Spinal Cord Injury Respiratory Complications

Issues with spinal cord injury breathing happen to many of those dealing with the diagnosis and have had difficulty with it at some point. In fact, respiratory complications are the most critical cause of death in those with spinal cord injuries.

Issues with spinal cord injury breathing happen to many of those dealing with the diagnosis. Click to learn more.

In this article, we discuss how a spinal cord injury can affect breathing functions and the complications patients can expect after experiencing a spinal cord injury.

What is the respiratory system? How does it work?

The respiratory system is responsible for breathing, allowing the body to inhale oxygen into the bloodstream and exhale carbon dioxide, which is necessary to survive.

Breathing comes naturally to humans, and the brain is responsible for sending signals down your spinal cord to the phrenic nerves starting at the 3rd, 4th and 5th cervical spinal levels to contract the diaphragm.

The diaphragm is the muscle which sits underneath each lung and is responsible for inhaling. This muscle moves down as it contracts, and the rib cage, stomach and lungs will expand as air goes into the lungs through the nose and mouth.

To help with breathing when coughing or during exercise, the brain sends signals down to the spinal cord, where additional muscle strength helps to support the body through the process.

The impact of spinal cord injury on the respiratory system

After injuring the spinal cord, the signals sent from your brain will no longer be able to pass through the damage to the spinal cord, limiting the brain from controlling the muscles you would usually use to inhale and exhale.

The effect on muscle control loss entirely depends on the level of spinal cord injury, whether it is complete or incomplete, and the extent of the damage. They are losing muscle control, forcing the functioning muscles to work twice as hard to get oxygen into the blood and remove the carbon dioxide.

A person with spinal cord injury will also have difficulty coughing with enough strength to get rid of mucus in the lungs – further contributing to respiratory issues.

Issues that come with spinal cord injury and respiratory problems

Sleep apnea

Sleep apnea, due to loss of muscle function, causes the tongue or other tissues of the throat to close the airway and obstruct airflow when breathing in, lowering blood oxygen levels and a rise in carbon dioxide. Sleep disruption of this level will occur throughout the night, creating sudden bursts of breath that some may not notice or wake up from, but will feel the effects of lack of sleep the next day.


Those with spinal cord injury are at the highest risk of experiencing respiratory tract infections, such as pneumonia, due to restrictions around coughing and breathing. Respiratory problems are the leading cause of death in spinal cord injury patients, despite accounting for only 3% of deaths in the general population.

Pneumonia symptoms can include chest pains, shortness of breath, confusion and loss of appetite. There are many risks associated with the infection, including blood poisoning and lung failure in heavier circumstances.

To limit the chances of pneumonia, individuals should consider maintaining a balanced diet, limiting physical contact with those with a cold or flu and keeping any respiratory devices clean and free of infection.


Aspiration occurs after an individual inhales something other than air, which could entail anything from choking on a piece of food to saliva or even vomiting. When a paralysed person experiences aspiration they may not be able to clear the throat, and solids or liquids can get trapped in the lungs. If coughing is difficult, a carer is required at all times to induce the cough.

Methods to support breathing

The key to supporting the respiratory system after spinal cord injury is prevention. Here are just a few ways:

  • Maintain or achieve a healthy weight: Those who are overweight may struggle with more lung-related issues than people who maintain a healthy weight and can suffer from obstructive sleep apnea. Taking part in rehabilitation programmes and exercising with professional medical guidance can provide a higher quality of life for individuals with a spinal cord injury
  • Avoid contact with people who are sick with a cold or flu and make sure to get a flu shot every year
  • Do not smoke: Smoking causes lung cancer, and exposure to cigarette smoke encourages chronic obstructive pulmonary disease (COPD), causing excess mucus and build-up and limiting lung function
  • Consider machine assistance: To prevent build-up in the lungs, individuals can use a cough assist machine or, in some circumstances, a ventilator to keep the lungs clear
  • Hydration: Make a conscious effort to drink lots of water, especially during infection, unless advised otherwise by a medical professional
  • Keep an eye on symptoms: Anything can change overnight, so it is crucial to keep an eye on present symptoms and ones that may develop over time. The quicker any issues are discovered, the sooner things can improve.

Aspire Law can help

The sooner rehabilitation begins the better your recovery. Aspire Law are here to support you in receiving the best possible compensation to get the help you need. Click to get in touch with us to learn more.