Hot Topic: What Happens When You Can't Sweat?

Did you know that many paralyzed people can’t sweat?

Remember Wolfgang Illek, the Wings for Life project manager who told us what life is like when you’ve lost the simple ability to cough? We asked him to fill us in on some other less-known effects of spinal cord injury, and here’s one that may surprise you: Many paralyzed people cannot sweat!

“No sweat” is one of those things we say when something is easy. But in fact, living without the ability to sweat is pretty hard. 

Sweat is the body’s way of cooling itself,” Wolfgang explains. “You sweat, the excess body heat transforms that sweat into vapor, and the chill of evaporation takes the heat away from the body.”

If you can’t cool down, you may feel weak, sluggish, dizzy – or have trouble breathing. In extreme cases, you might suffer heatstroke. So why do some spinal cord injury patients lose the ability to sweat?

Specific nerves that leave the spinal cord between vertebrae Th3 (upper back) and L2 (lower back) are responsible for sweating. Patients whose injury is between the Th3 and L2 vertebrae can sweat only in certain body areas. And those with full paralysis due to injury above the Th3 vertebra cannot sweat at all.

Affected patients have to find other ways to cool down – spraying themselves with water, using damp towels, thinking ahead to make sure that a shaded parking spot or air conditioning is available. Illek is one of those who can’t sweat at all, and as he explains, even an afternoon hanging out with friends can suddenly become complicated, miserable or even dangerous

“One day I was at a barbecue and I was feeling cold, so I sat in the sun for a long time,” he relates. “Then I got dizzy. Fortunately my friends acted quickly. They tipped me out of my wheelchair and onto a couch, and my girlfriend put wet, cold towels right onto my face and on my legs for about 30 minutes. That helped a lot, but I was sorry to give everyone a scare.”

With a smile, he adds, “It’s all quite a fuss. I’d much rather have sweaty armpits.”


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