Travelling is one of the important aspects of life and after surviving a spinal cord injury the survivors have somewhere in their mind that they won’t be able to explore places again. There is a big stereotype among people with SCI, their family members, and the society that they can’t travel ever again. So, to bust their bubble and create history KSNR came into the picture with our easier said than done plan to take our patients to Vaishno Devi, Katra.
Additionally, KSNR is setting a record by doing so as no group of wheel chair users have ever been there. However, we knew that it’s not going to be that easy but as a rehabilitation center it’s our responsibility to make our patient feel confident and teach them every aspect of life after SCI.

Planning the trip

As we have decided to go on a hilly area with our wheel chair users so it is very essential for us to plan everything properly before starting our journey. The crucial things which need to be taken care are mentioned below:

Transportation

First and most important thing is to decide how we are going to reach. There are so many ways to reach Vaishno Devi like by road, by train or by air but we have decided to go by bus as we are travelling with our patients thus our main motive was their comfort along with their enjoyment.

So, we booked a bus for the whole trip so that we don’t have to worry about the transportation throughout the trip.

Booking Accommodations

Booking the stay prior to the the journey is equally important because it nearly takes around 12-13 hours to reach Vaishno Devi, Katra from Delhi by road. So, those long sitting hours are definitely going to be tiring for the SCIs as there are many Quadriplegic patients travelling with us as well hence the first thing we need to do after reaching there is to let them take proper rest to avoid any further complexities like UTI, bed sores, etc.

Packing Essentials

Pack all the necessary medications and useful things like comforters , gel cushions etc. which will help to avoid problems like swelling, pain and discomfort. Some individuals with SCI do CIC for urination so for them it is very essential to pack a proper bag with all the necessary items like catheters, gloves, sanitizer, etc.

Visit the Bhavan

It’s the most challenging part of the trip as there are so many obstacles in between like to take Parchi (entry pass) to visit the temple, to complete around 15km trek with people who are not able to stand/walk on their own to reach the bhavan, and most importantly to do the Darshana of Mata and seek blessing in such crowd.
Earlier, we were planning to take our patients to the Bhavan by helicopter but as wheelchairs are not allowed in helicopter we had to drop this plan and then we booked Palkis as our alternate option.

Executing the Plan

After planning our itinerary we are all set to get started with our journey. We started from Delhi around 5-6 PM in the evening and stopped in Jammu in one of the Ashram and afterwards we reached our destination that is Katra in the afternoon. Thereupon our team reached out to Shrine board to inform them about our initiative and seek help from them for VIP Darshan and surprisingly they agreed on the same.

First day in Katra

Once we reached Katra, we let our patients take adequate amount of rest and then in the evening around 7PM we started our trek to the Bhavan along with our patients. As the Yatra route is open 24×7 so one can start their trek whenever they want.

Furthermore, we shifted our patients in the Autorickshaw and reached Bhanganga (where we have to start our trek) thereafter as per the planning SCIs have started the stretch till the Bhavan by Palki and their attendants or family members along with our team have started the trek on foot. We are almost around 30 people so it was almost impossible to reach the Bhavan at same time. So, as soon as our patients reached the Bhavan we started taking them inside the Bhavan one by one. There was around 15-20 stairs which was a big hurdle for us but somehow with the blessings on Mata we reached inside the Bhavan and that’s how our patients did the Darshan and seek the blessings. It took us whole night to complete the Darshan of all the patients and get back to our hotel.

Second day in Katra

On the second day we reached back to hotel around 10 AM in the morning and everyone was so tired so we decided not to do much and let our patients take rest. In the evening the patients explored the Katra market and that’s how we ended our second day.

Third day in Katra

To take some memories from the trip we took our patients to one of the nearby hill station (PATNITOP) and with all those breathtaking views and abundant memories we reached back to Delhi the next morning and completed our trip. It was a wholesome experience for our team as well as our patients and their family members or attendants.

Conclusion

After completing our trip to Maa Vaishno Devi temple successfully I can surely say that it was not at all easy, indeed we faced a lot of difficulties in between but with the proper planning we completed our trip and the memories are going to stay with all of us for our lifetime.
If we can do it anyone can do it. SCI is never the barrier it’s your mind and the society who forces you to think that you cannot do it. So, never let anyone decide for yourself if you want to travel and explore places post SCI just plan it properly and go for it and set examples for others.

A blog by
-Dr. Virendra Vikram Singh ( PT )

A spinal cord injury is a life-altering event that can significantly impact not just the individual affected but also their entire support network. Among the key players in this network, family members often stand at the forefront, serving as the unwavering pillars of strength, support, and care. Their role is not just to provide assistance but also to provide emotional, physical and psychological support for the well-being and recovery of the individual.

The Immediate Impact after SCI

The moment an individual experiences an SCI, the entire family is impacted. Shock, disbelief, and emotional upheaval often accompany the initial news. In such tough time, family members become the first helping hands, offering comfort, reassurance, and a sense of stability to the survivor. Not only the comfort and reassurance but they also provide a sense of normalcy amidst chaos. In most of the cases family members are not aware of what is SCI and how to deal with it. So, along with being the helping hand for the survivor they also needs to gather knowledge about SCI and it’s complications.

Emotional Support and Encouragement

Emotional well-being plays a very important role in the recovery journey of SCI. Family members often act as emotional anchors, lending a listening ear, providing empathy, and fostering an environment of positivity. Definitely, the positivity is the reason that SCIs regain their health speedily. Additionally, the family members play a crucial role in preventing feelings of isolation and depression that can often accompany after such a life-altering event.

The consistent encouragement and motivation by these constant pillars contribute significantly to the injured individual’s mental resilience. Their unwavering belief in the person’s ability to adapt and overcome challenges becomes a driving force during the recovery process.

Physical Care and Assistance

Other than emotional support, family members also helps SCIs with proper physical assistance. They becomes caregiver for the survivors immediately after their injury. After SCI the survivors lose their mobility depending on their level of injury and therefore require significant physical support. The practical aspects of caregiving post-SCI are multifaceted and demanding. From aiding with daily activities to ensuring accessibility within the home, family members often take on the role of primary caregivers. Tasks like mobility assistance, personal care, helping in daily activities and managing medical needs become integral parts of their daily routine.

Adaptation and Environmental Adjustments

The family’s role extends beyond physical care; they are instrumental in creating an inclusive and supportive environment. Adapting the living space, altering routines, and making adjustments from installing ramps and handrails to rearranging furniture for easier mobility, these adaptations are essential for the injured person’s comfort and independence. This inclusivity not only aids the individual’s physical well-being but also fosters a sense of belonging and normalcy, crucial for mental health.

Learning and support

Families often need to undergo a learning process post-SCI, understanding the intricacies of the injury and how to support the individual in the best possible way. As, the impact and severity of the injury is different for different individuals. Also post-SCI the individuals faces a lot of challenges like immobility, bladder & bowel dysfunction and many more.

Moreover, family members may need to advocate for the injured person, navigating healthcare systems, rehabilitation programs. Their dedication and advocacy often ensure that the individual receives the best possible care and resources for their recovery.

Conclusion

In the journey of recovery after a spinal cord injury, the role of family stands unparalleled. Their unwavering support, dedication, and sacrifices contribute immensely to the individual’s rehabilitation and quality of life. Moreover, the demanding nature of caregiving can be emotionally and physically draining. Thus, respite care and self-care are vital for caregivers as well.

– By Dr. Virendra Vikram Sigh(Physiotherapist)

After Spinal cord injury an individual’s life is significantly altered, making it challenging for them to adjust to the new changes. This can have a profound impact on their mental health, leading to feelings of difficulty adapting and a sense of loss of control. However, there are several positive actions that can be taken to foster a healthy mindset and move forward with life. One of the most effective ways to promote mental well-being is through participation in sports.

Sports can bring sense of positivity and purpose back into an individual’s life, helping them to adapt new circumstances. Additionally, it can provide a source of income for individuals with SCIs, which can be a valuable tool in their recovery. Apart from this participation in sports holds immense transformative potential in enhancing the lives of individuals with SCISs. Here’s how:

• Physical Rehabilitation and Health Benefits
• Improved mobility and functionality
• Reduced secondary health issues
• Social connection and support
• Boost in confidence and self-esteem
• Advocacy and awareness

Numerous Benefits of Sports

1. Physical Benefits

Engaging in adapted sports can significantly enhance the physical fitness of individuals with SCIs, leading to improved strength, endurance, and overall fitness levels. These activities also contribute in better health and vitality.

Moreover, it can improve mobility and functionality by enhancing range of motion, balance, and coordination, resulting in improved mobility and a sense of independence.

Additionally, it can help in minimizing the secondary health complications such as osteoporosis or cardiovascular problems.

2. Psychological and Emotional Benefits

Participating in sports can have a positive impact on psychological well-being and emotional resilience of an individual.

Furthermore, it can boost confidence and self-esteem, leading to a sense of positivity and accomplishment.

Additionally, sports can help reduce stress, anxiety, and depression, which is a significant concern for individuals with SCIs.

3. Improved Social Connection

Involvement in sports programs can also create opportunities for social interaction, friendship, and a sense of belonging within society.

Furthermore, this social connection and support can be particularly important for individuals with SCIs, who may face social isolation and stigma.

4.Advocacy and Awareness

The involvement of SCIs in sports can serve as a platform to advocate for disability rights and accessibility.

Also, by showcasing the capabilities and potential of individuals with disabilities, adapted sports can also help in breaking down stereotypes and promote a more inclusive society.

Adaptive Sports for disabled bodies

Like abled bodies people with disability can also play any sort of games. Some of the games are mentioned below:

• Archery
• Athletics
• Track and field
• Boccia
• Shooting
• Wheelchair Basketball
• Wheelchair cricket
• Wheelchair rugby
• Powerlifting
• swimming

Classification determines who is eligible to compete in a para sport and it groups the eligible athletes in sport classes according to their activity limitation in a certain sport.

Transformative Power of Sports: Key points

Adapted sports play a crucial role in transforming the lives of individuals with SCI by not only improving their physical health but also nurturing their mental and emotional well-being. These sports create a pathway to empowerment, independence, and a fulfilling life beyond the confines of their injury.

-By Dr. Virendra Vikram Singh(PT)

Following a spinal cord injury, Spasticity is a common complication that can impact daily life and overall function. In this article we will discuss spasticity, its underlying causes, challenges and effective strategies for managing and overcoming the condition.

What is Spasticity?

Spasticity refers to the increased muscle tone and involuntary muscle contractions that often accompany spinal cord injury. It is a disruption in muscle movement pattern which is caused due to contraction of many muscles at once (sometimes called co-contraction). Spasticity can also be in the form of jerky muscle movements (spasms) or stiffness.

It is very common in individuals with SCI and gradually depends on the level and impact of injury. Individuals with cervical injury are more likely to have spasticity than individuals with lower level injuries. Spasticity can vary greatly in how it affects someone — it may be as mild as the feeling of tightness of your muscles or may be so severe that it causes painful, uncontrollable stiffness and spasms of your extremities.

Causes of Spasticity

Spinal cord works as a pathway which helps brain to communicate with other parts of the body. Spinal cord helps to send sensory information such as hot , cold, pain, movement, etc. from body to brain and vice-versa. Once the brain receives these sensory signals, it processes the information, and then sends the appropriate signals back down the spinal cord to tell the muscles how to respond.

However, when the spinal cord is injured the communication gets disrupted and due to which sensory information is unable to reach the brain. The lack of proper communication contributes to the hyperexcitability of spinal reflexes, which can results in muscle spasms.

Changes in neurotransmitter levels, particularly a decrease in inhibitory signals, play a role in the development of spasticity. This imbalance contributes to excessive muscle contractions.

The loss of supraspinal (above the spinal cord) control over reflexes results in unregulated muscle activity. The absence of inhibitory signals from the brain contributes to heightened muscle tone.

Challenges and Benefits

There are a lot of challenges or difficulties faces by individuals due to spasticity.

• Spasticity can significantly impact mobility, making it challenging for individuals with SCI to move freely.
• Prolonged stiffness or spasticity can limit the range of motion in your joints. This may lead to joint contractures, which can cause structural changes in the affected joints.
• Sometimes the spasticity can be so severe that it can cause unbearable pain to the individuals.
• Spasticity can make movement so hard which complicate tasks like dressing, grooming, and bathing, making independent self-care more challenging.
• Repeated muscle spasms at night can cause difficulty in sleeping which may impact fatigue and mental health.
• Severe spasm can make individuals fall out of the wheelchair, if not taken care properly.
• Spasms in bladder can lead to leakage of urine which may results in UTI.

However, there are so many many difficulties faced by people with SCI due to spasticity but it has some benefits as well.

• The muscle contractions associated with spasticity can enhance blood circulation, reducing the chances of vascular complications. Improved blood flow contributes to overall cardiovascular health.
• Regular muscle contractions can assist in joint flexibility and reduce the risk of joint immobility.
• Stiffness causes fingers to bend which helps in holding things and grip objects.
• Spasticity can provide a degree of postural support, aiding individuals with SCI in maintaining certain positions.
• It minimizes the risk of pressure sores associated with prolonged immobility.

Strategies for Overcoming Spasticity

There are various ways to overcome spasticity. Though there’s no cure for spasticity, these treatments can help alleviate symptoms and improve quality of life.

1. Physical therapy/ Rehab exercises

Engaging in targeted physical exercises can help manage spasticity. Rehab exercises like weight bearing, prone lying (lying on stomach) help stimulate the nervous system and activate neuroplasticity. Exercising consistently also helps reduce the excitability of hyperactive muscles.

Therapists can design personalized routines to stretch and strengthen muscles, improving overall mobility. It can also help in reducing muscle spasms and getting range of motion over the time.

2. Medications

Muscle spasms can cause severe pain and can be very discomforting at times. There are some medicines which healthcare professionals can prescribe to overcome the pain and discomfort. However, it is advisable to take these medications only when it’s needed and not on regular basis.

For severe spasticity cases, baclofen pumps are used for delivering muscle relaxant directly to the spinal fluid. This targeted approach can effectively reduce spasticity levels.

3. Orthotic Devices

Implementing orthotic devices, such as braces or splints, can aid in supporting joints and controlling spasticity. These devices helps to improve mobility and enhance overall comfort.

Additionally, we can prevent deformities caused by spasticity by using the orthotic devices which helps to maintain range of motion of an individual.

4. Botox Injection and Surgery

Botulinum toxin injections, commonly known as Botox, are a medical treatment option for managing spasticity, particularly in conditions like stroke and spinal cord injury. The injections are injected directly into specific muscles to get temporary relief from spasticity.

Surgical treatment is also a type of treatment for spasticity. Although, we should consider surgical treatments for spasticity only in cases where conservative approaches, such as physical therapy and medications, have not provided sufficient relief.

Additionally, It’s important to note that surgical interventions and Botox treatment for spasticity are typically reserved for cases where other treatments have not been effective, and the decision to undergo surgery should be carefully considered after consulting with consult with a multidisciplinary team of healthcare professionals. The choice of surgery depends on factors such as the underlying cause of spasticity, the severity of symptoms, and the individual’s overall health.

For individuals living with a spinal cord injury (SCI), maintaining proper bowel function
is a crucial aspect of daily life. An SCI can disrupt the natural neurological control of
the bowel and bladder, leading to challenges like constipation and incontinence. However, with
tailored strategies and support, individuals with SCIs can regain control and enhance
their overall quality of life.

Understanding Bowel Dysfunction in SCI

A spinal cord injury alters the communication between the brain and the nerves
below the level of the injury. This disruption often results in neurogenic bowel
dysfunction, where the muscles and nerves responsible for bowel function no longer
operate as they should. This can give rise to a range of bowel management issues that
significantly impact an individual’s daily life.

Common Bowel Dysfunction Issues in SCI

Constipation: One of the most prevalent problems in neurogenic bowel dysfunction is
constipation. The slowed movement of stool through the colon due to weakened or
paralyzed muscles can lead to infrequent, hard-to-pass bowel movements.
Incontinence: Some individuals with SCI may experience loss of sensation and muscle
control in the rectal area, resulting in involuntary bowel movements. This can be
emotionally distressing and may require extra care and management.
Impaction: In severe cases, stool can become impacted in the rectum, causing
discomfort, pain, and further complications. This condition may necessitate more
intensive interventions to resolve.

Risk Factors and Severity

The extent of bowel dysfunction in SCI can vary widely depending on factors such as
the level and severity of the injury, as well as the individual’s overall health. Those with injuries higher up on the spinal cord (closer to the head) typically experience more pronounced bowel dysfunction, as the nerves controlling bowel function originate higher up in the spinal cord.

Management and Treatment

Diet and Hydration: A balanced diet rich in fiber, along with sufficient water intake, is
crucial in managing bowel dysfunction. Fiber helps regulate bowel movements, while
staying hydrated softens stool, making it easier to pass.
Scheduled Bowel Care: Establishing a regular bowel care routine can help train the
body to have predictable bowel movements. This often involves techniques like digital
stimulation, suppositories, or enemas.
Medications and Supplements: Depending on the specific needs of the individual,
healthcare providers may recommend medications or supplements to regulate bowel
function.
Adaptive Equipment: Specialized tools and equipment, like bidets or assistive devices,
can assist with bowel management and improve comfort and hygiene.
Physical Activity: Engaging in regular, safe physical activity within one’s abilities can
help maintain overall health and support bowel regularity.
Consultation with Healthcare Providers: Working closely with healthcare
professionals, including specialists in SCI care and dietitians, is essential. They can
provide personalized guidance and address any complications or concerns.

Bowel dysfunction is a common and significant aspect of life for individuals with SCI.
However, with proper care, management, and support, it’s possible to mitigate its
impact and lead a fulfilling life.

By Virendra Vikram Singh(PT)

Spinal cord injury patients are at a higher risk for developing bed sores, also known as pressure ulcers or pressure sores, due to decreased mobility, sensation, and blood flow. The main cause of bed sores in SCI patients is prolonged pressure on the skin and soft tissues, which leads to tissue damage and skin breakdown. Here are some specific causes of bed sores in SCI patients:

Immobility: Individuals with SCI often have limited mobility, which can cause pressure on specific areas of the body and increase the risk of developing bed sores. This is especially true for those who are unable to shift their weight or change positions independently.

Lack of sensation: SCI patients may have decreased or absent sensation in certain areas of the body, making it difficult to detect early signs of skin breakdown. This can lead to delayed treatment and increased risk of developing bed sores.

Incontinence: SCI patients may experience bowel or bladder incontinence, which can lead to skin irritation, maceration, and increased risk of developing bed sores.

Shearing forces: SCI patients who are repositioned or moved frequently may experience shearing forces on the skin, which can lead to tissue damage and increased risk of developing bed sores.

Poor nutrition: SCI patients may have difficulty maintaining a healthy diet, which can lead to malnutrition and weakened skin, increasing the risk of developing bed sores.

Certain medical conditions: SCI patients with certain medical conditions, such as diabetes or circulatory problems, may be at higher risk of developing bed sores due to impaired blood flow to the skin and soft tissues.

Stages of Bed sores

In individuals with SCI, pressure sores often occur in areas where there is prolonged pressure, such as the sacrum, buttocks, and heels. It is important to catch pressure sores in the early stages to prevent progression to more severe stages. There are four stages of pressure sores, each with increasing severity:

Stage 1: This is the mildest stage of pressure sores, where the skin may appear red, but it is not broken. The affected area may feel warm or spongy to the touch, and the person may experience itching or pain.

Stage 2: In this stage, the skin is broken and there may be a shallow open wound or blister. The area around the sore may be red and inflamed, and there may be some drainage or pus.

Stage 3: At this stage, the sore has extended through the skin and into the underlying tissues, such as muscle or fat. The wound may be deeper and appear as a crater-like hole, and there may be signs of infection such as redness, warmth, and pus.

Stage 4: This is the most severe stage of pressure sores, where the wound has become very deep, extending into the muscle, bone, or joint. There may be necrosis or dead tissue, and the wound may have a foul odor. Infection is very likely at this stage, and there is a risk of complications such as sepsis.

Prevention of Bed Sores

Preventing bed sores is very important for individuals with spinal cord injury, as it has a great impact on the patient’s rehabilitation and also they are painful and may increase the risk of infection, which can be especially dangerous for individuals with spinal cord injuries.Here are some specific prevention strategies for SCI patients:

Regular repositioning: SCI patients should be repositioned at least every two hours to relieve pressure on the skin. This can be done manually by a caregiver or with the help of specialized equipment, such as a tilt table or turning frame.

Pressure relief devices: There are various pressure relief devices that can be used to help prevent bed sores in SCI patients, such as cushions, mattresses, and overlays. These devices work by distributing pressure over a larger surface area and reducing the risk of skin breakdown.

Skin care: Keeping the skin clean and dry is important for preventing bed sores. SCI patients should be washed with mild soap and water, and moisturizers can be used to keep the skin hydrated. Any areas of redness or irritation should be addressed promptly.

Nutrition: A healthy diet with adequate protein intake is important for promoting skin health and preventing bed sores. SCI patients may also benefit from nutritional supplements, such as vitamins and minerals.

Exercise: Regular exercise can help improve circulation and prevent bed sores. SCI patients should work with a physical therapist to develop an exercise program that is safe and appropriate for their level of injury.

Manage moisture: Excessive moisture on the skin can increase the risk of developing bed sores. Incontinence should be managed promptly, and moisture-wicking fabrics can be used to keep the skin dry.

Regular skin checks: SCI patients and caregivers should regularly check the skin for any signs of redness, irritation, or pressure sores. Early detection and treatment can prevent bed sores from developing or worsening.

So, it is very important to seek medical advice as soon as possible to prevent progression of bed sores to more severe stages, which can result in complications such as infection and sepsis.

By Virendra Vikram Singh(PT)

After spinal cord injury due to severe nerves damage the bladder and bowel movement got impacted. Before SCI a message sent from the brain travelling along the spinal cord and sacral nerves to allow the bladder to get empty. But after spinal cord injury sometimes the communication between the brain and the nerves in the spinal cord that control bladder and bowel function got interrupted. This can cause bladder and bowel dysfunction known as neurogenic bladder or neurogenic bowel.

So some of the ways of Bladder management after SCI are mentioned below:

Intermittent Catheterization

It is one of the ways to empty the bladder without keeping the catheter in the bladder all the time. In this a catheter is inserted into the bladder to drain out the urine from the bladder. The urine is drained out from the other end of the catheter. Remove the catheter once done and you are good to go for your normal activities. It is usually done 4-6 times a day to avoid leakage. It is advised to drain out the urine after every four hours so that catheterization volumes less than 500 ml. So you may have to catheterize often depending on how much you drink.

Indwelling Catheterization

Indwelling catheterization uses a catheter and a urine collection bag that stays in place all the time. The catheter has a balloon at the tip of the catheter which sits in your bladder. Once the catheter is in your bladder, the balloon can be inflated to keep the catheter from falling out or deflating when it’s time to change the catheter.

There are two types of indwelling catheters: urethral catheters and suprapubic catheters. Most urethral catheters that are kept in place by filling up a balloon. People might call your indwelling catheter a Foley’s catheter.

Reflex Voiding 

This technique works best for male patients but it can be used in female patients. For males, try to train the bladder to urinate just by reflex so when the bladder reaches a certain set point it causes the bladder muscles to contract and squeezes the urine out. For male patients, the urine can be captured by applying a condom to the penis which is then collected to a drainage bag. This is a method that has a less chance of developing infection and it is sometimes less labor intensive for the patient and caregiver because care is just application of a new condom every day, the condom is removed and the penis is cleaned and allow to dry for about 20 minutes before the next condom is applied then it is connected to the leg bag or bed  bag and the only care during the day is that the bags  have to be emptied when they get to a certain level of fullness.

Urinary Tract Infections

But proper bladder management is a must for a SCI patient because as we discussed above spinal cord injury can affect the ability to control the bladder, leading to an increased risk of urinary tract infections (UTIs). UTIs are common in people with SCI, and can cause many symptoms such as frequent urination, pain or discomfort during urination, and fever. These symptoms can mild or severe depending upon the impact of infection.

In individuals with SCI, UTIs can occur more frequently and may lead to more serious complications such as kidney damage and sepsis if it is not treated well.in people with SCI, the infection can be more serious and harder to treat than in general population. This is because the spinal cord injury can interfere with the body’s immune system, making it harder to fight infections.

Preventing UTIs in people with spinal cord injury involves maintaining good hygiene practices, such as washing the genital area daily and cleaning the catheter insertion site regularly. It is also important to ensure that catheters are changed regularly and that the bladder is fully emptied during each catheterization.

If a UTI is suspected, it is important to seek medical attention promptly. Treatment typically involves antibiotics to clear the infection, as well as measures to manage any associated symptoms. In severe cases, hospitalization may be necessary.

By Virendra Vikram Singh(PT)

It is a big-big challenge for people to start their life again after a Spinal cord injury because shifting from an able to a completely or partially disable person is a life-long process and it takes a lot of courage as well as adjustments. A person’s life and lifestyle is completely changed after SCI. Their independency, their worth everything is on stake andwhichgives rise to negative thoughts and further causes psychologicaldistress.

Depression and anxiety are very normal reactions to the physical changes as well as to the day-to-day consequences of the injury and subsequent disability. Sometimes the case may worsen and people need to consult psychiatrist and start medications as well. Moreover, the mental health becomes a major issue when it starts limiting the person from taking part in their physical therapy and moving on with life. Without proper management this can hinder one’s ability to pursue rehabilitation and negatively impact recovery outcomes.

The factors that affect the mental health are mentioned below.

Chronic Pain

Chronic pain is basically the pain that lasts 3 months or longer and hence causes changes in the spinal cord injury and how the brain perceives the pain. Chronic pain can affect the entire central nervous system resulting in severe pain that is hard to treat. It can be debilitating and problematic that is often accompanied by depression and psychological issues.

There is not always a known cause of chronic pain, whereas other times the pain is lingering symptom of an injury or accident.

Impaired Mobility

It is one of the major causes of depression among SCI patients. Impaired mobility is a state in which the individual experiences the limitation of physical movement. After the spinal cord injury due to this impaired mobility people are unable or may not be able to perform or participate in their favorite activities, atleast in initial phases and this leads to negativity in the thoughts of the individual.

Medications

There are so many complications related to SCI which includes chronic pain, respiratory infection, urine infection (UTI), spasticity, depression and so on.  So to conquer these complications and get going with the rehabilitation in a proper way SCI patients are advised to start medications. These strong medicines affect the function of the brain very badly.

Lack of Independence

SCI usually causes severe locomotion disability due to paralysis of muscles. Depending of the level and impact of injury a person with SCI can completely be independent or need full assistance in their daily living activities and rehabilitation.

Other consequences of SCI, such as sensory, spasticity, chronic pain, neurogenic bladder, etc. also influence the degree of disability and reduce functional dependency.

Having to rely on someone else more often for your daily living needs can hinder one’s mental health vigorously and in some cases it may also leads to suicidal tendency.

Physical Inactivity

It is said that physical activity is god for the mind and the body. Engaging in a moderate amount of physical activity will result in instant upliftment of mood and emotional states. There are a lot of said benefits of exercises and physical activities which are.

• Improved mood
• Good and improved self-esteem
• Reduced symptoms of depression and anxiety
• Reduced stress level and improved ability to cope up with stress level.
• Increased feeling of positive energy

But due to the disability SCI patients are unable to take part in physical activities more often and hence their mental health is impacted negatively.

Poor Diet

Poor diet can contribute to many health problems including depression and anxiety. It is said the resourcesthat the chemicals present in food can instantly promote the feeling of a person. So in order to maintain a good mental health, a good diet is very important.

Neurons are the major cells of the brain which is affected by the food a person eats. An unhealthy diet, that is rich in fats and sugars causes inflammation of neurons and inhibits the formation of new neurons. This can affect the way the brain works and contribute to brain disorders like depression.

Poor diet and the low frequency of meals can also leads to fatigue an tiredness which further affects performance and mood of an individual.

Poor Sleep Quality

The whole life and life style of a person changes after SCI .Like all the other things the sleep schedule is also impacted very badly which results in poor sleep quality.Everything needs to be re-functioned and the person who is dealing with SCI has to start from the scratch.

The other complications related to SCI as discussed above are one of the major factors of disrupted sleep. Lack of sleep is associated with low energy levels, increased irritability, and reduced alertness.

Isolation

In the initial phase of the injury people are afraid to go out and live their life as earlier. And in some cases out of embarrassments people do not want go out and hang with their friends and relatives and get comfortable around their own space, which results in loneliness and isolation and triggers the mental health.

Financial problem

Some individuals with SCI may not have a good financial background or might lost their job due to their motor impairments and hence to bear the cost of proper rehabilitation and treatment of SCI is a big issue for them.

The instability in financial condition increases the stress level and causes anxiety issues.

 How to deal with these psychological effects?

So with proper management these psychological effects can be handled very well and it is very-very important to take good care of a person’s mental -health who is dealing with SCI. Spinal cord injury recovery is both a physiological and psychological challenge. While damage to the spinal cord does not directly affect psychological states, the resulting motor and sensory impairments can contribute to changes in mental health.

Failure to address the psychological effects of spinal cord injury can interfere with rehabilitation efforts and slow down recovery. Psychological management interventions generally focus on improving one’s perceived sense of control and purpose, as well as promoting a positive mindset.

We hope that this article helped you to get an idea about how SCI can affect one’s mental health. And incase if you are dealing with any of the symptoms of these psychological distress mentioned in the article then immediately consult with a mental health advisor and get help from them.

Dr. Virendra Vikram Singh(PT)

Founder & Director

KUSUM SPINE & NEURO REHABILITATION

Phone/Whats App +91-98916-66133