Sensory loss leads to obvious dangers. Pain produced by damage is a protection against continuation of the damage. If pain is not felt then damage can occur with no protective reaction. Many cases of skin lesion and ulceration are due to this problem. Many of these patients have sphincter problems and are incontinent. This renders the skin soggy and even more vulnerable. Pressure sores are a common complication.
If pain is felt and the patient is unable away from its cause damage will also occur. Muscle flaccidity, dyssynergia and spasticity may all lead to ill-controlled joint positioning so that joints are put to undue strain and ligaments permanently stretched. The hyerextended knees of extemsor spasticity are an example of this. The joint distortion may in some cases be great enough to cause subluxation. Malposturing may also lead to undue pressure on nerves and blood vessels. This…
