Damage to the spinal cord may result from a number of different causes, for example:
- Congenital defects (such as spina bifida)
- Inflammatory problems (such as meningitis, post-viral infection)
- Tumours (most commonly secondary deposits from a primary tumour in the breast, prostate or lung)
- Degenerative or Demyelinating diseases (such as Motor Neurone Disease (MND), Multiple Sclerosis (MS))

Damage may also be the result of a traumatic injury, for example:
- Road traffic accident
- Domestic or work-related accident
- Fall from a height Sporting injuries (diving, horse-riding, trampolining, gymnastics, rugby)

Most of the injuries to the spinal column do not affect its’ inherent stability, so the spinal cord and the nerve roots remain protected. However, greater forces, especially those with a rotational/torsional element, can lead to ligament disruption and bony injury/displacement, whereby the spinal cord can be overstretches, damaged by direct bony trauma/impingement, or torn, leading to a complete or an incomplete spinal injury. This results in problems with sensation and/or muscle power below the level of the injury.

Complete tear: No function, voluntary movement or sensation below the level of the injury. Affects both sides of the body equally.

Incomplete tear: Variable effects depending upon the severity and the level of the injury. The individual may have a greater ability to function/move/feel one side or part of their body than other areas.

The effects of a spinal cord injury are entirely dependent on the type, severity and the location of the lesion. Sensory and motor changes occur below the level of the injury, and may include the following:
- Reduced sensation
- Reduced voluntary movement
- Reduced proprioception (position sense)
- Pain
- Muscle spasms
- Loss of bladder/bowel function
- Loss of sexual function
- Gastrointestinal problems
- Changes in blood pressure and circulation
- Difficulty breathing and coughing

Diagnosis: Any complaints of pain in the neck, between the shoulder blades, in the chest, or the lower back following a traumatic accident should be treated with suspicion of a spinal injury. Symptoms such as altered sensation (numbness/electric shock feeling into the limbs) are also suggestive of cord/nerve damage. Any unconscious patients or those who have fallen from a height or been involved in a road traffic accident are always considered for spinal injury.

Assessment should include a detailed history of the trauma and the resulting symptoms. A physical examination must include a thorough neurological assessment, which looks for areas of sensory loss, muscle weakness, and checks normal reflex responses.

Physiotherapy Management: A spinal cord injury is a life-changing event for both the individual and their family. At PEAK Physiotherapy, we are experienced in helping you to maximise your potential by assisting you to overcome the problems associated with such an injury.

The specific treatment approach will depend upon the severity and level of your injury, but will be goal-orientated and tailored to your individual needs.

Treatment may include:
- Positioning
- Pain control
- Range of exercises and stretches (passive and/or active)
- Transfers (for example; bed, chair, toilet, wheelchair, bath/shower)
- Wheelchair skills
- Assistance with chest clearance and breathing techniques
- Advice to you and your carers regarding appropriate manual handling techniques and management strategies
- Skin and joint care
- Balance and gait training (as appropriate)

The aims of physiotherapy intervention are to:
- Reduce pain and stiffness in muscles and joints
- Reduce painful muscle spasms
- Increase muscle strength and control
- Increase functional independence
- Decrease the risk of secondary complications such as chest infection and DVT
- Improve quality of life

Our specialist neurophysiotherapist, Karen Wood can provide assessment and treatment at our fully equipped clinic at Iveridge Hall (Oulton, Leeds).

Alternatively, it may be considered more appropriate to see you in the comfort of your own home. For further information about our neuro-physiotherapy services, please click here. Should you wish to arrange an appointment please click here or telephone Cathy Preston on 07908 684440 or Sarah Joice on 07908 684441.

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