• The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

  • The online Community for people with spinal cord injury, their relatives and friends

Risks when living with limited sensitivity

How do we define sensitivity?

With sensitivity, we mean our fifth sense, namely feeling. Different from the other four senses, sensitivity is not perceived through a sensory organ such as vision is through the eyes. Our sensory system retrieves information from numerous nerve endings and receptors1 that are spread all over our body. This system gives us feedback from our body through pressure, stretching, vibration, temperature or pain. This feedback comes from different places: from the mucous membranes, the inner organs or the muscular / skeletal system (position of the joints, flexion of muscles).

This sensitivity is an important warning system of our body. If there is no or only partial sensitivity, we are not receiving information that would make us aware of hazards. Due to the limited sensitivity of people with spinal cord injury, this important warning mechanism is disabled, which can lead to various complications.

Risks due to limited or non-existent sensitivity

Pressure sores

As a result of limited or non-existent sensitivity, the risk of pressure sores is particularly great for people with spinal cord injuries (see chapter 4.02).

Burns through heat therapy and the touching of hot objects or surfaces

Heat therapy is one of the oldest medical treatments and is used in conventional Western medicine as well as in natural medicine. Since it is used in the home environment, nearly everybody knows it: it includes a number of different applications such as hot-water bottles, cherry pit pads, heating pads and blankets, red light therapy, warm compresses and heat packs. Usually heat applications are perceived as comfortable, relaxing and revitalizing. However, using heat applications can be dangerous if the perception of heat is limited because this can cause burnings and scalding.

Furthermore, there are many everyday situations in which we come into contact with hot objects and surfaces. If the person’s ability to sense the heat is eliminated or limited, one has to be especially careful with:

  • Taking a shower or a bath (watch out for changing water temperatures!
  • Sink drainage
  • Heating pads or hot-water bottles
  • Carrying hot objects on the legs (you need protection between the object and the legs, e.g. use a tray with equalising padding.)
  • Surfaces that retain heat (deck chair, sand, etc.)

16 170 05 Koerperfuersorge EN Seite 11


The perception of heat and cold is impaired when sensitivity is limited. This may lead to hyperthermia or hypothermia of the body. People with a high spinal cord injury often feel cold and therefore dress overly warm and enjoy the warmth of the sun.

However, the sun also has its drawbacks. UV radiation can damage the skin (sunburn), and heat can lead to an overheating of the body (sunstroke). Excessive sunbathing speeds up the ageing process of our skin and promotes several other skin changes – it may even cause skin cancer.

Check your skin for alterations after spending time outside. Good sun protection (hat, sunglasses and sunscreen) is recommended.

16 170 05 Koerperfuersorge EN Seite 12

Regulation of body temperature

Humans regulate their body temperature by sweating, among other things. People usually start to sweat at air temperatures just over 30°C. People with spinal cord injury are only able to sweat as a regulating measure in those areas of the body that are not paralysed. This means that especially tetraplegics have a considerably limited ability to regulate their body temperature, which is insufficient to keep it within a normal range when they expose themselves to high temperatures.

Due to the spinal cord injury, the autonomous nervous system can no longer control the mechanisms responsible for our temperature regulation (heat production and heat loss). These mechanisms include blood circulation in the skin, sweating, shivering and directing the blood from the abdominal organs towards the muscles. This may result in a decrease in body temperature (hypothermia) or an excessive elevation (hyperthermia). These issues may be caused by high room temperatures, intense sun radiation or wrong clothing. People with tetraplegia therefore have to pay special attention to ambient temperatures. They need to be especially careful when travelling to very hot countries but also during the summer time in Switzerland.

The following points are important for tetraplegics but also for people with paraplegia:

Fluid loss

Increased sweating requires increased fluid intake. As a general rule, the bladder should excrete at least 1.5 litres of urine per day. This helps to prevent thromboses and urinary tract infections.


The risk of thrombosis is increased during the hot season. Adequate fluid intake and compression stockings are the best possible prophylaxis. It is therefore important to check the legs for rashes, overheating, swelling and oedemas on a daily basis, because these are the first signs of thrombosis.

Pressure sores

Sweating causes damp skin and thus increases the risk of pressure sores. Pressure relief in the wheelchair is therefore important in order to prevent pressure sores. Damp clothes need to be changed and the skin check should never be forgotten.


People who are taking anticholinergics such as Ditropan® (for the treatment of an overactive bladder) or Buscopan® (against stomach cramps and spastic constipation) only perspire to a limited extent and therefore need to be particularly careful when being exposed to the sun. It is also important to check the package information leaflet to see if taking these drugs increases photosensitivity.

What to do on hot summer days:

  • Take along a spray bottle filled with water to spray on your body in the case of hyperthermia – this makes up for the limited perspiration.
  • Always wear a hat
  • Drink plenty of water
  • Avoid heat
  • Wear light clothing
  • Use a mobile fan

16 170 05 Koerperfuersorge EN Seite 12 2

Also hypothermia may have severe physical consequences and can even lead to unconsciousness. It is therefore very important to be especially careful when staying outside for a longer period of time, also during the winter time, for instance when going for a stroll or skiing.

What can I do when I notice that I am overheating?

Spraying yourself with cold water (e.g. with a spray bottle) may be very efficient. Also make sure you drink enough. In general you should avoid strong and direct sunlight.

Are electric heating pads better than hot-water bottles?

Electric heating pads can also become very hot and therefore you need to be very careful about where you use them. Generally, you should use them only in those areas that show sensitivity.

Is it still possible for people with tetraplegia to travel to countries with a hot climate?

Yes, if you follow the above-mentioned recommendations, it should be possible. However, not everyone can withstand heat equally well. If the heat causes blood pressure problems, isotonic drinks might help.

1 specialised cell that transmits stimuli

Comments (0)

There are no comments on this topic yet.
Be the first to comment!
Most Recent Answers
3939 odyssita
Explaining what life with a chronic disability is like
Hi cAro, all the best for your research! I am very curious to hear about the results once they are being published. Thank you for researching this...
6 odyssita 2018-05-02
3497 Wheelie
Good news for all who would like to try out the Scewo by themselves: according the Scewo constructors, the feedback on their invention was so...
5 Johannes 2018-03-12
Ask the Expert
Most Recent Answers
3 Dr._Hans_old 2015-07-20
3 Dr._Hans_old 2015-05-07

Most Recent Blog Posts
Cindy 2019-08-20 In Science
Meditation – Think it’s just for monks?
Think again. Here are 5 ways that meditation goes beyond the spiritual to improve your health.
Let’s go to the beach!
Enjoy real beach holidays with these wheelchairs
kitwan 2019-07-30 In Society
The Sex Toy Revolution
‘cause sexuality and disability co-exist
Most Read
Anatomy and physiology of respiration
Breathing is the most normal thing in the world for us. We hardly think about it, even though we breathe in and out about 20,000 times per day. We breathe more when we are active and exerting ourselves, and we breathe less when we are...
What are contractures and how do they develop? Contractures are shortenings of muscles, tendons or ligaments that have a limiting effect on the movements of the joints. The normal ability to move a joint is lost. Contractures are frequently...
In some cases, support is needed for cleaning the nasopharyngeal space and keeping it free from secretion. For this purpose, suctioning is performed through the nose and, if necessary, the mouth. This is particularly necessary if the nose cannot be...

About the Community
Most Recent Topics
2019-07-03 In Latest
UK’s “New” Disability Measures?
With 14 million people living with a disability in the country, the UK Prime Minister announced new measures last week to address the inequalities these people face. These measures include higher...
2019-03-27 In Latest
Our new Community
Glad to have you back! We have done a lot to make sure that you find your way around quickly and feel at home – including this new section, where we regularly post latest tips, information, links,...


Swiss Paraplegic Research
Guido A. Zäch Strasse 4
6207 Nottwil

This email address is being protected from spambots. You need JavaScript enabled to view it.
T 0800 727 236 (from Switzerland, free of charge)
T +41 41 939 65 55 (from other countries, charges apply)

Be part of the Community – sign up now!