Patient education: Paraplegia and quadriplegia (The Basics)

What are paraplegia and quadriplegia? — 

These are when a person has paralysis of their limbs. Paralysis means being unable to move that part of the body.

●Paraplegia – This is when a person can't move their legs, but can move their arms.

●Quadriplegia – This is when a person can't move both their arms and legs.

"Quadriparesis" and "paraparesis" are when a person has some weakness of the legs, arms, or both, but not complete paralysis.

The most common cause of paraplegia and quadriplegia is an injury to the spinal cord. The spinal cord is the bundle of nerves that runs down a person's back (figure 1).

Other problems that affect the brain or nerves can also lead to paraplegia and quadriplegia in some cases. Examples include Guillain-Barré syndrome, multiple sclerosis, polio, and stroke.

What other symptoms can happen with paraplegia and quadriplegia? — 

Besides being unable to move part of their body, you might also have:

●No feeling in your arms or legs

●No control over your bladder or bowels

●Sex problems – For example, in males, these can include trouble getting an erection or ejaculating.

●Trouble breathing – This can happen only with quadriplegia.

Will I need tests? — 

Yes. You will have tests to see what's causing your condition and how serious it is. Different tests can include:

●Imaging tests, such as a CT or MRI scan – These create pictures of the inside of the body.

●Nerve tests to check if they are working normally

●Lumbar puncture (sometimes called a "spinal tap") – A doctor puts a thin needle into the lower back and removes a small amount of spinal fluid. Then, they check the fluid for infection or inflammation. This can be useful if imaging tests do not show what caused the paraplegia or quadriplegia.

●Blood tests to look for inflammation or infection

How are paraplegia and quadriplegia treated? — 

Treatment involves immediate treatment right after the symptoms start, as well as long-term treatment.

Right after a spinal cord injury, you will be treated in the hospital. There, doctors can monitor you and treat any medical problems. For instance, people who are having a very hard time breathing usually need a breathing tube. This is a tube that goes down the throat and into the lungs. The other end is attached to a machine that helps with breathing.

Some people with a spinal cord injury are treated with:

●Steroid medicines – These can help reduce swelling in the spinal cord and nerves.

●Surgery to fix the back bones (vertebrae), if they got pushed out of position

People with Guillain-Barré syndrome or multiple sclerosis will be treated for those conditions.

As you recover from your injury or illness, you might get "rehabilitation" ("rehab"). In rehab, doctors, nurses, and other health professionals will teach you how to be as independent as possible and stay as healthy as possible. This includes learning how to:

●Use a wheelchair

●Manage your bladder and bowels, if you cannot control them

●Exercise, so you can regain as much movement in your arms or legs as possible

●Cope with feelings of sadness or anger

A big part of long-term treatment is helping prevent problems that commonly happen in people with paraplegia or quadriplegia. These include:

●Urinary tract infections and kidney problems

●Pressure sores – These are areas of skin damage caused by pressure.

●Lung infections and breathing problems

●Osteoporosis – This is a disease that makes bones weak.

●Muscle and joint stiffness

●Pain

●Depression

Your doctor or nurse will show you how to prevent and manage these problems.

What will my life be like? — 

Most people with paraplegia or quadriplegia lead a full life. Many can work, drive, have serious relationships, and have children. Some people regain some movement or feeling in their arms or legs.

Many people worry about whether they can have sex. Problems with sex are common, but there are medicines and devices that can often help.

If you are struggling with depression or anxiety, tell your doctor or nurse. There are treatments that can help.

More on this topic

Patient education: Neck fracture (The Basics)
Patient education: Guillain-Barré syndrome (The Basics)
Patient education: Multiple sclerosis in adults (The Basics)
Patient education: Multiple sclerosis in children (The Basics)
Patient education: Stroke (The Basics)
Patient education: Autonomic dysreflexia (The Basics)
Patient education: How to use a catheter to empty the bladder in males (The Basics)
Patient education: How to use a catheter to empty the bladder in females (The Basics)
Patient education: Sex problems in males (The Basics)
Patient education: Sex problems in females (The Basics)
Patient education: Depression in adults (The Basics)
Patient education: Depression in children and teens (The Basics)

Patient education: Stroke symptoms and diagnosis (Beyond the Basics)
Patient education: Sexual problems in males (Beyond the Basics)
Patient education: Sexual problems in females (Beyond the Basics)
Patient education: Depression in adults (Beyond the Basics)
Patient education: Depression in children and adolescents (Beyond the Basics)