Spinal Cord Injury – Symptoms and Causes
Overview
Spinal cord injuries (SCIs) damage the spinal cord or the nerves at the end of the spinal column called the cauda equina. The spinal cord plays a vital role in transmitting signals between the brain and body.
When injured, these communication pathways become disrupted, often causing permanent changes in strength, sensation, and bodily functions below the injury site.
The effects of SCIs extend beyond physical symptoms. Many individuals experience significant mental, emotional, and social challenges following their injury.
Despite these challenges, there is hope. Ongoing research worldwide shows promise for potential future treatments. Scientists remain optimistic about eventually developing methods to repair spinal cord injuries.
Meanwhile, current treatments and rehabilitation programs help many people with SCIs lead independent, fulfilling lives.
- Affects signal transmission between the brain and body
- Often causes permanent physical changes
- Impacts mental and emotional wellbeing
- Research continues to advance treatment options
Signs and Symptoms
Spinal cord injuries affect movement and feeling based on where the damage happens and how severe it is. The part where the healthy spinal cord ends is called the neurological level. How much sensation remains helps doctors classify the injury.
Warning Signs Requiring Immediate Help
Several symptoms indicate a serious spinal injury that needs emergency care:
- Severe pain or pressure in the neck, back, or head
- Sudden weakness or loss of control in any body part
- Tingling or numbness in hands, fingers, feet, or toes
- Inability to control bladder or bowels
- Problems with walking or balance
- Breathing difficulties following injury
- Visible twisting of the neck or back
These symptoms can appear right away or develop slowly over time after an accident.
When Medical Care Is Needed
Anyone with a head or neck injury should be checked by a doctor right away. Always treat possible spinal injuries seriously because:
- Serious spinal damage isn’t always obvious at first
- Moving someone with an undiagnosed spinal injury can cause further harm
- Numbness or paralysis might develop immediately or gradually
- Quick treatment can significantly affect recovery outcomes
If you notice any symptoms after an accident or fall, don’t wait to seek help. Early diagnosis allows for better treatment planning and improved chances of recovery.
First Aid for Suspected Spinal Injuries
If you think someone might have injured their spine:
- Keep them still. Don’t move them unless absolutely necessary.
- Call emergency services (911) immediately
- Stabilize their position. Don’t allow any movement of their head or neck.
- Place heavy towels on both sides of their neck or gently hold their head to prevent movement.
- Provide basic care for other injuries without moving their spine.
Proper handling at the accident scene is crucial. Incorrect movement can lead to permanent paralysis or other serious complications.
Spinal injuries can cause:
- Loss of movement ability
- Changed or lost sensation (including temperature and touch)
- Bowel or bladder control problems
- Muscle spasms or overactive reflexes
- Sexual function changes
- Nerve pain or stinging sensations
- Breathing difficulties
The type of paralysis depends on the injury location:
- Tetraplegia (also called quadriplegia): Affects arms, hands, trunk, legs, and pelvic organs.
- Paraplegia: Affects the trunk, legs, and pelvic organs, but not the arms.
Healthcare providers use various tests to determine both the injury level and completeness.
What Causes Spinal Cord Damage
The spinal cord is a soft tissue structure that extends from the base of your brain. It contains nerve cells and bundles of nerves called tracts that send messages throughout your body.
Bones called vertebrae protect the spinal cord. Your spinal cord stops just above your waist in an area called the conus medullaris. Below this area, a group of nerve roots called the cauda equina continues downward.
The spinal cord works like a highway system. Motor tracts carry signals from your brain to control your movements.
Sensory tracts bring information back to your brain about feelings like heat, cold, pain, and where your arms and legs are positioned.
When the spinal cord gets damaged, the nerve fibers passing through the injured area can’t work properly. This affects the parts of your body below the injury site.
Injuries can be complete or incomplete:
- Complete Injury: All feeling and movement below the injury are lost.
- Incomplete Injury: Some function remains below the injury site.
A back or chest injury can affect your trunk, legs, bowel, bladder, and sexual function. If the injury happens in your neck, it can also affect your arms and sometimes your ability to breathe on your own.
Main Causes of Spinal Cord Injuries
Vehicle Accidents
Car and motorcycle crashes cause almost half of all new spinal cord injuries each year. These accidents often deliver powerful forces to the spine.
Falls
Falls are the leading cause of spinal cord injuries in people over 65. Even a minor fall can cause serious damage in older adults with conditions like osteoporosis.
Violence
About 12% of spinal cord injuries come from violent acts. Gunshot wounds are the most common, followed by knife injuries.
Sports Injuries
Athletic activities cause roughly 10% of spinal cord injuries. High-risk activities include:
- Football and rugby
- Diving in shallow water
- Gymnastics
- Horseback riding
Medical Conditions
Not all spinal cord injuries happen suddenly. These conditions can also damage the spinal cord:
- Cancer that spreads to the spine
- Arthritis that severely damages the spine
- Inflammation of the spinal cord
- Infections
- Disk degeneration
The damage from a spinal cord injury often continues to worsen in the days or weeks after the initial injury. This happens because of bleeding, swelling, and fluid buildup in and around the spinal cord.
Risk Factors
Several factors can increase a person’s chance of experiencing a spinal cord injury:
- Gender Differences: Men face a much higher risk, making up about 80% of all traumatic spinal cord injuries in the United States.
-
Age Considerations:
- Young adults (16-30 years old) account for more than half of all cases
- People 65 and older face increased risk, primarily from falls
-
Lifestyle factors:
- Alcohol consumption plays a role in approximately 25% of cases
- Engaging in dangerous activities without proper safety measures
- Common causes by age group:
| Age Group | Leading Cause |
|---|---|
| Under 65 | Motor vehicle accidents |
| 65+ | Falls |
- Risky behaviors that increase danger include diving into shallow water and participating in sports without proper protective equipment.
- Health Conditions: People with certain diseases affecting bones or joints (like osteoporosis) can suffer spinal cord damage from even minor injuries.
Complications
A spinal cord injury often leads to several health challenges. These problems range from changes in body functions to mental health concerns. The right support team can help develop strategies to manage these issues.
Bladder and Bowel Function
Bladder control often changes after a spinal cord injury. The brain may not receive signals needed to control urination. This can increase the risk of urinary tract infections and kidney problems.
Bowel function also changes, though the digestive system still works similarly. Eating high-fiber foods may help regulate bowel movements.
Skin Problems
People with spinal cord injuries may lose sensation below their injury level. Without feeling pain or pressure, they cannot tell when skin is being damaged.
This increases the risk of pressure sores (also called bedsores).
Circulatory Issues
Several blood flow problems can develop after a spinal cord injury:
- Low blood pressure when changing positions (orthostatic hypotension)
- Swelling in arms and legs
- Blood clots in veins
- Autonomic dysreflexia (a dangerous spike in blood pressure that can be life-threatening)
Healthcare teams provide training to recognize and manage these conditions.
Breathing Difficulties
Injuries affecting chest and stomach muscles can make breathing and coughing harder. The risk of pneumonia and other lung problems increases, especially with injuries to the neck and chest area.
Bone and Muscle Changes
After a spinal cord injury, several physical changes occur:
| Change | Description |
|---|---|
| Reduced bone density | Higher risk of osteoporosis and fractures below injury level |
| Spasticity | Involuntary muscle tightening or movements |
| Flaccidity | Soft, limp muscles lacking tone |
Physical Issues
Weight changes are common after spinal cord injury. Initially, patients often lose weight and muscle mass. Later, reduced mobility may lead to weight gain and increased risk of:
- Heart disease
- Diabetes
- Other health problems
Sexual Function and Fertility
Spinal cord injuries typically affect sexual function, including changes in:
- Erection and ejaculation for men
- Lubrication for women
- Fertility
Specialists in urology and fertility can provide options to address these changes.
Pain
Pain after spinal cord injury comes in different forms:
- Muscle or joint pain from overusing certain muscle groups
- Nerve pain, especially in people with incomplete injuries
Emotional Wellbeing
The physical changes and pain following spinal cord injury can lead to depression.
Professional counseling and peer support groups often help people adjust to life changes.
How to Prevent Spinal Cord Injuries
Safe driving practices can greatly reduce the risk of spinal cord injuries. Always wear your seat belt when in a moving vehicle.
If you have children, ensure they use proper safety seats based on their age and weight. Children under 12 should sit in the back seat to avoid air bag injuries.
Be cautious around water. Before diving, check that pools are at least 9 feet deep and marked for diving. Never dive into aboveground pools or water of unknown depth.
Falls are a common cause of spinal injuries. Use step stools with grab bars when reaching high objects. Install handrails on stairways and place nonslip mats on tile floors and in showers.
For homes with young children, use safety gates on stairs and consider window guards.
Take proper precautions during sports activities:
- Always wear recommended safety equipment
- Avoid leading with your head in contact sports
- Don’t slide headfirst in baseball
- Avoid tackling with the top of your helmet in football
- Use spotters when trying new gymnastics moves
Never drive while under the influence of alcohol or drugs. This impairs judgment and reaction time, increasing the risk of accidents. Also, refuse rides from drivers who have been drinking.
