Hesperian Health Guides

Spine and Neck Injuries

In this chapter:

Inside the bones of the spine is the spinal cord, an extension of the brain. An injury to the spinal cord can cause life-long disability or death. If there is any chance the person hurt his spine, you can protect him from further injury by keeping his neck and back still!

Assume that the spine may be injured after any car, motorcycle, or bicycle crash, any big fall, or blow to the back or head. Keep the neck and back still so they cannot turn side to side or up and down, which could further damage the spine. Tape a roll of clothes, fabric, foam, or something else around the neck to keep it from moving.

a shirt being rolled up and put around a person's neck.


Do not give pain medicine until you are sure there is no injury to the spine. Pain reminds the person to keep still.

Signs of spine injury
  • Pain or tenderness along the neck or spine
  • Weakness or loss of movement in the arms or legs
  • Numbness in the arms or legs


Other signs of spine injury include loss of control of urine or stool, difficulty breathing, or shock. If there is any doubt, it is safest to treat the person as if he has a spine injury.

a man on his back, raising his arms.

To check for spine injury, ask the person to stay flat on his back and to raise his knees. Then ask him to raise his arms. Can he move them? Does he feel pain? Touch the fingers and toes. Can he feel your touch? Can he feel your pinch?

If there is a place on the body below which the person cannot move or feel, the bones in the spine are broken. But with help from others, you can prevent his problems from
getting worse.

a man speaking to 2 others as they get ready to roll a woman's body.
Roll on "three'. One, two...
Hold the head in line with the body, keep the neck straight.
the men rolling the body as the first man speaks.
three

If he still has feeling and movement, feel the spine itself. Carefully “log roll” him to his side like this to check his whole back.

Keep the head, neck, and back in one straight line as you roll. Then keep the body still, and gently feel each bump along the back bone, from the back of the head to between the buttocks. Feel for bones out of place, breaks, or pain.

Use the same group effort to carefully roll him back.

(If the person is vomiting, place something under his head so he can stay on his side.)

If there is pain or tenderness, the person needs x-rays to see if there are smaller breaks in the bones. He will need to rest in one position, being turned every few hours but keeping the neck and back still, until pain subsides in a week or so.

NWTND fa Page 22-3.png

To move the person, log roll him onto his side and put a long flat board, like a wooden door, under him. Then roll him back onto the board. Use a few long strips of strong tape or cloth to secure his head, chest, and thighs to the board. If you must keep the person on this board for a long time, you should roll him to his side every couple of hours.

A person who has had an injury to the spine needs long‑term physical therapy. Seek help from those with experience, or use a book like Disabled Village Children or A Health Handbook for Women with Disabilities, both available from Hesperian.

This page was updated:01 Feb 2021