Autonomic Dysreflexia

What is Autonomic Dysreflexia

Autonomic dysreflexia (AD) is a dangerous condition. It is a problem that can happen to people with back (spinal cord) injuries. AD makes your blood pressure go too high. AD can also cause a fast or uneven heartbeat (palpitations). Common causes (triggers)of AD include an injury, infection, or irritation.

AD is an emergency. If you do not get treatment for AD, you could have a stroke or a seizure. A stroke or a seizure may lead to even more serious problems.

Follow these instructions at home:

Checking your blood pressure

Ask your doctor for a blood pressure cuff that you can use at home. Make sure:

  • You know how to use the blood pressure cuff.
  • You know what a normal blood pressure level is for you.
  • You check your blood pressure as told by your doctor.

If you have AD:

  • Check your blood pressure.
  • Sit up straight on a chair or in bed, or raise the head of your bed.
  • Move your feet closer to the floor, if you can.
  • Follow the needed steps to poop (pass stool).
    • Stop using your finger (digital stimulation) to help you poop if that caused your AD.

Check your body for injuries, ingrown toenails, broken bones, or sores from lying in bed for long during illness (bedsores).

Removing other causes of AD

Take away any other causes of AD as soon as you can. Check and do the following:

  • If a tube was put in your body to drain your pee (urinary catheter):
    • Make sure that it is draining well.
    • Be sure it is not bent (kinked) or clogged.
    • Make sure that the leg bag is not full. This bag catches your pee (urine) when it comes out of the catheter.
  • If you are wearing any of these things, take them off:
    • ACE wraps.
    • TED hose.
    • A wide belt around your belly (abdominal binder).
    • A leg bag for your pee.
  • If you are wearing tight clothing, take it off or make it looser.
  • If you put the pee tube (catheter) in by yourself, try to pee until all your pee is out of your body (empty your bladder).

General instructions

  • Make sure you and people who care for you at home know the symptoms and causes of AD.
  • Carry a wallet card that explains the symptoms and treatment of your AD. You can get a card from the Reeve Foundation:
  • Take over-the-counter and prescription medicines only as told by your doctor.
  • Keep all follow-up visits as told by your doctor. This is important.

Contact a doctor if:

  • You have a hard time passing stool.
  • You have a hard time passing urine.

Get help right away if:

  • Your blood pressure goes up very fast.
  • You have any of these:
    • Pain in your chest.
    • Trouble breathing.
    • A sudden change in your ability to see (vision).
    • Sudden weakness on one side of your face or body.
    • Sudden loss of feeling (numbness) on one side of your face or body.
  • You have AD symptoms that do not go away after treatment at home.
  • You are confused, or your thinking gets very mixed up.
  • You cannot talk.
  • You cannot understand what people say.

These symptoms may be an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital. Be sure to tell all your doctors that you are at risk for AD.


  • Autonomic dysreflexia (AD) is a dangerous condition. It is a problem that can happen to people with back (spinal cord) injuries.
  • Any injury, irritation, or infection below the level of your spinal cord injury may cause AD.
  • Get treatment right away for symptoms of AD, such as high blood pressure or a pounding headache.
  • Treatment depends on the causes of your AD. It may include raising your head and lowering your legs, loosening tight clothes or shoes, or taking medicines for blood pressure.
  • Get help right away if you have sudden high blood pressure, loss of vision, chest pain, trouble breathing, or weakness on one side of your body.

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