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Management of spinal cord injury

The spinal cord is part of your central nervous system and is responsible for carrying messages from the brain to the rest of the body. These messages control feeling, sensation and movement and are responsible for our bodily functions, such as breathing, bladder and bowel management.

When the spinal cord is damaged (through trauma or infection, for example) this essential channel of communication is disrupted. This can lead to a loss of movement and sensation in the body below the injury.

There are approximately 2,500 spinal cord injuries every year in the UK. Roughly half of these are caused by trauma, with the rest caused by some form of non-trauma, for example, spinal cord infections or cancerous tumours.

The most common causes of trauma to the spinal cord are as a result of falls, road traffic collisions and sporting injuries. Spinal cord injury used to be common amongst young males, but more recently, we are seeing a demographic change with more older people sustaining a spinal cord injury. This is affecting both males and females alike.

Spinal cord injuries are complicated, which is why we’ve put together this helpful resource to help you understand some things you need to know about spinal cord injury.

Understanding spinal cord injury

The level of your (or your family member’s) spinal cord injury is referred to using a letter and a number.

Neck injury - Tetraplegia (C1-7)

If the spinal cord injury is in the neck, then you or your family member will have injured one of the cervical nerves (1-7). Damage to the cervical nerves results in tetraplegia or quadraplegia, where paralysis affects all four limbs and trunk muscles. A very high tetraplegia injury can affect a person’s ability to breathe on their own.

Back injury – Paraplegia (T1-12, L1-5 or S1-5)

If a spinal cord injury is in the back, then you or your family member will have injured the thoracic, lumbar or sacral nerves. Damage to the back results in paraplegia, where paralysis affects the lower limbs only.

Complete and incomplete spinal cord injuries

Spinal cord injuries are also referred to as being either ‘complete’ or ‘incomplete’:

  • A complete injury means that the injured person has no sensation or movement below their level of injury.
  • An incomplete injury means that the injured person has some residual sensation or movement below their level of injury.

With an incomplete injury, there may be the potential for recovery in the future with rehabilitation. Every spinal cord injury is unique, and each person’s potential for improvement will depend on many factors, such as their age at the time of the injury, gender, lifestyle choices pre-injury and the person’s engagement with rehabilitation.

What happens after a spinal cord injury?

There is a recognised pathway of care and rehabilitation after a spinal cord injury. This can be summarised as follows:

Stage 1: Scene of trauma care

At the accident scene, paramedics will treat the injured person, suspecting spinal cord injury in the event of any form of trauma. The injured person will be immobilised and taken to A&E at a major trauma centre.

Stage 2: A&E at a major trauma centre

On admission to a major trauma centre, x-rays and scans will be used to diagnose an actual spinal cord injury. When a spinal cord injury is diagnosed, the injured person will be referred to a spinal injury centre. Whilst waiting for a place to become available, they will usually receive treatment in the major trauma centre for around 4-6 weeks after the referral has been made. The length of time the injured person is in the major trauma centre can be extended if some other complications or injuries are being treated, such as serious orthopaedic injuries, or if they are dependent on a ventilator.

Stage 3: Spinal injury centre

When a place becomes available, the injured person will be transferred to a spinal injury centre. These are centres of expertise with specific experience in supporting people after spinal cord injury. The injured person is likely to be here for around 4-6 months, depending on their level of injury and the progress that they make in their rehabilitation.

Stage 4: Coordinated discharge home

A discharge coordinator will be involved early in the rehabilitation process to start making arrangements for the injured person to return home. This will include identifying adaptations needed to accommodation, contacting the local authority for a care assessment, identifying what care might be required and considering other aids and equipment. This will all assist with the injured person’s discharge when you are ready to go home from the spinal injury centre and avoid delays.

Stage 5: Ongoing lifelong care needs

After returning home, the injured person should remain in contact with the spinal injury centre for continuing support and their future care needs. They should have regular check-ups and the opportunity to be referred back to the spinal injury centre if they need treatment in the future.

Unfortunately, due to pressure on the service and capacity in the system, not everyone can access a spinal injury centre after their spinal cord injury. If you or your family member do not access a spinal injury centre, then care and treatment will take place in a District General Hospital or an alternative rehabilitation centre.

Spinal cord injury rehabilitation

When the injured person is ready, they will start a programme of rehabilitation, involving physiotherapy and occupational therapy. This therapy will help the injured person to achieve their maximum independence.

The rehabilitation process works best when everyone works together. This process will involve other professionals such as physiotherapists, occupational therapists, nurses, doctors, counsellors, clinical psychologists and other specialists.

In addition to treatment at the spinal injury centre, there are plenty of things you and your family can do to ensure the injured person has the best possible outcome after their injury:

  • Engage with physiotherapy
  • Do exercises to strengthen muscle function
  • Learn how to use equipment like wheelchairs, and know what to look for
  • Find new ways to approach old tasks and hobbies
  • Be as encouraging and positive as possible
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Living with a spinal cord injury

A spinal cord injury will have a huge impact on the injured person’s lifestyle, but it’s important not to see that as the end of a life, but the start of a different one. With the right support, aids, equipment and care, it is possible to lead a fulfilled life after a spinal cord injury.

Family life

Many people who sustain spinal cord injuries are worried about their family members having to care for them, but this should not automatically be the case, and it's essential to explore other options for meeting your care needs. During the discharge process, you should have had a care assessment to identify what care is available so you can start to think about the best options for you and your family.

For people with a young family, you may have concerns about how your children will cope with the effects of your injury. It is important to talk to children about the adjustment process, but children do adapt quickly to change in their lives.

You may also be concerned about having a family in the future and whether or not this is going to be possible. Many people after spinal cord injury have gone on to have families. It would help to have a think about this and what your plans are for the future. Consider what you would like to achieve and seek advice about this from the spinal injury centre or other support organisation.

Mental health and emotional impact

A spinal cord injury is a life-changing event, so it is not uncommon for people to experience low mood and depression as they come to terms with the change in their lifestyle. Neither is it unusual for people to experience this later on in life.

If you experience low mood or depression, it is essential to talk to someone about this. The spinal injury centre will have clinical psychological support available, or you may wish to speak to a counsellor or seek advice from a mental health charity. You can also talk to your GP, who will be able to provide help and advice.

Spinal cord injury FAQ

Will I walk again after a spinal cord injury? plus symbol minus symbol

There are people with an incomplete spinal cord injury who have walked out of a spinal injury centre. The majority of people, however, are left with some form of paralysis affecting their mobility. You need to seek advice from your treating team about how paralysis will affect you.

What is the potential for recovery after a spinal cord injury? plus symbol minus symbol

The word ‘recovery’ can be misleading for spinal cord injuries. With an incomplete injury, depending on the type of injury, there is potential for improvement through intensive physiotherapy and the rehabilitation process. It is difficult to say over what period of time improvements will occur, as every spinal cord injury is different.

How long will I be in a spinal injury centre? plus symbol minus symbol

Although it varies depending on the severity of your injury, most people are in the spinal injury centre for approximately 4-6 months. A typical stay for a person with tetraplegia is approximately six months and for a person with paraplegia four months. The discharge process should enable you to be discharged home when you are ready.

Will I have to move to a new house? plus symbol minus symbol

Most people after a spinal cord injury will need to make some alterations and adaptions to their property to make it accessible for them. If you are a wheelchair user, this may be more difficult, and it might be more appropriate to find an alternative property.

What equipment will I need to go home? plus symbol minus symbol

The hospital discharge process should identify what aids and equipment you need when you get home. This might be a specific wheelchair, for example, a pressure relieving cushion or grab rails and ramps around your property.

Read our blog: "Making adaptations to your home after a serious injury"

Will my family members have to be my carers? plus symbol minus symbol

Some people after a spinal cord injury do have care from their family, but it is vital that you have a care assessment, so you are fully aware of your options for having personal care support. Having a good family life is essential, and this doesn’t have to include care. If any of your family members do want to care for you, they may be entitled to Carer’s Allowance or other welfare benefits.

Will I ever play with my kids again? plus symbol minus symbol

After a spinal cord injury, you can lead a fulfilling life enjoying many of the same things you did before your injury. Enjoying family time and playing with your kids is an excellent example of this, and children are good at adapting to new circumstances. There are plenty of fun things and accessible days out you can do with your children after a spinal cord injury that doesn’t involve as much physical activity.

Will more care be needed as I get older? plus symbol minus symbol

As you get older, you may need additional care and support - particularly as other health issues become more of a concern. Our bodies naturally slow down as we age, and for people with spinal cord injuries, this may mean secondary health conditions, which require additional treatment or care.

Paying for treatment and financial support

After a spinal cord injury, unfortunately many people will not be able to return to full-time work. This means that financial support is extremely important - not just during the rehabilitation process, but afterwards as well - to ensure you and your family are financially comfortable for the rest of your lives.

But who pays for treatment?

Spinal cord injury claims can help you to pay for treatment and rehabilitation, as well as providing financial stability in the long-term. While many people believe that the overall settlement amount is the most important factor in a claim, interim payments are essential in helping you access essential funds early on when you need them most.

At CFG Law, we also have an emergency fund that can be used in some cases, to help our clients to access the financial help they need by paying for the treatment ourselves. This ensure ours clients have the best possible rehabilitation support to help them to accomplish their short and long-term goals and achieve their best outcome.

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What is the claims process for spinal cord injury?

We pull together with you and your family to understand what your most crucial needs and concerns are, to help you get your life back on track. This can include helping you with emergency funding, access to treatment and rehabilitation, and providing support for the whole family.

We build a team around you and your family, choosing solicitors with specialist expertise in spinal cord injuries. As well as providing expert legal advice, one of our Client Support Managers will also work with you, providing practical support and insight into your and your family’s needs.

To ensure you have the support you deserve, our solicitors work with fewer clients than is typical in the legal industry, meaning they have the time to get to know you and your family. This means we can work intensively and proactively on your claim, resulting in full compensation for your injuries and the best possible outcome for you, without unnecessary delay.

Find out more

Useful organisations

There are a wide range of excellent charities and organisations in the UK who provide support and information after you or a family member has suffered a spinal cord injury.

SIA-iconSpinal Injuries Association

The Spinal Injuries Association supports anyone who has been affected by spinal cord injury, and they work to enable people to live a fulfilled life after injury.

backup-iconBack Up

Back Up inspires people affected by spinal cord injury to get the most out of life with a range of community activities.

aspire-iconAspire

Aspire provides practical help to people with spinal cord injuries throughout their rehabilitation, helping them to achieve independent lives.

spirit-1SPIRIT

SPIRIT is an international spinal injuries charity working to improve the treatment and care for people with spinal cord injuries.

assist-iconASSIST

ASSIST Trauma Care employs experienced therapists trained to work with Post Traumatic Stress Disorder (PTSD).

mind-logoMind

Mind offers support and advice with mental health to make sure nobody has to face mental health problems alone.

spinal-research-iconSpinal Research

Spinal Research is the UK’s leading charity funding medical research around the world to develop reliable treatments for paralysis caused by a broken back or neck

regain-iconRegain

Regain improves the independence of all British men and women who have become tetraplegic as a result of a sports or leisure injury.

Free Help and Advice

We have a range of informative content from our expert solicitors and healthcare professionals, as well as real-life practical advice from people who have been through serious injuries themselves.

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