Injuries to the Spine

You can have a variety of injuries to your back after an accident. Your back, otherwise known as your spine, is divided into different levels. The highest level which is your neck region is your called your cervical spine. Lower down is the thoracic spine which is the largest area of your back. At the lowest part is your lumbar spine and sacrum where some people may experience back ache.

If you or your loved one sustains a spinal injury there may be a variety of consequences, depending on which part of your spine you injured. The higher up, closer to your neck is usually more dangerous and can cause more problems compared to injuries in your thoracic or lumbar spine. Some of the organisations that help people with spinal injuries are listed in the right hand menu.

What is a Spinal Cord Injury?

Your spine is made up of 33 separate bones (vertebrae) plus many discs, ligaments and muscles which together form your spinal column.  This surrounds and protects your spinal cord. A break, dislocation or ligament injury in any one of these bones can cause significant injury. Breaks can occur in the body of the vertebrae or to one of the processes or two vertebrae may detach (dislocate) from each other damaging surrounding ligaments. When any of these injuries occur it can also damage your spinal cord and might result in paralysis (loss of feeling and movement) below the level of the injury, reduced muscle power (weakness), altered sensations and muscle tone. This is because the messages in the brain can no longer travel down to the appropriate muscles as there is a break in the pathway.

Spinal cord injuries are generally caused by a direct trauma, for example a fall down stairs, sporting injury or car accident, where a force to the spine causes the bone to break and impacts on the spinal cord. Injuries can also be caused swelling (haematomas) from spinal fractures.

In an older person, the force needed to cause these injuries may be substantially less (thinning of the bones making them more fragile) causing the bones to break more easily.

Symptoms of Spinal Cord injury

Everybody with a spinal cord injury will experience slightly different symptoms, depending on the part of the spine that been injured, and any other related injuries, for example to surrounding muscles or ligaments. Common symptoms include:

  • Numbness below the level of the injury
  • Significant muscle weakness below the level of the injury
  • Changes in your bladder function being unable to urinate
  • Changed in your bowel function being incontinent / or unable to initial a motion
  • difficulty moving in bed
  • Possible difficulty taking deep breaths or coughing
  • Dizziness when sitting upright and reduced balance in sitting
  • Difficulty with eating and drinking if your arms are injured


Spinal cord injuries are managed differently depending on where they are located and what symptoms you are experiencing. Management may include surgery, a neck collar or a spinal brace, but some people do not require any of these. If you need to wear a collar or brace it may be required for up to twelve weeks after your injury.

Management of your pain may be difficult and you may need nerve specific pain relief to resolve burning and shooting pain, alongside other pain relief.

Your rehabilitation from your injury will start as soon as you are able after management of your injury has been decided.

Depending on the level of your injury the ward teams will help you with:

  • Referrals to specialist Spinal Rehab Centres
  • Assessments of your power and sensation
  • Moving in bed and care of your skin and hygiene needs
  • Using splints to ensure your joints remain supple
  • Getting into a wheelchair
  • Becoming independent with transferring from a bed to a chair
  • Bladder and bowel care
  • Moving around safely in a wheelchair
  • Standing and beginning ambulation
  • Beginning of planning to go home

In addition, if your injury is in your upper back or neck the therapy team may also:

  • Assess your deep breathing and the strength of your cough
  • Possibly help you to have a strong cough or use a cough assisting device
  • Monitor the strength of your breathing

Possible complications

  • Following a spinal cord injury you can develop stiffness and pain in your neck and any part of your body that you are unable to move. This may cause some muscle spasms which can contribute to your pain.
  • You may also develop a cough or feel you have a lot more phlegm on your chest in the first few days.
  • You may also have some dizziness and difficulty sitting up or in a chair for a few days, which may need medication or abdominal support to address.

What happens after I have left hospital?

You will be followed up in a fracture clinic and reviewed, usually at 6-8 weeks after injury.

In most cases you will be discharged to a rehabilitation centre, if you do go home provisions will be made for you to manage and help or rehabilitation will be arranged for you at home.

Thanks to St Georges' University Hospitals NHS Foundation Trust, Major Trauma Therapy Team, @STGTraumaPTOT for much of this information