Body
Orthostatic or postural hypotension is a sudden drop in blood pressure caused by moving from a lying to a sitting or standing position. It often occurs after spending a long time in bed and then suddenly getting up. Although orthostatic hypotension can happen to anyone, it is more common following a spinal cord injury (SCI). This is because of loss of nervous system control which works to keep the blood pressure stable, as well as loss of muscle tone which helps to return blood to the heart.
Orthostatic hypotension is most common right after an injury and in the first few weeks of rehabilitation. It is more common with cervical and high thoracic (levels 1‑6) spinal cord injuries. In most cases, the problem resolves and only happens after being in bed for long periods of time, and in the morning. For a few people, however, hypotension can continue, and medications may be needed.
Orthostatic hypotension causes dizziness or fainting when sitting or standing due to a drop in blood pressure. To manage it, use a reclining wheelchair and gradually sit upright. Wearing an abdominal binder and compression stockings can help stabilize blood pressure. Before transferring to a wheelchair, raise the head of the bed slowly and sit up for a few minutes. Stay hydrated and avoid prolonged bed rest.
If dizziness occurs, lie down immediately and check that your binder and stockings are properly applied. Recline the wheelchair and elevate your legs until symptoms pass, then slowly sit up again. Repeat as needed until your body adjusts. Do not ignore symptoms—fainting can lead to serious complications. If dizziness becomes frequent or sudden, contact your doctor, as it may signal an underlying issue like infection. Medications may also help regulate blood pressure.
