent pressure sores and stay fit, and maximizing the potential for neuroplasticity through practice, practice, and more practice! Other therapies that exist include nerve stimulation (Functional Electrical Stimulation or FES), Botox for spastic muscles, and exoskeleton training. There robotic legs that can be used in therapy to practice walking, but also some newer models that can be taken home and used for mobility, in addition to a wheelchair. Some countries are starting to look at stem cell therapy for SCI, but this is not yet available in Canada.

The most important thing for a client with an SCI is to figure out the best way for them to continue to move, stay fit, and live well. For more information, check out the resources below or book an appointment with us today!