Orthostatic hypotension in spinal cord injury

The nervous system helps tighten blood vessels when posture changes. Spinal cord injury can interrupt some of those signals, particularly when moving from lying to sitting or standing. Reduced leg-muscle activity, deconditioning, dehydration, infection, pain, and medicines can add to the challenge. Symptoms may include light-headedness, weakness, visual changes, nausea, or fainting.

Autonomic dysreflexia is a different urgent problem that can occur with some spinal cord injuries and may involve a sudden blood pressure rise rather than a fall. New sweating, headache, flushing, or a sudden feeling of illness needs urgent specialist advice, especially if a bladder, bowel, or skin trigger is possible.

Use the transfer and standing plan from your rehabilitation team. Move in stages, pause after sitting, and use prescribed support such as a tilt table, abdominal support, or compression garments only as directed. Have someone supervise transfers until your team confirms they are safe. Stop and sit or lie down if symptoms begin. Keep a record of posture, symptoms, fluids, meals, and medicines.

A [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) can coordinate review with your spinal injury or rehabilitation team. For a general symptom guide, see [Dizziness](/symptoms/dizziness/).

Contact your rehabilitation or medical team if episodes recur, transfers become harder, or you faint. Seek urgent help for chest pain, severe breathing difficulty, new neurological changes, serious injury, or symptoms suggesting autonomic dysreflexia such as sudden severe headache with sweating or a marked blood pressure change. Do not attempt an unfamiliar standing method while symptomatic.

Ask how your injury level affects posture-related blood pressure, which transfer supports are appropriate, how to distinguish a blood pressure fall from autonomic dysreflexia, and when to call your specialist team.