What began as a mild back pain 20 years ago has confined Margaret Achola in bed for the past 15 years. She has been lying anxious with faint hope that someday, she’ll stand strong and get back to simple tasks that gave her joy like gardening.
Her agony started in 1993 with some mild back pain she felt while weeding her garden. Three years later, she was bedridden. And it was only four years later that she was diagnosed with paralysis of the spine at Kisumu County Hospital. By then, the damage had been done. Her legs were no longer functional.
According to Dr Thadeus Massawa of the Kisumu County Referral Hospital, Achola’s condition must have begun from the point she felt pain in the garden, and probably from hurting her back. Had she had proper and immediate intervention administered, her paralysis may have been averted. While physiotherapy, in addition to other medical therapies, is the appropriate response to spinal paralysis, Achola hasn’t considered them.
Why? I ask.
“At the beginning, I made numerous trips to different hospitals and consumed different concoctions that at some point hurt my stomach. I have sold almost everything I have in a bid to afford treatment in hospital and from traditional doctors. Nothing has worked, so I have given up,” she says.
For now, Achola takes painkillers to ease joint pain and frequent headache that she gets.
Spinal cord injury (SCI) involves damage to the nerves within the bony protection of the spinal canal. The most common cause of SCI is trauma, although damage can occur from various diseases acquired at birth or later in life, from tumours, electric shock, poisoning or loss of oxygen related to surgical or underwater mishaps.
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The quicker a patient obtains treatment, the better the chances for recovery from spinal injuries.
“Now I cannot leave the house or even the bed without help. Sometimes someone will bring me food or take me out for some sun. I rely on well-wishers for daily needs,” says Achola.
“A traumatic spinal cord injury may stem from a sudden, traumatic blow to your spine that fractures, dislocates, crushes or compresses one or more of your vertebrae,” says Lilian Opolo, a Kisumu-based physiotherapist. The vertebrae column consists of bones that protect the spinal cord.
Common causes of spinal injuries include:
· Motor vehicle accidents
· Acts of violence like a gunshot or a knife wound that penetrates and cuts the spinal cord
· High impact sports injuries
· A non-traumatic spinal cord injury may be caused by arthritis, cancer, inflammation, infections or disk degeneration of the spine.
· Use of alcohol. Alcohol use is a factor in about 1 out of every 4 spinal cord injuries.
After the injury has occurred, and if interventions are not taken, additional damage usually occurs over days or weeks because of bleeding, swelling, inflammation and fluid accumulation in and around your spinal cord.
“The time between injury and treatment can be critical in determining the extent and severity of complications and the possible extent of expected recovery.
Numbness or paralysis may occur immediately or come on gradually as bleeding or swelling occurs in or around the spinal cord,” says Opolo.
In Achola's case, had she sought treatment immediately after her injury, she may not have progressed to paralysis.
Treatment options after a spinal injury
Prompt treatment to injury is the best bet. Surgery can be done to relieve the pressure and stabilise the spine followed by intense physical therapy to increase chances of recovery. Studies show that most recoveries will happen in the first six months and if there is loss of function after a year, it is likely to be permanent.
Red flags to watch out for
Spinal cord injuries can often be identified from various signs that include:
· Loss of movement
· Loss of sensation, including the ability to feel heat, cold and touch,
· Loss of bowel or bladder control
· Changes in sexual function,
· Changes in sexual sensitivity and fertility
· Pain or an intense stinging sensation caused by damage to the nerve fibres in the spinal cord
· Difficulty in breathing, coughing or clearing secretions from your lungs.
Scientists are optimistic that advances in research will someday make the repair of spinal cord injuries possible.
A 2016 spinal injury study carried out at the Kenyatta National Hospital showed that using computers at work was the most common cause of back injuries.
An initiative done in the same year between June and December by a group of clinicians, to educate the public about back and neck disorders revealed a few things.
1. For every 10 people screened, eight suffered from nerve tension along the upper back ranging from mild to very severe.
2. Road Traffic Accident was the most common cause of injury. 50 per cent of accident victims have a cervical spine injury.
Spinal cord injuries after age 65 are most often caused by a fall. Overall, falls cause about 31 per cent of spinal cord injuries.
Why the spinal cord is a sensitive body part
Unlike other body parts, the spinal cord does not repair itself once damaged. And there is no cure for spinal injuries currently.
Quadriplegia is paralysis of arms and legs. Paraplegia is paralysis of only the legs and is caused by spine injury to the legs.
8 ways to reduce risk of spinal injury
1. Wear a safety belt when in a motor vehicle
2. Children below age 12 should always be in a seat belt or the appropriate safety seat and always in the back seat to protect them from air bag injuries
3. Don’t dive in shallow pools. The impact of the dive could damage the spine.
4. Have non slip mats on the shower to prevent falls
5. Wear safety gear while playing high contact sports like rugby and football. Falls during horse riding too can lead to spinal injuries.
6. Wear appropriate safety gear when riding a motorbike
7. Don’t drink and drive
8. Prevent falls by having hand rails in staircases.
Common injuries after a car accident (use images to illustrate)
1. Whiplash: Symptoms arising from a sudden jolt; a back and forth movement of the neck, can appear 24 hours after the accident. Common symptoms include pain in the back and arm, stiffness, headache and weakness. A specialist should be consulted to ensure that there is no permanent damage to the spine.
2. Fractured vertebrae. The vertebrae are the bones that encase the spinal cord, and in an accident, they can get fractured. This can be seen in an X-ray. Treatment depends on the severity of the fracture. Sometimes one could need to be immobilised to allow recovery. Other times surgery may be necessary.
3. Herniated disk. Disks are found between the vertebrae to reduce friction and act as shock absorbers. And in an accident, the disk can slip out and pinch the spinal cord which can then cause pain or weakness or numbness.