Dr. Brian Higdon showing a patient results on a tablet device

Preventing Secondary Problems After a Spinal Cord Injury

Spinal cord injuries can be devastating and almost always leave the patient with permanent mobility issues. In addition to the accompanying loss of mobility and independence, a patient with a spinal cord injury (SCI) is predisposed to secondary complications they have to deal with for the rest of their lives.

Finding a rehabilitative healthcare system to help with your specific spinal cord injury treatment is critical for promoting quick recovery. The healthcare provider’s responsibility doesn’t end when the SCI patient leaves the rehabilitation center to reenter the community.

Brooks Rehabilitation remains proactive and vigilant in monitoring all SCI patients. Our specialized, ongoing medical care helps prevent any secondary complications that may occur after a spinal cord injury. Brooks prioritizes maintaining long-term health and maximizing each SCI patient’s overall quality of life.

Bowel and Bladder Management

Following up with a qualified and licensed primary care physician and spine doctor after an SCI is important to identify and treat possible medical complications after the injury.

After an SCI, nerve impulses from the patient’s bladder may no longer relay to the brain that their bladder is full or allow patients to void on their own. This condition is called neurogenic bladder and occurs due to SCI.

The patient may also have similar problems controlling their bowels (such as constipation) due to neurogenic bowel dysfunction (NBD). NBD is the inability of the patient to control defecation because of a nervous system problem.

Bowel and bladder management is an important priority for patients and for SCI caregivers. A bladder and bowel management program can help patients deal with these issues. How much treatment a patient needs will depend on a variety of factors such as their fluid intake, diet, ability to evacuate, and their level of spinal cord injury.


Another common secondary complication after a spinal cord injury is spasticity – it affects about 65% of SCI patients. Spasticity is abnormal muscle tightness due to prolonged contraction. It can affect muscles in any part of the body, but it’s most common in the legs. Symptoms include spasms, muscle stiffness, and involuntary contractions which can be painful and, in severe cases, disabling.

Proper stretching techniques and functional movement exercises can help to reduce spasticity. A multi-disciplinary team of doctors, nurses, and physical therapists can work with patients to help manage or improve their symptoms.

Current clinical spasticity management involves treatments that range from physical and occupational therapy to medication or surgery.

Pressure Sores

Pressure sores are the most dangerous secondary condition following a spinal cord injury. It occurs from sitting in one position for too long and not moving enough to flex the affected muscles and nerves. Pressure sores may be caused by sitting on anything for too long, such as a shower chair or wheelchair.

We recommend seeking professional advice from a qualified physical therapist to choose the best cushion for a patient’s seating. We also suggest checking mobility equipment and seating places to ensure that your skin is always protected.

The pain from pressure sores can be debilitating and life-threatening if the infection enters a patient’s bloodstream. Seek medical intervention from a pressure wound doctor to monitor the SCI for the best diagnosis and treatment.


This medical complication occurs from the sideways curvature of the spine following an injury. While scoliosis can be brought about by numerous conditions, such as muscular dystrophy and cerebral palsy, its main cause is still unknown.

However, scoliosis is widely recognized as a secondary complication that can occur after a neurological injury. Patients can experience a loss of core muscular control (in the abdominals, paraspinal, obliques, etc.). Paralyzed or weakened core muscles force the patient to lean more on one side.

Over time, the patient’s spine starts to fixate more on the supporting side of the body, which can result in uneven shoulders, one side of the rib cage jutting forward, and, in severe cases, breathing problems.


Many SCI patients are also at a higher risk of osteoporosis brought about by not walking or stretching their muscles and nerves. Osteoporosis becomes even more dangerous as people age. Fortunately, SCI patients can help prevent osteoporosis by taking Vitamin D and calcium supplements daily.

Using a standing frame can also help stave off this secondary condition. Doctors recommend that patients stand for at least 1 hour daily to combat osteoporosis.

Respiratory Issues

Deep breathing exercises have proved to be highly effective for patients with spinal cord injuries. Compromised muscle ability in the victim’s torso cavity can decrease their lung capacity, making breathing difficult.

Pneumonia is another high-risk condition many SCI patients are susceptible to. It’s important for patients to monitor their respiratory health after an injury. A home breathing machine like a Spirometer can help increase a patient’s lung capacity.

Emotional and Mental Well-Being

Spinal cord injuries are also likely to affect patients emotionally and mentally as they try to regain control of their lives. Our professional and compassionate caregivers at Brooks Rehabilitation never overlook the emotional and mental aspects of a spinal cord injury.

By not addressing the original traumatic event, patients often carry a tremendous mental and emotional burden that may get buried, only to cause more grief later. Most spinal cord injury survivors may experience several mental health issues, including:

  • Anxiety
  • Depression
  • Clinical stress
  • Post-traumatic stress disorder (PTSD)

Our therapists are here to help patients work through their experiences and to provide the most appropriate ways of moving forward from the event with proper emotional and mental health.

Cardiovascular Disease

Early onset of cardiovascular disease and premature coronary heart disease are also common secondary problems following spinal cord injuries. However, the risk factors for developing cardiovascular disease are generally the same for everyone, whether they have an SCI or not.

These include:

  • Age
  • Ethnicity
  • Smoking
  • Gender
  • Stress
  • Family history
  • High blood pressure
  • Physical inactivity
  • High cholesterol

While some risk factors are out of our control, reducing controllable risk factors such as smoking and physical inactivity can help significantly reduce the risk of cardiovascular disease.

Diabetes Prevention

People with an SCI are at a higher risk of developing diabetes. Other contributing factors include:

  • Age
  • Obesity
  • High blood pressure
  • Family history

Unfortunately, changes in how the body responds to insulin may increase the patient’s risk for diabetes. Steps to reduce or prevent the risk of diabetes may include:

  • Exercising regularly, if possible
  • Eating the right foods
  • Keeping blood pressure under control
  • Maintaining a healthy weight

Weight Management and Nutrition

We understand how challenging maintaining optimal weight after a spinal cord injury can be, especially because of the many changes to the patient’s metabolism. Most SCI patients have problems with being underweight or overweight.

Working with a nutrition specialist is helpful when planning the best dietary strategies to maintain a healthy weight. Patients should also consider physical exercises, such as pushing a manual wheelchair or using a hand cycle to burn calories while stretching core muscles and nerves.

Pain Management

It’s common to experience pain after a spinal cord injury. However, the type and amount of pain differs for each person and can interfere with their day-to-day life. Therefore, we recommend talking to our SCI physician if you have pain to help diagnose and treat it at its source.

In cases where a patient experiences chronic pain, we recommend seeing a pain management specialist.

Continued Care for SCI at Brooks

Our spinal cord injury programs at Brooks Rehabilitation are designed to meet every patient’s recovery needs and goals. Our patient-focused, holistic treatments focus on helping SCI sufferers transition from inpatient rehabilitation to at-home care and eventually to smooth reintegration into the community.

Brooks Rehabilitation’s sole purpose is to help patients reach their highest recovery level so they can participate in life at their own pace and time. We are constantly developing and enhancing our field by offering advanced, scientifically proven spinal cord injury treatments and therapies to all patients in a compassionate and comfortable setting.

Get in touch to start your spinal cord injury treatment and recovery journey today at one of our locations.

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