Paraplegia After Spinal Cord Injury

What is paraplegia?

Paraplegia (payr-ah-PLEE-jah) is a condition where you are paralyzed and you cannot move your legs. You may become paralyzed after an accident where you broke your upper back. The spinal cord is inside the bones in your neck and back. When your back is broken, the spinal cord may be damaged. If the spinal cord is damaged, the brain has trouble communicating with the lower part of your body.

  • Paraplegia means that you have a spinal cord injury (SCI) to the part of the spinal cord inside your chest or back. This injury causes you to lose sensation (feeling) and movement. Spinal cord injuries are described by where on the spinal cord they have happened. Caregivers use letters and numbers to describe where your spinal cord is injured. There are eight cervical, 12 thoracic, five lumbar, and four sacral bones. The letter "T" stands for thoracic. If you have a T5 spinal cord injury, the damage is at the level of the fifth thoracic spinal cord section.

  • Spinal cord injuries are also described as complete or incomplete. This refers to how much function (movement and feeling) is left after you have healed from the injury. A complete SCI means that you have totally lost the movement and feeling below the injured level. An incomplete SCI does not cause total loss of movement or feeling.

What causes paraplegia?

You may become paralyzed following a car or sports accident that broke your back. Having a tumor or other diseases in your spinal canal can also cause paraplegia. It is possible for the nerves to start working again if your spinal cord is just bruised or swollen. The longer that there is no change in feeling or movement, the less likely that you will see improvement.

What happens to your body when you have paraplegia?

The symptoms of paraplegia differ depending on where and how badly your spinal cord is injured. You may have one or more of the following signs or symptoms:

  • Limp muscles, especially in your arms and legs.

  • Inability to move or feel anything below the damaged area.

  • Inability to control your bowel (BM) or bladder (urine).

  • Trouble breathing or you are unable to breathe on your own.

What type of care will I receive if I have paraplegia?

A team of health caregivers work with you to help you learn to live with paraplegia. This team may include:

  • Your regular doctor.

  • Neurology nurses.

  • Psychologists.

  • Physical and occupational therapists.

  • Respiratory therapists.

  • Social workers.

  • Speech pathologist.

What tests will I need?

Tests help caregivers find out more about your spinal cord injury. They may also help caregivers plan your treatment. You may need one or more of the following tests.

  • Neurologic tests: Caregivers may ask you questions and do other tests to learn what area of your spinal cord is injured.

  • X-rays: X-rays help caregivers see the part of the spine that is damaged.

  • CT scan: This test is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your neck and spine. Your caregivers look at the pictures to see areas that might be injured.

  • MRI: This test is also called magnetic resonance imaging. This test may be done to show where and how much damage has occurred. You may need an MRI if you are having pain or muscle spasms.

What treatments will I receive?

You will need to stay in the hospital right after the injury. Soon after, you may be moved to a rehabilitation center. The goal of rehabilitation is to help you learn to take care of yourself as much as possible. Ask your caregiver if you would like more information on any of the following treatments. You may have one or more of the following treatments during rehabilitation:

  • Bowel and bladder programs: Being paralyzed makes you unable to control when you urinate or have a BM. Caregivers will teach you how to manage your bowels and bladder.

  • Braces: You may need a brace if the ligaments that support your spine are injured. A special type of brace may be used if the injury is in your chest or lower back area. These braces include a clamshell (plastic body jacket) or a plaster or plastic body cast.

  • Medicines: Caregivers teach you what medicines you need, why you need them, and how to take them. You may need one or more of the following medicines:

    • Steroids: This medicine is used to prevent and reduce spinal cord swelling and improve blood flow.

    • Osmotic diuretics: An osmotic diuretic is a medicine that may help decrease and prevent spinal cord swelling.

    • Blood pressure medicine: This is given to lower your blood pressure. A controlled blood pressure helps protect your organs, such as your heart, lungs, brain, and kidneys. Take your blood pressure medicine exactly as directed.

  • Mental health: Being paraplegic can cause you and your family to be sad. Mental health therapists help you and your family learn to cope with your spinal cord injury.

  • Occupational therapy: Occupational therapists (OT) teach you how use special equipment so that you can care for yourself. They help you relearn how to perform your activities of daily living. This means learning how to eat, get dressed, and care for yourself. Your OT also teaches you work-related skills.

  • Physical therapy: Physical therapists (PT) teach you how to keep your muscles strong. They also help your joints stay limber (able to move easily) and teach you how to stay active. This therapy includes learning how to use a wheelchair. Caregivers teach you how to move from your bed to the chair and to the commode (toilet).

  • Recreational therapy: Recreational therapists continue your skills training so that you can be active in your community. You may also learn fun activities.

  • Respiratory care: Being inactive after your SCI can cause breathing problems. Respiratory therapists make sure that your breathing system stays healthy.

  • Skin care: Being paralyzed puts your skin at risk for getting decubitus ulcers (sores). These also are called pressure sores. Caregivers help you learn how to keep your skin healthy, and what to do if you develop skin problems.

What types of surgery may I need?

The injury to your spinal cord cannot be repaired, even with surgery.

  • You may need surgery to stabilize (support) the bones in your spine. Pieces of vertebra or disc may be pressing on the spinal cord or nerve roots coming out of the spinal cord. You may need surgery to remove these pieces of bone or disc. Surgery also can be done to line up the bony spinal column. Caregivers may use bone from your hip or metal rods and screws to support your spine.

  • You may be able to have surgery or use pieces of equipment to help you move better. Some of these procedures are called muscle tendon transfer, or functional electrical stimulation (FES). These procedures may be done about a year after your spinal cord injury. This will allow you to recover as much as possible.

Where can I go for support?

  • Having a spinal cord injury and becoming paraplegic is life changing for you and your family. Accepting that you are paraplegic is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Your caregiver can help your family better understand how to support a person with paraplegia.

  • You may want to join a support group. This is a group of people who are also paraplegic. Ask your caregiver for the names and numbers of support groups in your town. You can contact one of the following national organizations for more information:
  • Paralyzed Veterans of America
    801 Eighteenth Street NW
    Washington, DC , 20006
    Phone: 1- 800 - 424-8200
    Web Address:
  • National Spinal Cord Injury Association
    1 Church Street, Suite 600
    Rockville , MD 20850
    Phone: 1- 800 - 962-9629
    Web Address:
  • American Spinal Cord Association
    2020 Peachtree Road, NW
    Atlanta, Georgia , 30309-1402
    Phone: 1- 404 - 355-9772
    Web Address:

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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