Body Inflammation with Spinal Cord Injury

Posted by Nurse Linda in Life After Paralysis on May 05, 2020 # Health

When you get a cut on your finger, you can see the area become red and perhaps even swollen. The area might feel warm to the touch and painful due to the extra fluid volume. This inflammation is a natural response to a disruption in the skin. It is the way the body attempts to heal itself, by bringing extra blood flow and fluid to protect the disruption in the skin. Temporary injuries are called short term inflammation as they last only a few days. They may or may not require treatment. Medication with nonsteroidal anti-inflammatory drugs (NSAIDS) may help discomfort but as always check with a healthcare professional to make sure the treatment does not interfere with your current medications or personal health.

If you have or have seen someone with arthritis, you see the same inflammation process within the body such as swelling, perhaps redness and warmth over the area of the affected joint. Pain is typically present with arthritis. This type of inflammation that occurs within the body is usually caused by a disease process. Longer lasting episodes of inflammation is called chronic inflammation. This can last months, years or a lifetime.

The body will respond to any injury as above. A disruption inside the body can induce the inflammation process. The disruption might not be visible from the outside of the body. You might not even know it is there. Inflammation can be widespread depending on the source of the problem. Some body diseases can start internal inflammation.Spinal cords

A small number of examples of diseases that cause chronic internal body inflammation are:

  • Allergies
  • Arthritis and other joint diseases
  • Cancer
  • Cardiovascular disease (CVD)
  • Chronic obstructive pulmonary disease (COPD)
  • COVID-19
  • Diabetes
  • Inflammatory bowel disease
  • Lupus
  • Lyme disease
  • Neurological disease, including spinal cord injury
  • Obesity
  • Psoriasis
  • Rheumatoid arthritis

Chronic inflammation can be started by diseases but can also cause diseases. Diseases affect your body by increasing your risk of some autoimmune disorders much as those listed above. Also, chronic inflammation can increase stress, making decisions more difficult, affect your gut health, produce heart disease, asthma, COPD, periodontal disease, increase fat and insulin resistance and other auto immune disorders.

We all know an infection can lead to inflammation, but diseases can trigger an autoimmune response within the body. This is because even internally, the body will respond to a change such as infection or tissue damage. It is the same process as with the cut on the skin. Changes within the body due to disease, will result in the body’s normal process by sending fluid and white blood cells to the affected area. The blood vessels must enlarge to accommodate the extra fluid which results in inflammation. However, if the disease remains, so does the inflammation. Continual internal body inflammation becomes chronic.

Of interest to most reading this blog will be the issue of inflammation and spinal cord injury. At the time of illness or injury, the inflammation process takes over by cushioning to try to correct the area where the spinal cord is affected. This is a normal body response to injury. However, the extra fluid volume is going to a place in the spine which is contained in the rigid structure of the boney vertebrae. There is no extra room for the fluid. The body will not stop sending the fluid because of the natural response. Therefore, the pressure of the fluid will push on the soft spinal cord, diminishing the blood supply within the cord. The same process happens with a brain injury where fluid is rushed to the brain, but the hard skull container will not expand. Therefore, the soft brain will be squeezed to hold the extra fluid.

As time passes, the body continues to provide extra fluid to the damaged area of the spinal cord, brain or both as it attempts to correct any injury. This then becomes chronic inflammation. Medications such as diuretics and steroids might be used to reduce acute inflammation depending on the specifics of the acute neurological injury. Control of chronic inflammation is much more difficult as the body has now adapted to a new way of functioning.

Physical symptoms of chronic inflammation can be difficult to pinpoint as they are rather vague and symptoms of other issues. Individuals with chronic inflammation have some or all these symptoms:

  • Feelings of aches and pains
  • Fatigue-more than just being tired for a day.
  • Obesity or weight gain
  • Red or itchy skin
  • Autoimmune disease
  • Allergies or infection(s)
  • Depression or anxiety
  • Gastrointestinal issues-diarrhea, constipation, acid reflux

If you are concerned about chronic inflammation, talk with your healthcare provider. A blood test is a good start to assessment. Elevated biomarkers in the blood will determine your level of inflammation. Some inflammation does not require treatment. Get treatment for the specific disease or diseases that are the source of your chronic inflammation or if you have an acute infection.

Follow a Mediterranean style diet which includes fresh foods and healthy oils. Changing your diet will not eliminate inflammation but it may help or decrease progression. Foods that are thought to improve inflammation include olive oil, high fiber, nuts especially almonds and walnuts, leafy green vegetables, tomatoes, fatty fish and fruit. Foods to avoid are foods heavy with sugar, fried foods, saturated and trans fats, processed foods, and red meat.

Practice good sleep hygiene. Set a regular time for going to sleep and waking. Maintain consistency in this regardless of the day of the week or your activity. Turn off your electronics at least two hours prior to going to bed for sleep. Do not turn on electronics in the night. Avoid alcohol and caffeine as they disrupt sleep. Do not take sleep medication unless there is a specified medical need and it is prescribed by a healthcare provider. If you do take sleep medication, discuss with your healthcare provider how you might reduce it. A hard stop of sleep medication will affect future sleep ability. Check your sleep surface and mattress to ensure it is supporting your body correctly.

Other lifestyle changes that are thought to help chronic inflammation is to stop smoking, reduce weight, exercise and reduce your stress. These are all processes that take time and effort. It will take a while to achieve your goals in these areas but do not give up. You can accomplish your goals with time and effort. Nurse Linda

Pediatric Consideration: Children tend to collect many acute infections especially as they attend school. As with adults, it is important to have these treated early especially when a spinal cord injury is present. Long term chronic inflammation is under study. As more information is discovered, more treatments will become available. Be sure to discuss with your child’s healthcare professional when to test for chronic inflammation. Follow the recommended diet for long term health. Be sure the diet is meeting the needs of your child. A dietitian is an excellent resource for assessing the dietary needs of children. Nurse Linda

Linda Schultz, Ph.D., CRRN, a leader and provider of rehabilitation nursing for over 30 years, and a friend of the Christopher & Dana Reeve Foundation for close to two decades. Within our online community, she writes about and answers your SCI-related healthcare questions in ourHeath & Wellness discussion.

The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.