|The spine is made up of a number of small bones called vertebrae. Those form the backbone or spinal column, through which runs the spinal cord (the part of the central nervous system connecting all parts of the body with the brain) and major blood vessels. Injuries to the back are caused in a number of ways: through direct impact (such as a heavy blow to the neck or back); indirect impact (landing on the head or feet without bending the legs, thus allowing the force to travel up the body); and whiplash, when the head is violently thrown forward and backward (common in traffic accidents).
COMPLICATIONS WITH BACK INJURY
The biggest danger with back injuries is the risk of nerve damage. The spinal cord containing the spinal nerves runs down the center of the vertebrae and fractures can severe or pinch these nerves, leading to partial or full paralysis. If the fracture is high in the neck, breathing may stop. Displaced vertebrae or swelling due to blood loss can also apply pressure to the spinal cord, leading to nerve damage.
Not all broken backs result in immediate damage to the spinal cord. However, the risk of spinal cord injuries is greatly increased if bones are broken, and any suspected fracture of the spines should be treated with extreme care.
Suspect a broken back or potential nerve damage if the accident involved:
- Rapid slowing down movement.
- A fall from height.
- A sharp blow directly to the back.
- Injury to the face from the head being thrown backward and forward).
SIGNS AND SYMPTOMS OF A BROKEN BACK
- Dent or step in the spine, which may indicate a displaced vertebra
- Bruising or swelling over the backbone
- Complaint of pain in the back
- Tenderness over the area of the break
Any spinal injury is potentially serious and you should seek emergency assistance immediately. The treatment for injuries to the back is to keep the injured person still while monitoring and maintaining airway breathing. The general rule for dealing with broken bones or spinal cord damage is to keep the victim in the position that you found him until a doctor arrives, taking particular care to ensure the head is immobilized.
Unless the person is in danger or unconscious and requires resuscitation, do not move him form the position in which he was found. If you have been trained to do so, you can move the head into the neutral position before immobilization. Remain in this position until emergency help arrives.
- If the victim is conscious and already lying down, leave him where he is. If the victim is still walking around, support him in lying down on the ground. If you can, put a blanket or coat underneath before you lie the person down.
- Ensure that an ambulance has been called at the earliest opportunity.
- Tell the person to keep still until medical help arrives and reassure him.
- Hold the victim’s head still by placing your hands over the ears and your fingers along the jaw line.
- Do not remove your support from the head until help arrives.
If the victim is unconscious, maintaining a clear airway is your first priority. See Unconscious Victim.
If spinal injury is suspected, the safest position for a person to be in is with the head, neck, and spine aligned. To check alignment, make sure that the victim’s nose is in line with his navel. Keep the head immobilized.
There are many causes of back pain. Among the most serious is damage to spinal cord, which may lead to paralysis or meningitis. More commonly, neck or lower back pain can be cause by muscle strain or damage to the ligaments or the disks between the vertebrae (the back bones). Broken ribs or damage to the muscles between the ribs at the back may also cause back pain.
- Check the nature of the incident carefully—if the pain is related to a recent heavy fall or other accident, assume that there may be spinal cord damage and treat as for a broken back.
- Help the person to lie down. Usually the most comfortable position will be flat on the back on a hard surface.
- If the symptoms do not ease, seek medical attention promptly.
If back pain is accompanied by signs of spinal cord damage, such as a numbness, tingling, or by headaches, nausea, vomiting, fever, or a deterioration in the level of consciousness (e.g. increasing drowsiness), call 911.
SIGNS AND SYMPTOMS
- Dull or severe pain, usually made worse by movement
- Tension in the neck or shoulders
- Pain traveling down limbs
The spine or backbone enables the body to stand upright, supports the head, and protects the spinal cord. Joints between vertebrae give the spine flexibility; ligaments and tendons stabilize the spine and control movement.
Bony projections anchor ligaments and muscles, which stabilize the spine and control movement.
The spine is cushioned by shock-absorbing disks that lie between each vertebra.
The spinal cord is protected by the bony spine, and spinal nerves pass through cavities in the vertebrae.
SIGNS AND SYMPTOMS OF SPINAL CORD DAMAGE
- Loss of movement below the site of the break
- Tingling in the fingers or toes or throughout the body
- Feeling strange, perhaps “jelly-like”
If any of these signs and symptoms is present, or if the nature of the accident indicates a potential fracture, assume that a bone is broken and keep the person still help arrives.
Do not move the victim unless he is in danger or requires resuscitation.
- Do not give anything to eat or drink—the victim may need a general anesthetic in hospital.