For many SCI survivors, recapturing independence is your single most significant achievement. You view any concessions to that independence - accepting more help, using more or different equipment - as giving up, as failure, as the ultimate defeat. But it's hard to deny the fatigue and pain that may come from years of pushing a manual chair. Switching to a power chair actually could be the way to maintain that independence.

Symptoms & Signs:


  • lower strength or function
  • increased pain
  • decreased mobility
  • weight gain or loss
  • less activity
  • skin sores
  • posture problems
  • fatigue
  • aging of the primary care givers


The stigma of disability keeps many people from increasing or changing equipment. Some find that they must let go of their 'live for the moment' attitude. Others, some of whom were injured during "the super quad" era when more equipment seemed to mean being "more disabled," may struggle to accept the idea that changing equipment doesn't mean going backwards.


It's Not Always Obvious:

Sometimes fatigue and pain can get in the way too slowly or gradually to notice. People may eliminate errands in order to avoid the car transfers or they may skip certain chores at home. They don't have the energy to do the things they want or need to do, like playing with their kids or stretching each night. Quality of life becomes the issue. Power chairs allow people to do more things with less pain, less fatigue and more mobility, resulting in more independence.

It's for Real!


In a study of 279 British SCI survivors, all of whom had been injured at least 20 years, 59% reported having made changes in durable medical equipment - new wheelchairs, cushions, hoists and lifts to ease transfers. Almost 25% listed fatigue and/or weakness as the cause for change. The same number listed medical problems. Others cited stiffness, pain, other injuries, or their age.



When Is It Time to Change?


  • do you find yourself avoiding going certain places - places you used to go or want to go, but don't - because it's just too hard or simply not worth it?
  • do you have persistent shoulder pain when wheeling?
  • do you have noticeably less fatigue and pain on days when you don't wheel much?

Roadblocks to Change:

But power chairs are big and bulky. Most don't jump curbs. They do cost a lot of money. They are a hassle to travel with. But the hassles of lifts and power chairs may be small potatoes compared to the hassles of needing an attendant or simply not being able to work or play at all.

People use lots of reasons to avoid changing to a power chair - money, exercise, strength, travel. Often, their reluctance is really about not wanting to give in to aging and decline of function. Used equipment, family help, charitable organizations, Medicare or Medicaid can help pay for equipment. Different types of exercise can be less destructive to shoulders and arms, while preserving strength and stamina. Travel can be more fun without fatigue.

The costs of "hanging in there" and putting off getting new equipment may be greater than we had imagined, not just in money but in muscle pain, strength loss and general quality of life.

Prevention, Tradeoffs, & the Future:

Sometimes more equipment can prevent future problems and can mean more independence. Equipment changes in response to warning signals can help control or prevent chronic conditions such as scoliosis, carpal tunnel syndrome, degenerative shoulder disease or major muscle imbalances. Power wheelchairs and other equipment changes can also serve to project a more positive, independent and functional image, as they are faster, more maneuverable and energy conserving.



When the price for not changing is a clear decline in quality of life, then change may be easier to accept. No one has a formula for how to figure this out - everyone is different. What is clear, though, is that survivors who have made the change to a power chair clearly report less pain and fatigue. If pain and fatigue from pushing a manual chair are ongoing problems and threats to independence in your life, a power wheelchair may be a logical and appropriate response.

