Spinal cord injury affects around 2,500 people every year in the UK. The severity and long term impact of a spinal cord injury varies, but for the majority, it will be the beginning of a long and challenging journey of rehabilitation. 

Whilst damage to the spinal cord is usually permanent, there are recovery signs that can emerge over time In this article, we will explore the various signs of recovery from spinal cord injury.

Initial Period Immediately Following Injury

When the spinal cord is injured it can go into a state of ‘shock’ which can cause signals sent to and from the brain to be disrupted, resulting in a loss of sensation and movement below the level of injury.. This can be an incredibly frightening time, filled with uncertainty. It's important to recognise that this initial paralysis may be a temporary consequence of spinal shock. As the swelling subsides, which can occur over days or weeks, sensation, muscle control and some bodily functions may begin to return.

Medical teams in this acute phase will monitor any changes to movement or feeling, no matter how slight, as these can be the first promising signs of recovery. 

During this time, it's vital for both the individual and their loved ones to understand that patience is key. The body's healing timetable is not always predictable, and comparing one's progress to others can be counterproductive. It’s also important to remember that if the spinal cord is damaged beyond the initial shock, then paralysis is likely to be permanent to some extent. Celebrating the return of every bit of movement or sensation is important, as it helps maintain a positive mental attitude, a crucial component for successful rehabilitation.

Sensation and Movement Below Level of Injury

Changes in movement or sensation below the level of injury can be subtle and gradual, but they can be significant. The sensation may start as a tingling or a change in temperature perception, indicating that the nerves are beginning to communicate with the brain once more.

Movement can start with the merest wiggle of a toe or finger, but these actions can be momentous. The return of voluntary movements might not follow a linear path and can vary greatly from person to person, often influenced by the nature and severity of the injury. It’s also important to remember that involuntary movements below the level of injury are a common side effect of spinal cord injury and can be misinterpreted as a sign of recovery. 

For individuals with an incomplete spinal cord injury, where some signals are still able to pass through the spinal cord, there is a greater likelihood of regaining some degree of sensation and movement. In these cases, the nerve signals and neural pathways may be intact, allowing for the possibility of recovery through rehabilitation and the natural healing process.

It’s important to note that every instance of returned sensation or movement brings with it a need for reassessment and often, adjustment of rehabilitation goals and methods. A multidisciplinary team will tailor their approach to support and enhance these emerging improvements to motor function, fostering further recovery where possible.

How Does Rehabilitation Aid Recovery

Rehabilitation plays a pivotal role in the recovery process following a spinal cord injury. It is the cornerstone of efforts to maximise the return of function and enhance the quality of life of the person with a spinal injury. Physiotherapy, a key component of rehabilitation, is tailored to each person’s specific needs and circumstances. It seeks to maximise the physical potential and to regain as much independence as possible.

The rehabilitation journey often begins with acute therapy, focusing on stabilising the individual’s medical condition and preventing secondary complications. As progress is made, the goals of rehabilitation evolve, moving towards more active and intensive forms of physical therapy. This includes exercises to strengthen muscles, improve coordination and increase flexibility. Therapists also work on functional tasks, where possible, such as transferring from a bed to a wheelchair, and eventually, standing and walking if recovery allows.

Occupational therapy, another integral part of the rehabilitation process, helps individuals relearn daily activities, like dressing, cooking and driving, with or without adaptive devices. This therapy is crucial for fostering independence and self-sufficiency, often vital for psychological wellbeing.

For those with spinal cord injury, rehabilitation is more than just physical recovery; it encompasses psychological support to help individuals adapt to changes in their bodies and lifestyles. Support from psychologists and peer mentors can be instrumental in navigating the emotional aspects of recovery. More information about organisations that provide support to people affected by spinal cord injury can be found here. 

Furthermore, rehabilitation for spinal cord injury may include emerging technologies such as robotic-assisted walking devices and electrical stimulation therapies. These innovative approaches can sometimes lead to breakthroughs in recovery of movement or sensation following spinal cord injury.

The overarching aim of rehabilitation is to ensure that those affected by spinal cord injury can lead fulfilling lives. With a dedicated multidisciplinary team, the rehabilitation pathway can open doors to new opportunities, paving the way for long-term improvements and a return to a life lived similarly to that prior to injury.

Long-term Improvements – What Can Be Done to Help?

The pathway towards recovery from a spinal cord injury is often a marathon, not a sprint,. Over time, with consistent and dedicated effort, many individuals experience significant gains in their independence and quality of life. These improvements may continue for years after the initial injury, facilitated by ongoing rehabilitation and support.

Technological advancements have opened up new avenues for assistance and improvement. Assistive devices, ranging from voice-activated home systems to sophisticated wheelchairs, offer greater independence. Moreover, ongoing research into neural repair and regeneration holds promise for future treatments that could potentially restore function to those with spinal cord injuries.

Chronic pain is a common challenge for those with spinal cord injuries and managing it effectively can lead to better overall functioning and participation in daily activities. Pain management strategies might include medication, physical therapy and complementary therapies such as acupuncture or mindfulness meditation. At the heart of efforts towards long-term improvement after a spinal cord injury is the concept of neuroplasticity, the nervous system's ability to reorganise itself by forming new neural connections. Rehabilitation activities are designed to harness this ability, encouraging the body to adapt to changes brought on by the injury. As understanding of the nervous system deepens, the potential for developing new recovery techniques grows.

It's essential to maintain a holistic approach to recovery, one that includes not only physical and medical interventions but also social and emotional support. Community groups, peer networks and counselling services play a critical role in supporting the mental health and wellbeing of those affected by spinal cord injury.