Paraplegia | Paraplegic: Definition, Causes, Symptoms and Treatment
Paraplegia, sometimes called partial paralysis, is a form of paralysis in which
function is substantially impeded from the waist down. Also known as Paraplegic.
Paraplegia, sometimes called partial paralysis, is a form of paralysis in which function is substantially impeded from the waist down. Most people with paraplegia have perfectly healthy legs. Instead, the problem resides in either the brain or the spinal cord, which cannot send or receive signals to the lower body due to an injury or disease.
Like other forms of paralysis, paraplegia substantially varies from one person to another. While the stereotype of a paraplegic is of someone in a wheelchair who cannot move his or her arms or legs, cannot feel anything below the waist, and cannot walk, paraplegics actually have a range of capabilities that may change over time, both as their health evolves and their physical therapy helps them learn to work around their injuries.
Paraplegia is almost always the result of damage to the brain, spinal cord, or both. In most cases, spinal cord injuries to the thoracic, lumbar, or sacral spinal cord are to blame. When these injuries occur, signals cannot travel to and from the lower regions of the body, and the body is prevented from sending signals back up the spinal cord to the brain.
Thus paraplegics not only struggle with movement below the waist; they also experience extensive loss of sensation. This sensation loss varies from a feeling of tingling or reduced feeling in the waist and legs, to a complete inability to feel anything below the waist.
Some injuries produce temporary paralysis in one or both legs. Even a broken leg can look like paraplegia in the right circumstances, as can the aftermath of a seizure, allergic reaction, and some surgical compilations. Consequently, doctors should not be quick to diagnose paraplegia immediately after an injury. Instead, it can take anywhere from a few hours to several days to diagnose this condition. Your doctor will need to look at your brain and/or spinal cord to see if there are damaged nerves or tissue that impede the ability of signals to travel to and from the legs. Those tests might include:
There may be occasions where paraplegia doesn’t fully affect both legs. For example, one leg may be fully paralyzed, while the other has limited or even normal function. This is sometimes known as “incomplete paraplegia,” and can be the result of many different conditions.
In some cases, a case of complete paraplegia may evolve into a case of partial paraplegia following rehabilitation therapy and other treatments for paraplegia. On the other hand, a degenerative condition may cause a case of incomplete paraplegia to become complete paraplegia as symptoms progress.
The primary difference between complete and incomplete paraplegia is whether the paraplegic retains some (or most) of their functionality in either leg. Where a complete paraplegic might not have any functionality or sensation in both legs, a case of incomplete paraplegia may leave the paraplegic with some sensation or motor control.
When some functionality remains in either leg, it may also be referred to as paraparesis, though there is some debate as to whether it should be referred to as such.
The overwhelming majority of paraplegics have perfectly healthy legs. The problem instead resides in the brain or spinal cord. The spinal cord is akin to the body's relay system, sending signals down into the body from the brain and relaying signals from the body to the brain. The brain processes and makes sense of these signals, before sending important information about how to react and feel down the spinal cord and back to the body.
When either the brain or spinal cord don't work properly, these signals may be weak or nonexistent. Consequently, spinal cord injuries (SCIs)—which affect more than 200,000 Americans, with more than 2,500 new cases each year—are the leading cause of paralysis, including paraplegia. According to data from the National Spinal Cord Injury Statistical Center (NSCISC), the leading causes of spinal cord injuries include:
Most spinal cord and brain injuries are traumatic in nature, which means they result from a sudden blow to the area, usually due to an accident. Some injuries, though, are non-traumatic, and usually attributable to diseases or genetic anomalies. A few other causes of paraplegia include:
Most SCIs that result in paraplegia occur in the thoracic, sacral, or lumbar sections of the spinal cord—not in the cervical spinal cord, which is closer to the neck. This is because a C6 spinal cord injury or higher is likely to affect more of the body than just the legs. Instead, this type of spinal injury is more likely to result in full-body paralysis, hemiplegia, or hemiparesis.
Paraplegia recovery can be a long and difficult process as paraplegics learn to cope with their paraplegia symptoms. There are numerous steps to recovering from paraplegia—steps that may change depending on the cause and severity of the condition.
Some basic steps to paraplegia recovery include:
As noted earlier, some (or all) of these steps may change. For any paraplegia recovery plan, it’s important to consult a qualified physician before starting any treatment regimen.
Paraplegia is a variable condition. The same person might experience symptoms that change over time, or that even alter from day to day. Proper treatment can greatly affect the prognosis and progression of the disease, but many outcomes appear random. There's much we do not yet understand about the brain and spinal cord, so doctors aren't yet sure why some people spontaneously recover while others languish without progress even with intense treatment.
In some cases, symptoms improve as swelling in the injured area dissipates. Treatment of infection and disease-related processes may also reduce or reverse symptoms, or slow the progression of paraplegia. Thus the best source for information on how paraplegia might affect your life is your doctor. Know, however, that even the best doctors cannot be certain about the prognosis, and you should not allow even a grim prognosis to undermine your motivation to keep working toward recovery.
Some of the most common effects of paraplegia include:
Every patient is different, and treatment that works well for you might not work for another person. Generally speaking, intensive treatment gives you the best chance at recovery, particularly when you begin receiving treatment immediately after the injury. Spinal Cord Injury Model Systems offer comprehensive and highly rated treatment, so if such a facility is near you, consider moving your recovery to that location.
Some treatment options include:
Physical therapy can prove to be an excellent tool for helping paraplegics improve their health and even help alleviate some paraplegia symptoms. Some paraplegia exercises that paraplegics can benefit from include:
Some facilities specialize in providing spinal cord injury rehabilitation to help people who are paralyzed from the waist down lead active and healthy lives. These spinal cord injury rehabilitation centers are scattered throughout the country, so SCI survivors may need to ask their physician or a local SCI advocacy group to find a facility near them.
One example of a spinal cord injury rehabilitation center could be an activity-based therapy center. These facilities focus on providing therapeutic activities and exercises to help members of the SCI community improve their health and body function. You can find a map of activity-based therapy centers here.
People who live with paraplegia resulting from a spinal injury or spinal nerve damage frequently need assistance in adjusting to life after an SCI. Finding and joining SCI community groups can help paraplegics by providing more than just resources and advice—they also provide an outlet for talking about whatever challenges or issues that SCI survivors and their loved ones have to deal with.
SCI community resources can be found online through social media platforms like Facebook or Twitter, by asking physical therapy specialists, or by looking at lists of SCI support groups like this one.
