12098 Spinal Cord Injury

Overview

A spinal cord injury is damage to the bundle of nerves that runs from your brain down your back. This damage can affect movement, feeling, and control of certain body functions. How much it affects you depends on where the injury is and how severe it is.

Spinal cord injury is not common. It affects a small number of people each year, often as a result of accidents or falls.

Anyone can have a spinal cord injury, but it is more common in young adults—especially men—and in older adults who have falls.

Symptoms

Common symptoms

• Loss of movement or paralysis in parts of the body
• Loss of feeling, or strange sensations like tingling or burning
• Trouble breathing or coughing
• Loss of bladder or bowel control
• Changes in sexual function
• Pain, pressure, or a stinging feeling in the back or neck

Symptoms in children

• Children may not be able to describe their symptoms, so look for changes in walking, using the toilet, or behaviour.
• Complaining of neck or back pain
• Weakness in the arms or legs
• Trouble breathing or a weak cry

Symptoms in older adults

• A fall followed by new weakness or numbness in the arms or legs
• Difficulty moving or getting up from a chair
• Loss of bladder or bowel control after a fall
• Confusion or drowsiness, especially if there is also a head injury

Causes

Main causes

• Traumatic causes such as car crashes, falls, sports injuries, or violence
• Non-traumatic causes such as infections, tumours, or diseases that damage the spine
• Sometimes the exact cause is unknown

Risk factors

• Being male
• Being a young adult, especially between 15 and 29
• Being older, especially 65 and over
• Taking part in contact sports or high-risk activities like diving
• Heavy alcohol use or risk-taking behaviour
• Health conditions that weaken the spine, such as osteoporosis

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number now. Do not move someone who may have a spinal injury unless they are in immediate danger.

Book a routine appointment if:

• If you have back or neck pain that lasts more than a few days, or if you have any new numbness, weakness, or muscle control problems, see a doctor.

Diagnosis

A doctor will ask about your symptoms and how the injury happened, then check your strength, feeling, and reflexes. They will also look at how well you can move and breathe. If they suspect a spinal cord injury, they will send you for imaging tests.

Tests that may be done

• X-ray: shows if there is a break or dislocation in the spine
• CT scan: looks at the bones of the spine in more detail
• MRI scan: shows damage to the spinal cord, nerves, and surrounding tissues
• Nerve tests such as an EMG to check how well nerves are working

What to expect at your appointment

If a spinal cord injury is suspected, you will be treated in a hospital. Your spine will be kept very still to prevent more damage. You may need to wear a neck or back brace. Tests are done quickly so that treatment can start as soon as possible.

Treatment

Treatment for a spinal cord injury starts with keeping you safe and stopping the spine from moving. After that, the focus is on helping you recover as much movement and function as possible, and on preventing further problems. Many people need several types of care, including surgery, rehabilitation, and long-term support.

Self-care at home

• Follow your care team's instructions carefully.
• Take part in physical and occupational therapy to build strength and skills.
• Avoid heavy lifting or risky activities while you heal.
• Make changes to your home so you can move around safely.
• Talk to a social worker or care coordinator about support you may need.

Medical treatments

Medical treatment may include surgery to stabilise the spine or to remove anything pressing on the spinal cord. Your care team may use medicines to help with nerve pain, muscle tightness, or other symptoms, but always ask your doctor or pharmacist about what is safe for you. You may also receive therapies to help with bladder, bowel, and breathing function.

When is surgery considered?

Surgery may be needed to remove pieces of bone or damaged tissue, to fix broken bones, or to reduce pressure on the spinal cord. In some cases, surgery helps prevent the injury from getting worse, but not everyone needs it.

Living with this condition

Living with a spinal cord injury often means adapting to a new way of doing everyday tasks. You may need help with dressing, washing, cooking, or getting around. Your hospital team will help you plan for life at home, and you may need equipment such as a wheelchair, a shower chair, or aids to help you dress.

Lifestyle tips

• Learn new ways to dress, bathe, and move around.
• Use assistive devices if they are helpful, and keep them well maintained.
• Plan ahead for visits out of the house, including accessible routes and restrooms.
• Keep up with appointments and check-ups, because your needs may change over time.

Diet and exercise

Eating a balanced, high-fibre diet and staying well hydrated can help prevent constipation and keep your bladder and kidneys healthy. A physiotherapist can design a safe exercise plan to keep your muscles strong, protect your joints, and improve your circulation. Exercise can also lift your mood.

Mental health and emotional wellbeing

A spinal cord injury is a major life change, and it is completely normal to feel sad, anxious, angry, or overwhelmed at times. These feelings can last a long time and are not a sign of weakness. Talk to your care team about how you are feeling. They can connect you with counselling or peer support. If your feelings become very heavy, or if you have thoughts of self-harm, get help right away by calling your local emergency number or a crisis helpline.

Prevention

Many spinal cord injuries cannot be prevented, but you can lower your risk by wearing a seat belt in the car, wearing a helmet when cycling or motorcycling, avoiding risky diving into shallow water, and doing exercises to keep your bones strong and prevent falls.

Vaccines

There is no vaccine for spinal cord injury. However, keeping up to date with recommended vaccines helps prevent illnesses that can sometimes cause nerve damage.

Screening programmes

There is no routine screening test for spinal cord injury. If you have a condition that weakens your spine, such as osteoporosis, your doctor may suggest bone density tests or other monitoring.

Complications

If left untreated

• Pressure sores from lying or sitting in one position
• Deep vein thrombosis, which is a blood clot in a leg
• Breathing problems and lung infections such as pneumonia
• Urinary tract infections and kidney damage
• Spasticity, or severe muscle tightness
• Blood pressure problems, including sudden rises

Long-term outlook

A spinal cord injury is serious, but it is not the end of an active life. Many people with spinal cord injuries live full, meaningful lives. The outlook depends on where the injury is and how severe it is. With modern treatment, rehabilitation, and support, many people gain more movement and independence than they first expect. Your health care team is there to help you adapt at every step.

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