First aid

Updated 09 November 2016

Spinal cord injury: First aid

Spinal cord injury (SCI) is always a medical emergency as it could lead to chronic painful conditions, permanent paralysis or even death.

Spinal cord injury (SCI) is always a medical emergency as it could lead to chronic painful conditions, permanent paralysis or even death.

SCI occurs when a traumatic event (usually a car, diving or sport accident) results in damage to cells within the spinal cord or severs the nerve tracts that relay signals up and down the spinal cord. The most common types of SCI include contusion (bruising of the spinal cord) and compression (caused by pressure on the spinal cord).

Other types of injuries include lacerations (severing or tearing of some nerve fibers, such as damage caused by a gun shot wound), and central cord syndrome (specific damage to the corticospinal tracts of the neck region of the spinal cord).

The types of disability associated with SCI vary greatly depending on the severity of the injury, the segment of the spinal cord at which the injury occurs, and which nerve fibres are damaged. Usually the higher up in the cervical spine the injury, the greater the damage.

If treated correctly, most people with SCI regain some functions between a week and six months after injury, but the likelihood of spontaneous recovery diminishes after six months. Rehabilitation strategies can minimise long-term disability.


  • Person is lying with his head, neck or back in an awkward position
  • Severe pain in the head, neck or back
  • Weakness, tingling or loss of sensation below the point of injury,
  • Inability to move arms or legs
  • Bruises on the head, neck, shoulders or back
  • Loss of bowel or bladder control
  • Difficulty breathing
  • Unconsciousness
  • Symptoms of shock

Even if the person does not have any of these symptoms but you know he has sustained a back, neck or head injury, treat it as a spinal injury. If a head injury was sustained and the person has disturbed level of consciousness, suspect a spinal injury as well.

Get help immediately if:
You suspect a spinal injury. The sooner a person is treated in hospital, the greater the chances for recovery.

Home treatment:

  • If you suspect a spinal injury, do not move the person unless he is in imminent danger from, for example, traffic or fire or you need to perform CPR.
  • If a person is in the water, don't move him to land. Keep him lying face up until help arrives. The water will immobilise the spine.
  • Don't remove helmets unless you need to perform CPR.
  • If the person must be moved, then there should be one person controlling the neck and head to keep them in alignment, and at least two people on either side of the person to lift him without moving the spine.
  • Treat other life-threatening injuries while waiting for help to arrive.
  • Keep the person warm.
  • Don't give anything to eat or drink.
- (Ilse Pauw, Health24)

Reviewed by Dr Elmin Steyn, trauma surgeon


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