Secondary Condition: Temperature Regulation

Individuals who suffer a spinal cord injury at T6 and above may have difficulty with temperature regulation. This condition of poor temperature regulation after spinal cord injury is referred to as being poikilothermic. The word “poikilotherm” is used to describe reptiles that are “cold-blooded.” These animals have a temperature inside their body that is controlled by the outside temperature of the environment.

This comparison is made of individuals who suffer a spinal cord injury at T6 and above because the temperature inside their body is significantly affected by the temperature of the environment. As mentioned in earlier topics regarding the autonomic nervous system, the sympathetic nervous system activity lacks control of the body as compared to able-bodied people and individuals with a spinal injury below T6. Therefore, when the outside temperature is hot (80° Fahrenheit or above), the poikilothermic patient cannot normally dilate the blood vessels and sweat appropriately in an attempt to cool the inside temperature of the body. Likewise, when the outside temperature is cold, the poikilothermic patient’s body cannot normally constrict the blood vessels in an attempt to conserve heat.

Patients with a spinal cord injury at T6 and above have to be aware of this limited protective response to adjust to the external environmental temperature. For example, an individual with a complete spinal cord injury at C7 can quickly overheat when the outside temperature is 90°F. Overheating means that the inside temperature of the body begins to rise and the individual develops an elevated body temperature. This condition is often not recognized immediately while it is occurring and, if severe, can lead to heat stroke. Individuals who experience this often describe it as a vague and significant decrease in energy and an overall sick feeling.

There is no literature or studies that give guidelines regarding an acceptable temperature and duration of exposure. Each individual must understand his or her own limitations and make adjustments accordingly. As a guideline, some individuals report that they can remain outdoors for any length of time if the temperature is 70-80° Fahrenheit. If the temperature outside is 85°F or above, the duration of time outside must be closely monitored to prevent becoming overheated. Each individual must determine his own “safe window” for temperature and duration of exposure outdoors.