Spinal Cord Injury Rehabilitation

Spinal Cord Injury

Spinal cord injury (SCI) is a condition that can cause significant physical, emotional, and social challenges for individuals and their families. SCI can be caused by a variety of factors, such as accidents, diseases, or degeneration of the spinal cord. Depending on the level and severity of injury, SCI can cause paralysis, loss of sensation, loss of bowel and bladder control, respiratory problems, and other complications.

 

Sub Types of SCI and What Subsequent Deficits They May Cause:

SCI can be classified based on the level and severity of injury. This means that depending on where the injury is and how severe it is, different parts of the body may be affected. For example, if the injury is in the neck area, it can cause paralysis of the arms, legs, and trunk, as well as difficulty breathing. The severity of injury is classified using the American Spinal Injury Association (ASIA) Impairment Scale, which ranges from A (complete injury) to E (normal function). Depending on the level and severity of injury, SCI can cause paralysis, loss of sensation, loss of bowel and bladder control, respiratory problems, and other complications.

 

Understanding Prognosis:

Prognosis refers to the expected outcome of SCI. It can be difficult to predict, but early intervention and aggressive rehabilitation can improve outcomes. The prognosis depends on the level and severity of injury, as well as other factors such as age, overall health, and access to rehabilitation. It's important to remember that everyone's journey with SCI is unique, and there is no one-size-fits-all approach to treatment and rehabilitation.

 

Role of Physiatry in a Patient's Care in an Inpatient Rehabilitation Facility or Skilled Nursing Facility:

Our physiatrists at Rehabilitation Associates provide specialized care for patients admitted for rehabilitation related to a diagnosis of spinal cord injury.  

 

Physiatry is a medical specialty that focuses on rehabilitation and restoration of function. Physiatrists work with a team of rehabilitation professionals to develop a comprehensive treatment plan for each patient. In an inpatient rehabilitation facility or skilled nursing facility, physiatrists oversee the medical management of SCI, including pain management, spasticity management, and prevention of complications.

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Common Complications of SCI and How a Physiatrist Can Help Manage Them

SCI can cause a variety of complications that can affect different parts of the body. Some of the most common sequelae of SCI include autonomic dysreflexia, neurogenic bowel, neurogenic bladder, and neuropathic and somatic pain.

 

Autonomic Dysreflexia:

Autonomic dysreflexia is a potentially life-threatening condition that can occur in people with SCI at or above the level of T6. It is caused by an exaggerated response of the autonomic nervous system to a noxious stimulus below the level of injury. Symptoms of autonomic dysreflexia include high blood pressure, headache, sweating, flushing, and bradycardia. A physiatrist can help manage autonomic dysreflexia by identifying and treating the underlying cause, such as a full bladder or bowel, and by prescribing medications to control blood pressure.

Click here to download a comprehensive guide on Autonomic Dysreflexia
 

 

Neurogenic Bowel:

Neurogenic bowel is a common complication of SCI that can cause constipation, diarrhea, and fecal incontinence. It is caused by damage to the nerves that control the bowel. A physiatrist can help manage neurogenic bowel by prescribing medications to regulate bowel function, such as laxatives or stool softeners, and by recommending dietary changes and bowel training programs.

Click here to download a comprehensive guide on the management of Neurogenic Bowel.

Neurogenic Bladder:

Neurogenic bladder is another common complication of SCI that can cause urinary incontinence, urinary retention, and urinary tract infections. It is caused by damage to the nerves that control the bladder. A physiatrist can help manage neurogenic bladder by prescribing medications to regulate bladder function, such as anticholinergics or alpha-blockers, and by recommending bladder training programs and intermittent catheterization.

Click here to download a comprehensive guide on the management of Neurogenic Bladder.

 

Neuropathic and Somatic Pain:

Neuropathic and somatic pain are common complications of SCI that can cause chronic pain and discomfort. Neuropathic pain is caused by damage to the nerves that transmit pain signals, while somatic pain is caused by damage to the muscles, bones, or other tissues. A physiatrist can help manage neuropathic and somatic pain by prescribing medications to control pain, such as antidepressants or anticonvulsants, and by recommending physical therapy, massage, or other complementary therapies.

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Treatment and Rehabilitation Goals:

The goal of rehabilitation for SCI is to help patients regain as much function and independence as possible. Treatment and rehabilitation goals depend on the level and severity of injury, as well as the patient's individual needs and goals. Rehabilitation may include physical therapy, occupational therapy, speech therapy, and other interventions to help patients improve their mobility, strength, and overall quality of life. The rehabilitation team works with the patient to develop a personalized treatment plan that addresses their specific needs and goals. Treatment may include exercises to improve strength and mobility, training in activities of daily living, and assistive devices to help with mobility and independence.

 

Family Support and Education:

SCI can have a significant impact on the patient's family and caregivers. It's important for family members to be involved in the patient's care and rehabilitation, as well as to receive education and support. Family members may need to learn how to assist with activities of daily living, manage medications, and prevent complications. They may also need emotional support and counseling to help them cope with the challenges of SCI.

 

Frequently Asked Questions:

- What causes SCI?

SCI can be caused by a variety of factors, such as accidents, diseases, or degeneration of the spinal cord.

- What are the subtypes of SCI?

SCI can be classified based on the level and severity of injury. The severity of injury is classified using the American Spinal Injury Association (ASIA) Impairment Scale, which ranges from A (complete injury) to E (normal function).

- What is the prognosis for SCI?

The prognosis depends on the level and severity of injury, as well as other factors such as age, overall health, and access to rehabilitation.

- What is the role of physiatry in SCI care?

Physiatrists oversee the medical management of SCI, including pain management, spasticity management, and prevention of complications.

- What are the treatment and rehabilitation goals for SCI?

The goal of rehabilitation for SCI is to help patients regain as much function and independence as possible. Treatment and rehabilitation goals depend on the level and severity of injury, as well as the patient's individual needs and goals.

- How can family members support a loved one with SCI?

Family members can be involved in the patient's care and rehabilitation, receive education and support, and may need emotional support and counseling to help them cope with the challenges of SCI.

 

Bringing Excellence in Physiatry Care to Your Facility​

If you or a loved one is currently at a facility that could benefit from our comprehensive physiatry and rehabilitation services, we'd love to help. Rehabilitation Associates is always ready to extend our top-tier care to more patients and facilities.

 

Partnering with us means access to personalized care plans, pain management programs, and an approach aimed at enhancing patient independence and quality of life. Our team can seamlessly integrate with your facility's existing operations, ensuring a smoother transition and better patient outcomes.  Please fill out our contact form and provide us with the name of the facility where you or your family member is currently staying. We will promptly respond to explore how we can help elevate rehabilitation care at your facility. Remember, quality care is just a click away.

 

Click Here to Contact Rehabilitation Associates​

 

At Rehabilitation Associates, we believe in the power of collaborative care. Let's join forces to create a better rehabilitation journey for patients.
 

Additional Resources:

https://pva.org/research-resources/publication/

Navigate to “for individuals with SCI/D and Their Families” to find the most up to date information and guidelines on spinal cord injury.