Rehabilitation After a Spinal Cord injury

What is rehabilitation for a spinal cord injury?

Your spinal cord runs from your brain down through your spine. Your brain sends messages out to your body through your spinal cord. These messages help you move your body parts, like when you pick up a cup or walk to the mailbox. As you go about daily tasks, messages travel from your arms, legs, and the rest of your body back to your brain through your spinal cord.

A spinal cord injury can prevent your brain and body from communicating normally. If you've had a spinal cord injury, you may need surgery or other treatments to fix the injury. After, you may need to spend time in a rehabilitation facility, or "rehab," as part of your recovery.

Why might I need rehab for a spinal cord injury?

The rehab process may help you regain some functions that the injury took away. You may need to learn things, such as how to control your body, take care of yourself, and use a wheelchair. The tasks you'll work on in rehab depend on the type of injury that occurred.

After a spinal injury, you may be at risk for complications. Rehab may help prevent them. Possible complications are:

• Pressure injuries

• Breathing problems and pneumonia

• A drop in blood pressure when you move around

• Muscle weakness and muscle spasm

• Blood clots

• A hard time moving joints

• Pain

• Bowel and bladder problems

• Reproductive and sexual function problems

• Depression

• Anxiety

What are the risks of rehab for spinal cord injury?

During rehab, your therapists will help you do different exercises and help you move around. As a result, another injury could happen during rehab. But your therapist will take extra care to prevent any more injury. You may also develop sore muscles from your exercises and activities.

There may be other risks, depending on your specific health problem. Be sure to discuss any concerns with your healthcare provider before rehab.

There is also the risk that parts of your rehab might not be able to overcome or help with some of the effects of your injury.

How do I get ready for rehab for spinal cord injury?

Your healthcare providers will determine when you will start a rehab program.

Rehab specialists may start working with you while you're still in the hospital. A rehab team often has a variety of specialists, depending on your needs. Your rehab program will probably be led by a physiatrist (also called a physical medicine and rehabilitation physician). This is a medical care provider who specializes in rehab for a wide range of problems from sore shoulders to spinal cord injuries. They are also experts in the treatment of both short-term (acute) and long-term (chronic) pain and musculoskeletal disorders. Other members on your team may be:

• Rehab nurses. These are registered nurses with specialty education in the physical care and health promotion of people with spinal cord injuries. They are experts in bladder, bowel, nutrition, pain, skin integrity, breathing, self-care, and the coordination of medical therapies.

• Psychologists and licensed clinical social workers. They give counseling and emotional support for you and your family members.

• Physical and occupational therapists. They lead you through muscle-strengthening and flexibility exercises. They help you relearn specific skills, such as eating and dressing.

• Pharmacists. They will help manage medicines.

• Case managers (registered nurses or social workers). They help you network with community resources and prepare for your discharge.

• Other specialty providers. These are providers who can meet the rehab needs for your specific type of injury.

What happens during rehab for a spinal cord injury?

Your rehab providers will discuss the results you may expect to see over the short-term and long-term. These results will depend on your type of injury and how much strength and sensation you have below the level of the injury.

While in rehab, your providers may help you with tasks, such as:

• Moving around. Depending on your injury, you may be able to walk with braces. Or you may need a wheelchair. You will learn to use these mobility devices.

• Dealing with complications. If your injury caused many changes in the way your body works, your rehab providers will teach you how to prevent and treat complications. You may need a specialist to treat complications if your bowel and bladder function is not normal.

• Doing things in a different way. Your providers may teach you how to get in and out of a car, roll over in bed, bathe, and do other daily activities that allow you to be more independent.

Individual therapists may work with you on specific tasks, including daily living activities like eating and dressing yourself, as well as job-related skills.

What happens after rehab for a spinal cord injury?

Your rehab specialists may help assess your home to see if it's safe and accessible for you. For instance, they will help you determine whether you will be able to easily use your wheelchair in your home or if you’ll need to make safety improvements to your bathroom. You may need special devices and equipment around your home after rehab.

Tell your power company and emergency services providers about your injury in case of an emergency. Your rehab team will also assist you in arranging help from family, friends, or care providers to help you with your day-to-day needs. They will also educate your care providers about how to safely meet your mobility and healthcare needs at home.

Next steps

Before you agree to a test or procedure, make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how will you get the results

• Who to call after the test or procedure if you have questions or problems

• How much will you have to pay for the test or procedure