Temperature Regulation
Why your body runs hot or cold after SCI, and what to do.
What is it?
After an SCI, the nerves that sense temperature, sweat, and adjust blood vessels below your injury are disconnected from your brain. The result: your body cannot regulate temperature the way it used to.
You can overheat in summer because you do not sweat below the injury. You can chill quickly in winter because your blood vessels do not constrict to keep heat in. People with injuries above T6 are most affected.
This is sometimes called poikilothermia — taking on the temperature of your surroundings.
How you might feel
Overheating:
- Feeling flushed, dizzy, lightheaded
- Headache
- Sweating only above the injury
- Confusion or fatigue
- Faster heart rate
Getting too cold:
- Shivering only above the injury
- Pale or blue skin below the injury
- Slowed thinking
- Loss of fine hand control (above the injury)
- Profound fatigue
What to do — heat
- Stay in air conditioning when temps are above 80°F.
- Spray bottle and a small fan — your two best portable cooling tools.
- Cooling vests, neck wraps, scarves wet with cool water.
- Drink steadily — cold water, sports drinks for long heat exposure.
- Wear light-colored, loose, breathable cotton.
- Schedule outdoor time for early morning or evening.
What to do — cold
- Layer. Base layer (synthetic or wool), insulating mid-layer, wind-blocking outer.
- Pay attention to extremities — gloves, thick socks, hat. You may not feel cold below the injury but tissue can still freeze.
- Hand warmers in pockets and gloves.
- Heated cushions and blankets with a known low-temperature setting (avoid burns — you may not feel them).
- Avoid alcohol in cold weather; it dilates surface vessels and accelerates heat loss.
🚨 Heat illness — call 911 if
- Body temperature above 103°F.
- Confusion or fainting.
- Stops sweating above the injury (heat stroke sign).
While waiting: cool with damp cloths, fan air over the body, ice packs at neck/armpits/groin.
🚨 Hypothermia — call 911 if
- Body temperature below 95°F.
- Confusion, slurred speech, or extreme drowsiness.
While waiting: get into a warm room, wrap in blankets, give warm sweet drinks if alert.
At your next clinic visit
Bring questions about cooling vests and insurance coverage, travel plans for hot or cold climates, and any medications that may affect temperature regulation (some antipsychotics, anticholinergics).
Education only. Not medical advice. If you have a clinical question, talk to your rehab team. For emergencies call 911.