What is a spinal cord injury?

A spinal cord injury (SCI) happens when there is damage to your spinal cord. It can cause a loss of movement and feeling in parts of your body. Bodily functions, such as breathing, digestion and sexual function, can also be affected by your injury.

Your spinal cord is a part of your central nervous system. It is a long tube of nerve tissue that extends from your brain down through the centre of your spine. It carries messages between your brain and body that manage movement and sensation. If you have a SCI, these functions can be disrupted or lost.

Types of spinal cord injury

The type of spinal cord injury you have depends on which part of your spinal cord is damaged. There are 2 major types:

• quadriplegia (also known as tetraplegia) — this refers to paralysis of your upper and lower body. This includes your legs, trunk, arms and hands.
• paraplegia — this refers to paralysis of the lower part of your body, including your legs and some or all of your trunk

The extent of damage to your spinal cord can be classified as:

• complete — this is when no nerve signals can be sent below your injury. You will not have any feeling or voluntary movement below your injury.
• incomplete — this is when you may be able to move one limb more than the other or feel parts of your body that you cannot move

A SCI can impact on how you live your life. It can cause severe disability and health complications.

What are the symptoms of spinal cord injury?

Immediate symptoms of a SCI after an accident can include:

• tingling, loss of movement or loss of sensation in your body below the site of your injury
• difficulty breathing
• an abnormal position of your head or neck
• pain or discomfort
• loss of bladder or bowel control
• altered state of consciousness or shock
• nausea, headache or dizziness

These symptoms can vary. The higher the injury along the spinal cord, the more your body is affected. Your symptoms also vary depending on whether you have a complete or incomplete SCI.

When should I call an ambulance or go to the emergency department?

If you suspect someone may have suffered a SCI, call triple zero (000) and ask for an ambulance.

What should I do while waiting for the ambulance?

If you suspect a SCI, do not move the person unless they are in danger. Moving them can cause more injuries.

If the person is unconscious:

• Follow DRSABCD (basic first aid).
• Place them in the recovery position whilst holding their head and spine in a neutral position by placing your hands on either side of their head. This is to prevent twisting or bending their spine.
• Maintain a clear and open airway.

If the person is conscious:

• Follow DRSABCD (basic first aid).
• Reassure them.
• Loosen any tight clothing.
• Support and hold their head and neck in a neutral position by placing your hands on either side of their head. This is to prevent twisting or bending of their spine.

What causes a spinal cord injury?

SCIs can happen because of a sudden trauma to your spine, due to:

• traffic accidents
• sports injuries
• diving into shallow water
• violence
• falls

SCIs can also happen without trauma, due to health conditions such as:

• arthritis
• cancer
• infection
• inflammation

After a serious injury, the spinal cord can swell. Because there's not much space inside the spine, this swelling can quickly stop the nerves from working properly.

How is a spinal cord injury diagnosed?

A SCI can be diagnosed by:

• neurological examination — your doctor will check your ability to move and feel different parts of your body
• magnetic resonance imaging (MRI) scan of your spine

What are my treatment options?

If you have a SCI, initial treatment focuses on stabilising your spine. You may need to have surgery to prevent additional damage to your spinal cord.

Depending on the extent of damage to your spinal cord, treatment may include:

• a mechanical ventilator or other forms of oxygen therapy to help you breathe
• having a catheter placed in your bladder to drain your urine
• skin care — you will be turned and moved every 2 – 4 hours to help prevent pressure sores from developing
• medicines to prevent blood clots
• emotional support — a social worker, psychologist or chaplain can provide support

Rehabilitation

After you have recovered from surgery and your condition has stabilised, you will begin rehabilitation at a spinal rehabilitation unit.

Rehabilitation can take many months.

A multidisciplinary team of nurses, allied health professionals and specialist doctors will work together to create a rehabilitation plan tailored to your needs.

During this time, you will learn how your body has changed and how to take care of it.

You will develop skills to help you do everyday tasks. For example, you may learn how to:

• weight train to build your strength
• manage a wheelchair on different surfaces
• transfer between a wheelchair and bed
• drive with hand controls
• manage your skin, bladder and bowel care

You will also learn how to access community services.

Complications of a spinal cord injury

Complications of a spinal cord injury include:

• loss of control of your bladder and/or bowel — you may have to use a catheter to empty your bladder and learn new ways to empty your bowel
• breathing problems
• changes in sexual function and/or fertility
• chronic pain
• pressure sores
• difficulty controlling your blood pressure, for example, orthostatic hypotension (a drop in blood pressure when standing) and autonomic dysreflexia (a dangerous increase in blood pressure)
• changes in muscle tone like spasms and stiffness

SCIs can also significantly impact your mental health and wellbeing. The trauma of the SCI puts you at a higher risk of suffering from depression and post-traumatic stress disorder.

Can spinal cord injuries be prevented?

A major cause of spinal cord injury is road trauma. You can help prevent SCI by being safe on the roads. Here are some ways to stay safe on the road:

• Don’t use your phone when you drive.
• Always drive within the speed limit.
• Avoid driving when you are tired.
• Don’t drive when you are under the influence of drugs or alcohol.
• Always wear a seatbelt.
• Never get into a car with someone you do not trust to drive safely.

Make sure to participate safely in sports activities. Never dive into shallow water.

Falls are another major cause of spinal cord injury. Take care when using a ladder.

Find out more about how to prevent falls.

Resources and support

• Spinal Cord Injuries Australia (SCIA) offers a range of services and resources for people living with spinal cord injury.
• Visit SpinalHub, a community website that connects people living with spinal cord injury throughout Australia.
• Learn more about how to keep healthy after a spinal cord injury at SpinalHub.
• If you or someone close to you has had a spinal cord injury and you are concerned about their mental health, visit Head to Health or call 1800 595 212 for mental health support.
• Forward Ability Support (FAS) is an organisation with a focus on supporting you achieve your goals after a spinal cord injury.

Do you prefer to read in languages other than English?

• Physical Disability Council of NSW has a list of resources, including for people from a range of culture and language backgrounds.
• Multilingual Disability Hub is a phone hotline and website with easily accessible information on disability and the National Disability Insurance Scheme (NDIS) in many languages.

Looking for information for Aboriginal and/or Torres Strait Islander people?

• Physical Disability Council of NSW has a list of resources, including for Aboriginal and/or Torres Strait Islander people.
• First Peoples Disability Network Australia offer services to people with disability and their families and local communities. The governing body consists of First Peoples with disability or lived experience of disability.