Spinal Cord Injury: Paraplegia and Quadriplegia

A spinal cord injury is damage to the spinal cord, most often from a fall or road accident, and it can cause weakness or paralysis below the level of the injury. How much function returns depends on how complete the injury is, and early care and rehabilitation make a real difference. Many people go on to live full, active lives.

Reviewed by Dr. Kshitij Chaudhary, Last reviewed October 2026

What are paraplegia and quadriplegia?

These words describe the effect of a spinal cord injury. In paraplegia, the legs are affected but the arms work. In quadriplegia (also called tetraplegia), the arms and legs are both affected. Doctors also describe the injury as complete, where there is no movement or feeling below the injury, or incomplete, where some movement or feeling remains. Weakness without complete paralysis is called paraparesis or quadriparesis.

What causes a spinal cord injury, and who gets it?

The most common cause is injury: a fall from a height, a road accident or a sports injury. It is most common in young adults and, after falls, in older adults. The cord can also be damaged by non-injury causes such as a tumour (Spinal Metastasis), infection (Spinal Tuberculosis) or severe narrowing of the canal (Cervical Spinal Stenosis).

What should I do right after an injury?

Keep the person still and call for emergency help. Support the head and neck in a straight line, and don't lift or twist the body unless there is immediate danger. Moving someone with a broken spine can make the damage worse. Get them to a hospital with spine and ICU facilities as quickly and carefully as possible.

How serious is it?

A spinal cord injury is a major event, but the outlook is not the same for everyone. It depends on the level of the injury, how complete it is, and how quickly the cord is protected from further damage. Injuries in the neck can also affect breathing, so they need close monitoring in intensive care.

What are the effects?

Beyond weakness or paralysis, a spinal cord injury can affect:

• Feeling and sensation below the injury
• Bladder and bowel control
• Sexual function
• Breathing, in higher neck injuries
• Blood pressure and temperature control
• Muscle tightness (spasticity), spasms and nerve pain

Not everyone is affected in every way. The pattern depends on the level and completeness of the injury.

How is it diagnosed?

We examine movement, feeling and reflexes carefully, and grade the injury. CT shows the broken bones, and MRI shows the cord and any pressure on it. We repeat the examination often in the first days, because it tells us how the injury is changing.

Will I recover movement?

It depends heavily on whether the injury is complete or incomplete. People with incomplete injuries often recover more. Most recovery happens in the first 3 to 6 months, and smaller gains can carry on for up to two years. We can't give an exact answer on day one. We give a clearer picture as your recovery unfolds.

What is the treatment without surgery?

Some injuries are stable and can be managed without an operation. The treatment includes:

• Keeping the spine still in a collar, brace or bed rest until it heals
• Intensive care monitoring for breathing, heart rate and blood pressure
• Preventing complications such as pressure sores, chest infections and blood clots
• Starting rehabilitation as early as it is safe

When is surgery needed?

Surgery is considered when the spine is unstable, when bone or disc is still pressing on the cord or nerves, or when it will let you sit up and start rehabilitation sooner. The timing depends on how stable you are overall. If you have been advised surgery and aren't sure, you can send your MRI for a second opinion.

What does surgery involve?

The aims are to take pressure off the cord and nerves, realign the bones and hold the spine steady with screws and rods while it heals. In the neck, the operation is done from the front, the back or both. In the mid and lower back, it is usually done from the back. Surgery protects the cord from further damage. It can't repair cord that has already been injured.

What does rehabilitation involve?

Recovery after a spinal cord injury is long. A team works with you: physiotherapists, occupational therapists, urologists, nurses and a psychologist. Rehabilitation focuses on:

• Strengthening the muscles that still work and retraining those that are weak
• Learning to move, transfer and use a wheelchair where needed
• Managing bladder and bowel function
• Preventing complications
• Supporting your mind through a major life change

How can complications be prevented?

People with paraplegia or quadriplegia are at higher risk of urine infections, pressure sores, chest infections, blood clots, bone thinning, muscle tightness and chronic pain. Your rehabilitation team will teach you how to prevent and manage these. Change position regularly, check your skin every day, and tell your team early if something changes.

What is life after a spinal cord injury like?

Many people with paraplegia or quadriplegia lead full, active lives, working, driving adapted vehicles, keeping relationships and raising families. Some regain movement or feeling over time, especially with incomplete injuries. Low mood and anxiety are common while you adjust. Support from your medical team, your family and, if it helps, a mental health professional is part of recovery.

Can a spinal cord injury be prevented?

Many can. Wear a seatbelt and a helmet, take care at heights, make your home safe against falls, and use proper protection in sport.

Questions to ask your doctor

• What is the level of the injury, and is it complete or incomplete?
• Is my spine stable, or do I need surgery?
• When can rehabilitation start?
• What recovery can I realistically expect?
• How do I prevent pressure sores and infections?
• Where can we get support at home?

Treatments we offer for this

Emergency assessment and imaging review, stabilisation and decompression surgery for spinal injuries, and guidance towards rehabilitation.

This page is for general information and does not replace a medical consultation. Please see a doctor for advice about your own symptoms.