Spinal Cord Injury - Treatment

The first step in treating spinal cord injuries is immobilization. Immobilization involves the use of splints, braces, or a cast to prevent the patient from moving. It keeps a spinal tear or injury from becoming worse. Steroid injections (shots) may be given to the patient as well. Steroids reduce inflammation and swelling, and this can prevent further damage to cells and tissues in the spinal cord. Immobilization and drug injections have greatly reduced the severity of spinal cord injuries in the last few decades.

There are currently no treatments that will make a spinal cord grow back to its normal condition. The most that can be done is to help people with spinal cord injuries avoid complications and to make the best use of those bodily functions they still control. Programs of this type often require a variety of professional workers, including a neurologist (specialist in nerve disorders), psychiatrist or psychologist, physical therapist and occupational therapist. Depending on the type of injury, a patient might also need the help of a respiratory therapist, speech-language specialist, nutritionist, special education teacher, or recreation therapist. Support groups also provide important information, advice, and emotional support for SCI patients. Support groups are made up of other individuals who have the same medical problem.

Some specific forms of rehabilitation (recovery) treatment include the following:

Paralysis and loss of feeling

Many patients with SCI can recover at least some of their ability to move. Physical therapists can teach patients how to use muscles that are still functional to take over for those that are not. The therapist can also help with exercises that will strengthen muscles that can still move. He or she also suggests equipment that may aid the patient's ability to move, such as braces, canes, or wheelchairs.

An occupational therapist teaches patients how to perform normal daily activities, such as eating and caring for oneself. The therapist may suggest changes in the person's home or work to make routine activities easier to perform.

A respiratory therapist helps SCI patients learn how to function with a weakened breathing system. For example, patients may learn new methods of coughing to make sure that disease-causing agents are eliminated from the lungs.

Pressure ulcers

Pressure ulcers (bedsores) often develop when a person is confined to bed for long periods of time. The sores can be prevented by turning the patient every two hours. Special chairs and mattresses are available that make pressure ulcers less likely.

Contracture and spasticity

Patients can be taught exercises that keep their muscles from becoming too stiff. In some cases, drug injections can help relax the muscle tissue. In extreme cases, surgery may be necessary to cut and/or replace tendons that have become too stiff.

Abnormal calcium deposits

A drug known as etidronate disodium (Didronel) helps control the way calcium is used in the body. When injected into SCI patients, it prevents calcium from depositing in muscles and tendons. In some cases, doctors may decide to remove abnormal calcium deposits by surgery.

Failure of autonomic responses

Patients and their families should learn to detect signs that autonomic responses are failing.

If not treated quickly, these failures can cause serious damage or death. Patients may need to be protected from conditions, such as exposure to the sun and pressure on the skin that may cause abnormal responses.

Sexual dysfunction

Counseling may help SCI patients to learn other forms of sexual behavior than traditional forms of intercourse. These alternative sexual behaviors can often be as satisfying as those with which the patient was familiar.

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