What are spinal cord injuries?

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

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

Types of spinal cord injury

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

• Tetraplegia (also known as quadriplegia) — paralysis that affects your upper and lower body. This includes your legs, trunk, arms and hands.
• Paraplegia — paralysis that affects your lower body. This includes your legs and some or all of your trunk.

Spinal cord injuries are also described by how much damage has occurred:

• Complete spinal cord injury — no nerve signals pass below your injury. There is no voluntary movement or feeling below your injury.
• Incomplete spinal cord injury — some movement and feeling may remain below your injury.

What are the symptoms of a spinal cord injury?

Symptoms that may happen soon after a spinal cord injury include:

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

Symptoms can vary between people.

In general, the higher the injury on the spinal cord, the more your body is affected. Your symptoms may also depend on whether you have a complete or incomplete spinal cord injury.

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

If you suspect someone may have a spinal cord injury, call triple zero (000) and ask for an ambulance. Do not move the person unless they are in danger. Moving them can cause further spinal injury.

What should I do while waiting for the ambulance?

If the person is unconscious:

• Follow DRSABCD (basic first aid).
• Prioritise airway and breathing. Check that they are breathing and keep the airway open and clear.
• Do not move the person unless they are in danger. Movement can cause further spinal injury.
• Only place the person in the recovery position if your DRSABCD check is clear and you are confident in how to do this while keeping the head, neck and spine aligned.

If the person is conscious:

• Follow DRSABCD (basic first aid).
• Tell them to remain still.
• Reassure them and stay calm.
• Loosen 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?

Spinal cord injuries can happen because of sudden trauma to the spine, including:

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

Spinal cord injuries can also happen without trauma, due to health conditions such as:

• arthritis
• cancer
• infection
• inflammation

How is a spinal cord injury diagnosed?

A spinal cord injury can be diagnosed by:

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

How is a spinal cord injury treated?

If you have a spinal cord injury, early treatment focuses on stabilising your spine and preventing further damage. Surgery may be needed.

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

• breathing support, such as oxygen therapy or a mechanical ventilator
• a catheter to drain urine from your bladder
• skin care — you will be turned and moved every 2 to 4 hours to help prevent pressure sores
• medicines to prevent blood clots
• emotional support from a social worker, psychologist or chaplain
• support from allied health professionals, such as physiotherapists, occupational therapists and dietitians

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 team of nurses, allied health professionals and specialist doctors will work with you to create a rehabilitation plan that supports your goals and needs. During this time, you will learn how your body has changed and how to care for it.

You may learn how to:

• build strength through exercise
• use a wheelchair on different surfaces
• move safely between a wheelchair and bed
• drive with hand controls, if relevant
• manage your skin, bladder and bowel care

You will also learn how to access community services and ongoing support.

What are the complications of a spinal cord injury?

Complications of a spinal cord injury include:

• breathing problems
• changes in sexual function and fertility
• chronic pain
• pressure sores
• blood pressure changes — such as a drop in blood pressure when you stand up or sudden dangerous increases in blood pressure
• changes in muscle tone, such as spasms and stiffness
• difficulty in regulating body temperature

A spinal cord injury may also affect bladder or bowel control. Some people may need to use a catheter to empty their bladder and learn new ways to empty their bowel.

Can spinal cord injuries be prevented?

A major cause of spinal cord injuries is traffic accidents. You can help prevent spinal cord injuries 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 injuries. 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.
• SpinalHub connects people living with spinal cord injury throughout Australia. They also have information on how to keep healthy after a spinal cord injury.
• If you or someone close to you has had a spinal cord injury and you are concerned about their mental health, visit Medicare Mental Health or call 1800 595 212 for mental health support.
• Forward Ability Support (FAS) is an organisation with a focus on supporting you to achieve your goals after a spinal cord injury.
• The Australian Government Department of Health, Disability and Ageing has an adult health services – Easy Read guide. It explains what healthcare you may need and how to access different services.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

• Physical Disability Council of NSW has a list of resources, including for people from a range of cultural 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.

Information for Aboriginal and/or Torres Strait Islander peoples

• Physical Disability Council of NSW has a list of resources, including for Aboriginal and/or Torres Strait Islander peoples.
• First Peoples Disability Network Australia offers services to Aboriginal and/or Torres Strait Islander peoples living with disability, as well as their families and local communities.

Information for sexually and gender-diverse families

• People with Disability Australia (PWDA) supports and advocates for people living with disability in the LGBTQIA+ community.