Written by Simrin Pardal
The spinal cord contains a bundle of nerves and nerves fibers which send and receive signals from the brain. The spinal cord starts at the bottom of the brainstem, traveling down the vertebral column and ending in the lower back region.
Damage to the spinal cord, or a Spinal Cord Injury (SCI), can cause temporary and/or permanent changes in sensation, movement, strength, and body functions. These changes are typically observed below the point of the injury to the cord. The symptoms of SCIs are dependent on the location on the injury and the amount of damage to the cord.
SCIs can be complete or incomplete. In a complete injury, there is no nerve communication below the site of injury. This results in loss of function, sensation, and movement below the injury.
In an incomplete injury, the spinal cord still has the ability to send and receive some messages to and from the brain. This means that it is possible for individuals with incomplete injuries to have some function, sensation, and/or movement below the injury.
Common symptoms of SCIs are paralysis, numbness, tingling, changes in sensation, pain, weakness, awkward positioning involving the spine or head, loss of bowel and bladder control, breathing difficulties, challenges with walking, and changes in sexual functions.1
When a SCI occurs in the upper parts of the spinal cord (above T1), the main resulting symptom is tetraplegia or quadriplegia, meaning the individual loses motor and sensory function in all four limbs. When the SCI occurs in the lower parts of the spinal cord (T1 and below), a common resulting symptom is paraplegia, which is a loss of motor and sensory function in the lower limbs.
SCIs can be traumatic and life changing. Navigating the changes in your body and ability to perform activities following the injury can be frustrating.
Occupational Therapists can assist with regaining skills to perform activities of daily living following an SCI or with coming up with strategies to perform those activities in a modified way.
Depending on the SCI, an individual may need braces, mobility devices, and computer adaptations or assisted technology, to perform activities in everyday life.
For example, Matthew, a 32-year-old construction site worker, sustained a T8 complete SCI from a motorcycle accident. Following the injury, he now experiences paraplegia, loss of independence with completing self-care activities, an inability to work, emotional distress, and financial concerns relating to his ability to provide for his family.
Once Matthew was discharged from the hospital and in-patient rehabilitation center, he had an Occupational Therapist visit him at his home. The OT sessions were covered through Matthew’s auto insurer.
The Occupational Therapist completed supporting documentation to allow Matthew to receive attendant care benefits, which would mean Matthew would receive a Personal Support Worker to assist with completing self-care activities. The Occupational Therapist was able to provide recommendations and strategies on how to complete these activities as independently as possible using adaptive equipment.
During the therapy sessions, the Occupational Therapist provided Matthew with education and training on safe use of his wheelchair at home and in the community, on safe transfers, devices to help with showering and dressing, and strategies to reduce the risk of developing pressure sores.
In later sessions, the OT discussed potential return-to-work strategies with Matthew, who had an office job, and met with his employer to create a return-to-work plan for Matthew with accommodations in place.
Matthew was able to gradually return to work with an adjusted schedule, an ergonomically adjusted sitting arrangement, and assistive devices at the workplace for limited hand and arm movement.
Some of the future goals for Matthew relate to home adaptation and accessibility, a return to driving, and providing a Future Care Costs report to quantify his needs for the future and provide him with a guide for future services, as he ages with a disability.
At GLA Rehab, our Occupational Therapists can assist with assessing and determining short-term and long-term goals to support clients and their families.
References
National Institutes of Health (NIH). (2025, April 7). Spinal Cord Injury. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/spinal-cord-injury