The first three months after a spinal cord injury are disorienting for families, and a great deal happens in them. This is a general guide to what that period usually involves. Every injury is different, and your team’s advice about your relative always takes precedence.
Medically reviewed by Dr. Naresh Kumar, MPT
Last reviewed: 2 August 2026 · Our clinical team
Weeks 1–2: medical stabilisation
The focus is the injury itself, and preventing early complications. Rehabilitation begins here even if it does not look like therapy yet — positioning, chest care, maintaining joint range, and protecting skin.
Families are often told very little about long-term outlook at this stage. That is usually because it genuinely is not yet clear, not because information is being withheld.
Weeks 2–6: starting active rehabilitation
As things stabilise, work usually begins on sitting balance and tolerance, maintaining and building strength where movement is present, respiratory function, and beginning transfers and early wheelchair skills where appropriate.
This is also when the practical education starts: skin checks, bladder and bowel management, and recognising complications.
Weeks 6–12: building independence
The emphasis shifts to function — transfers, wheelchair skills, dressing and self-care, upper-limb strength, and standing or gait work where the injury allows. Equipment is assessed and ordered, and discharge planning should be well underway.
Complications to understand early
- Pressure injuries. The most common preventable complication. Position changes and daily skin checks are not optional.
- Autonomic dysreflexia. In injuries at or above the mid-back, a sudden dangerous rise in blood pressure can be triggered by something below the injury level — often a full bladder. Families of anyone at risk should be taught to recognise and respond to this. It is a medical emergency. Ask the team to teach you specifically.
- Respiratory problems. More significant with higher injuries.
- Bladder and bowel management. Established as a routine early.
What families should be doing
- Ask to be taught transfers, positioning and skin care before discharge — see safe transfers
- Start home access planning early; modifications take time
- Confirm equipment and who is providing it
- Ask what happens after discharge and arrange continuing therapy
- Pace yourselves — this is a long process, and carer exhaustion in month three is common
On prognosis
Families understandably want to know whether walking will return. Early on, an honest team will often say it is too soon to know. As the picture clarifies, ask directly and expect a qualified answer. Uncertainty stated honestly is more useful than false reassurance.
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Medical disclaimer: this article is general information and is not medical advice, diagnosis or treatment. It is not a substitute for individual assessment. See our medical disclaimer.