Staying Warm in Winter with a Spinal Cord Injury


By: Cassandra Brandt

When you live with a spinal cord injury, your body’s inability to respond appropriately is impacted in numerous ways. Not walking is only the tip of the iceberg. There’s bowel and bladder dysfunction to contend with too, and there’s body temperature.

Thermoregulation is something most people just take for granted. If we’re too hot, we sweat, cooling the body. If we’re too cold we shiver to conserve heat, as our blood vessels undergo vasoconstriction and tighten to increase blood flow near the center of the body to conserve warmth. Our body informs the brain of its need to regulate.

People with SCI cannot regulate heat and cold

With a spinal cord injury, the signals the body sends are intercepted at the level of injury, though. They don’t make it to the brain, so it’s hypothalamus center doesn’t get the memo to activate or inhibit the sympathetic nervous system. Blood vessels and sweat glands don’t receive any signals it may try to send.

People with higher level spinal cord injuries are generally more sensitive to temperature fluctuations. Those with complete injuries also experience faultier thermoregulation. Incomplete spinal cord injuries may retain some thermoregulation below their level of injury because some neural pathways in the spinal cord may have been spared.

There are many dangers that come with becoming overheated, and during the summer people with spinal cord injuries must be mindful of hyperthermia (heatstroke), carry plenty of water and avoid long periods of exposure to the sun. In the winter, we’re at risk for hypothermia (a dangerously low body temperature below 95˚) because we can’t conserve heat. Producing it is harder too; reduced muscle mass and physical inactivity slows down our metabolic rate which limits the body’s ability to produce heat.

How do we know if we’re too cold? Many people with spinal cord injuries report significantly elevated nerve pain. Above the injury level our body and face may feel cold to touch. Sometimes we experience autonomic dysreflexia. Our pulse may weaken, skin pale, and speech even become slurred.

a woman holding a mug in the snow

How do you keep warm with a spinal cord injury?

  • Movement promotes blood circulation and heat production. Move anything you’ve got to get blood flowing. Passive range of motion counts!
  • Try wearing more layers. Cover your head and feet.
  • Take a warm bath or drink warm beverages.
  • Use an electric blanket or heating pad to warm up quickly (but check skin to avoid burns and be time-conscious to avoid overheating)
  • Try a microwavable rice pack around your neck
  • Use a space heater with safety features. Make sure it’s one you can control independently.
  • When enjoying outdoors, bundle up, cover your head, and don’t stay out too long.

A spinal cord injury comes with a lot of secondary health complications, but like most, lack of thermoregulation can be managed, remaining mindful of the ways we can keep the body warm.