Promoting Long-Term Health among People with Spinal Cord Injury: What’s New?

Family physicians are essential for promoting health and managing disability for people with SCI, who live longer with chronic disease. An innovative tool called Actionable Nuggets was developed to provide best evidence to family physicians about health promotions and primary care for people with spinal cord injury. The purpose of this article is to assist family physicians to play their role in promoting the health of people with SCI, by summarizing the changes in the management of spinal cord injury in primary care that have arisen in the literature between the 2nd & 3rd editions (2013–2016).

• 1
  Major changes in the management of SCI in primary care were noted for 8 of the 20 topics, specifically in the areas of pharmacological management of neuropathic pain and urinary tract infection; screening for bowel and bladder cancer; improvements in wound care; and clarification of dietary fibre recommendations.
• 2
  Instead of gabapentinoids alone as first-line treatment, this category now also includes tricyclic antidepressants and serotonin-noradrenalin re-uptake inhibitors (SNRIs), which work equally well for some patients
• 3
  As of the 3rd edition of Nuggets, routine screening for bladder cancer is no longer recommended for all SCI patients, but only for those considered high-risk—that is, those with indwelling or suprapubic catheters, complete lesions, >10 years since injury, bladder stones, or recurrent urinary tract infections