by James Hubbard, M.D., M.P.H.

A devastating spine injury could happen to anyone. A simple fall or hit on the head can break the spinal bones. But a break doesn’t always cause paralysis—if people react to it correctly.

Spinal bones surround and protect the fragile spinal cord. You can feel their prominences, called spinal processes, along your neck and back. Like any bone they can be broken. The difference is, if this fracture moves, it can push against and permanently damage the spinal cord. That’s why it’s essential to learn when to suspect a broken neck or back and what to do about it.


Causes of a Broken Neck or Back

You should suspect a spine injury:

  • After any head or neck injury.
  • After any injury in which the neck is jerked.
  • After any fall involving the head, neck, or back.
  • After any fall of more than a few feet.
  • If the neck hurts after a fall or hit.


Symptoms of a Broken Neck or Back

To rule out a spine injury you must check all of these things:

  • Alertness. Unless the person is totally alert, you must assume a possible spine injury after any significant trauma because you can’t trust the person to reliably tell you whether there’s a problem. If you suspect unwitnessed trauma and the person is confused or disoriented, you must assume a spinal injury until the person becomes alert enough that you can trust his or her story.
  • Tenderness. Press on each of the spinal processes along the back and neck to make sure they’re not tender.
  • Strength and movement. Check both hands for grip strength, and make sure the person can wiggle both hands and feet, and all fingers and toes. Compare sides.
  • Sensation. Make sure the person has good feeling sensation on their fingers and toes by scraping with a pin or light touch. Compare sides.

If you can’t rule out a spine injury you must assume there could be one and stabilize the neck and back. See my video on how to do this, coming next Tuesday.

Please comment if you have questions. You need to know how to do this and lead a team of others if you have help.

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