Spinal cord injury refers to damage to the spinal cord that affects its function in some way. It results in at least one of the following:
- Disruption or loss of motor control below the level of the injury,
- Disruption or loss of sensory perception below the level of the injury, and
- Disruption or loss of autonomic activity below the level of the injury
Nearly half of all spinal cord injuries occur to individuals between the ages of 16 and 30, and are mostly caused by sporting or automobile accidents. Full recovery is rare, and most spinal cord injuries are life-altering events.
CBD, along with many cannabinoids, has been studied extensively in regard to its neuroprotective and anti-inflammatory properties. There is a large body of scientific data that indicates CBD for spinal cord injury as an effective supplement to traditional treatments with little to no negative side-effects.
What is Spinal Cord Injury (SCI)?
The primary job of the spinal cord is to connect the brain and the body. This facilitates movement and sensation. Spinal cord injuries are any injuries that impede the ability of the spinal cord to allow for movement or sensation. According to the CDC, about 5.4 million people in the US were living with paralysis of some sort caused by a spinal cord injury as of 2009.
Depending both on the severity of the initial physical trauma (primary injury), and on sufficient mitigation of subsequent inflammation and other adverse endogenous metabolic processes, the injury can be either complete or incomplete.
Complete spinal cord injury
Complete spinal cord injury occurs when there is total loss of motor and sensory function below the level of the injury. These injuries result in muscle atrophy from disuse and renders the patient prone to injury due to inability to feel pain.
Common symptoms include:
- Difficulty breathing
- Paraplegia if the injury occurs below the chest
- Quadriplegia if the injury occurs above the chest
- Muscle atrophy due to disuse
Incomplete spinal cord injury
Incomplete spinal cord injuries by definition exhibit sacral sparing, or conservation of function of body parts innervated by the sacral portion of the spinal cord, which is the lowest portion, furthest from the brain.
Common symptoms include:
- Difficulty breathing
- Exaggerated reflex activities or spasms
- Loss of movement
- Numbness or tingling in the extremities
The central nervous system comprises the brain and spinal cord. The spinal cord, made of soft tissue and surrounded by bones (vertebrae), extends downward from the base of your brain and is made up of groups of nerve cells called tracts, which innervate different parts of the body.
Spinal tracts are either afferent sensory tracts or efferent motor tracts. Afferent refers to the nerves which travel from the body to the brain, relaying sensation and body position. Efferent refers to the motor neurons which travel from the brain to innervate muscles and glands and exert an activity in the body.
Causes of Spinal Cord Injury
Traumatic spinal cord injuries can occur by:
- Damage to the bones of the spine, called vertebrae
- Damage to the ligaments or discs of the spinal column
- Damage to the cord itself
Another common cause of spinal cord injury is gunshot or knife wounds penetrating the spinal column or spinal cord.
During the days and weeks that follow severe spinal cord injuries, patients may experience extreme swelling, inflammation, and pain in their back and neck. Fluid can accumulate in the chambers around the spinal cord or in between the vertebrates.
Nontraumatic spinal cord injury can be caused by arthritis, inflammation, and infection.
Common causes of spinal cord injuries include:
- Motor vehicle accidents. Auto and motorcycle accidents are the leading cause of spinal cord injuries, accounting for almost half of new spinal cord injuries each year.
- Falls. A spinal cord injury after age 65 is most commonly caused by a fall. Overall, falls cause more than 15 percent of spinal cord injuries.
- Acts of violence. Around 12 percent of spinal cord injuries result from violent encounters, often involving knife and bullet wounds.
- Sports and recreation injuries. Athletic activities, such as contact sports and shallow water diving, are responsible for about 10 percent of spinal cord injuries.
- Alcohol. Alcohol use is a factor in about 2 out of every 5 spinal cord injuries.
- Diseases. Cancer, arthritis, osteoporosis, and inflammation of the spinal cord can also cause spinal cord injuries.
Diagnosis and characteristics of Spinal Cord Injury
During an emergency situation, a physician can rule out a spinal cord injury or SCI with a physical exam that is used to test for function of the senses, movement, and by asking some questions about the accident.
However, when a patient complains about pain in their neck and/or weakness in parts of the body, a neurological injury may have happened and emergency diagnostic tests may be needed. These tests may include:
- X-rays. Medical personnel typically order these tests on people who are suspected of having a spinal cord injury after trauma. X-rays can reveal vertebral (spinal column) problems, tumors, fractures or degenerative changes in the spine.
- Computerized tomography (CT) scan. A CT scan may provide a better look at abnormalities seen on an X-ray. This scan uses computers to form a series of cross-sectional images that can define bone, disk and other problems.
- Magnetic resonance imaging (MRI). MRI uses a strong magnetic field and radio waves to produce computer-generated images. This test is very helpful for looking at the spinal cord and identifying herniated disks, blood clots or other masses that may be compressing the spinal cord.
After giving the patient some time to recover from the injury and medical procedures conducted, the physician may do another physical exam to see if some of the problems improved. In addition, the doctor will conduct a more comprehensive neurological exam to determine the level and completeness of the injury. This involves testing your muscle strength and your ability to sense light touch and pinpricks.
Current treatment options and best practices for SCI
From the ancient Egyptian times until now, medicine has progressed immensely. However, damage to the spinal cord cannot be cured or reversed. Scientists devote their lives to pioneering new treatments for many diseases and injuries, including spinal injury.
While there have been no drastic leaps forward, scientists currently are working on medications that stimulate nerve cell growth or improve how well nerves work after inflammatory assault due to spinal cord injuries.
In spinal cord injuries, there are two distinct phases of treatment. First, immediate care takes place at the site of the injury and in the hours immediately following. This care is focused on preventing more damage and preserving the tissue that has been spared. After this, long term care generally extends for the remainder of the patient’s life.
Current treatment begins on site of the emergency. Medical teams will immobilize a victim’s spine and head with a cervical collar. After this, the patient is placed on a firm carrying board and situated into an ambulance.
Emergency care focuses on the short term problems first, including:
- Difficulty breathing
- Complications in the urinary or cardiovascular systems
- Further immobilize your neck so the damage doesn’t get worse
One more important symptom to check for is neurogenic shock. This causes a sudden and dramatic drop in blood pressure and heart rate, known as hypotension & bradycardia, respectively. Neurogenic shock can cause a lack of oxygen supplying different parts of the body, leading to cell death and potential organ damage.
- Medication: anti inflammatory medications, respiratory medications and blood thinning drugs to counteract other medications that may cause your blood to clot.
- Surgery: this is necessary to repair fractured, compressed, or severed sections of the spine. Also, it is necessary because patients may have herniated discs or foreign objects lodged into their spine.
- Immobilization: although the neck may be stable, the spine may be fractured or malaligned so that will be taken care of, and if severe enough then surgery will be an option.
So, now after being stable & in the hospital for some time, can you go home? It depends. Spinal cord treatment is lengthy. The secondary problems that happen because of the damage are: pressure ulcers or skin damage from resting on it for too long, urinating and defecating issues, respiratory infections and even blood clots. After physicians are sure that none of these secondary problems occur then you can move on to the next stage of treatment, therapy.
Physical therapy is where the bulk of the recovery for day-to-day living is relearned. During the initial stages of rehab, therapists focus on maintenance and strengthening of the muscles, coording of movement, and learning new techniques to accomplish tasks if necessary. Once you graduate from this, therapists will encourage you to resume your favorite hobbies, participate in social and exercise activities, and return to work.
They will give you plenty of details on what to eat, and how to prevent complications so that you can live an independent life. As obvious as it seems, spinal cord injuries are very serious and should not be taken for granted. It is a long process to recover from one, beginning a week after the incident to six months on average.
Does CBD improve cases of Spinal Cord Injury (SCI)?
Cannabidiol (CBD), a non-psychoactive constituent of cannabis, has been reported to induce neuroprotective effects in several experimental models of brain injury. Current research as of July 1st, 2016 has backed up the notion that CBD, with it’s promotion of normal endocannabinoid system health, would alleviate pain, help with sleep, and positively affect quality of life of people who suffer from spinal cord injury.
CBD, cannabidiol, stimulates the reduction of inflammation in various parts of the body via activation of CB2 receptors which can reduce the pain that many patients deal with. The endocannabinoid system has an important role in pain sensitivity, along with other roles within the nervous system. Paradoxically, some injuries which eliminate sensory perception can actually cause pain of their own, in the form of phantom pain. This is partially correlated with a steep reduction in endocannabinoid system expression injured spinal tissue.
Arevalo-Martin, on January 4th, 2016, published a paper to the U.S. National Library of Medicine reportng CBD for spinal cord injuries actually counteract secondary damage following SCI, and treatments with endocannabinoids or synthetic copies of them promoted better functional outcome in experimental models.
Diana Cardenas reported in her survey of 117 people, who were dealing with chronic pain from SCI, that they found little relief of their chronic pain with traditional medications and that alternative treatments should be explored.
To conclude, M. Kwiatkoski on April 21st 2012, supported with evidence that cryogenic spinal cord injury to rats is easily reproducible with liquid nitrogen to impair locomotor function. Cannabidiol improved functional recovery and reduced injury extent, suggesting that CBD for spinal cord injuries would be useful for treatment. The evidence is clear, CBD for spine pain and CBD for spinal cord injuries is a huge opportunity for the medical research community, to both improve treatment, and learn more about the condition.