A Neck Injury Primer

Why is neck injury so prevalent? Largely because a very minor event can cause a devastating neck injury. Yet, there is no mystery in this. Your neck is slender in comparison to your head, which weighs an average of twelve pounds in an adult. A minor compression or twist can damage the cervical vertebrae, with resulting impingement of the spinal column, causing a devastating neck injury. Your spinal column is only the width of your small finger in the lower neck and controls your entire body. Think about it. Your entire life depends on a jelly-soft electrical cable that is about a half-inch wide. It’s not really a “neck injury,” it’s a spinal cord injury. You could strain you neck muscles all day long and they could be terribly sore, but the spine is what we are really talking about.

Spinal damage due to neck injury disables or incapacitates about ten to twelve thousand Americans every year. About a quarter million live with the result of neck injury. The most likely cause is a sudden, traumatic blow to the head, often in an auto accident. This fractures and dislocates vertebrae - the bones the hold up the spinal column. Bone fragments impact and traumatize the spinal cord, causing swelling and cell death. Blood vessels can rupture. At this point the neck injury causes the spinal cord to swell, cutting off oxygen and further hastening cell death. This is one reason that immediate care is needed after a neck injury. Swelling causes more damage than the initial accident.

After any neck injury it is essential to keep the neck as immobilized as possible. TV shows often have someone slapping an unconscious person to revive them, but given the movement of the spine this causes it’s a really bad idea - fit only for bad TV shows.

After calling for assistance and immobilizing the head as much as possible, cooling the neck with surrounding ice to reduce swelling, should help not arrive soon, is a good idea. The first treatment for neck injury, after any essential surgery, is axial traction using a rigid neck brace.

Neck injury can cause a large number of symptoms. The most commonly recognized, of course, is paralysis of some or all of the body. But there are many others, such as breathing problems and pneumonia, irregular heartbeat and blood clots, muscle spasms, bladder, bowel, and reproductive problems, and not least of all - pain.

Pain is probably the worst problem caused by neck injury, after paralysis, since it is often intractable and difficult to treat. Doctors don’t want to prescribe too many narcotics, and patients should not want to become drug-dependent zombies. So it’s a difficult balancing act for both patient and physician.