Question on Back Injury

Punk28 · Jul 10, 2015

So, in the chapter that I've written one of my characters gets into a right brutal fight. He's thrown up against a "medium-sized tree" that has a "thin trunk". His back is injured (broken in two places - middle and lower) afterwards.

Anyone know what it feels like when a back is broken? What type of pain is felt? Is pain felt or is it like *pow* back breaks, can't feel or move a thing?

MDSchafer · Jul 10, 2015

Depends on the injury. What do you mean by break? Like are we talking about the spinous process or are we talking about the complete fracture of a vertebra?

Punk28 · Jul 10, 2015

I've got to say a complete fracture of the vertebra.

Had to research what spinous process was to answer that question; while I have 5 herniated discs in my back I have no clue what all goes with a broken back. My basic knowledge (which is probably all wrong) just tells me that a broke back is just that. A broken back.

cornflake · Jul 10, 2015

Punk28 said:
So, in the chapter that I've written one of my characters gets into a right brutal fight. He's thrown up against a "medium-sized tree" that has a "thin trunk". His back is injured (broken in two places - middle and lower) afterwards.

Anyone know what it feels like when a back is broken? What type of pain is felt? Is pain felt or is it like *pow* back breaks, can't feel or move a thing?

What do you want to happen? People walk around with broken backs - the Tour de France leader broke his back in two places in a crash the other day and I don't think they realized how serious it was until he got it imaged. If it affects the spine, that's a different deal, and I'm sure there are plenty of people who break their backs and are immobilized by pain or what have you, but I know it can be a 'wait, what?' kind of situation. I'd think it depends on what kind of break, where, etc.

MDSchafer · Jul 11, 2015

Punk28 said:
I've got to say a complete fracture of the vertebra.

There are different types of injury and it depends if the break is stable or unstable. So there's a pretty wide range options you can go with.

boron · Jul 11, 2015

After breaking the vertebra, but not the spinal cord, you can expect pain in the back and eventual pain/tingling in the body parts below the break.

When the spinal cord is cut completely, you do not feel any pain or anything in the body parts below the injury. I'm not sure if throwing someone into a tree would result in spinal cord break. This usually occurs after falls from the height or in car accidents.

Punk28 · Jul 11, 2015

cornflake said:
What do you want to happen? People walk around with broken backs - the Tour de France leader broke his back in two places in a crash the other day and I don't think they realized how serious it was until he got it imaged. If it affects the spine, that's a different deal, and I'm sure there are plenty of people who break their backs and are immobilized by pain or what have you, but I know it can be a 'wait, what?' kind of situation. I'd think it depends on what kind of break, where, etc.

Honestly, I don't want him to be able to get up. Basically, he's thrown against the tree then he finds himself unable to move anything of his body (except for his eyes and mouth, that is). He feels pain, it courses through his body, but he can't feel or move his extremities.

Since I want a sense of reality in what I've writing I'm wanting to make sure that pain (and what type of pain) is felt after such back trauma occurs.

boron said:
After breaking the vertebra, but not the spinal cord, you can expect pain in the back and eventual pain/tingling in the body parts below the break.

When the spinal cord is cut completely, you do not feel any pain or anything in the body parts below the injury. I'm not sure if throwing someone into a tree would result in spinal cord break. This usually occurs after falls from the height or in car accidents.

It was a pretty brutal fight and the impact from his hitting the tree was a very bad one. One of the witnesses does claim that the guy's head "did a 360" - meaning; his head just flipped back - after he hit the tree.

Would temporary paralysis happen from a middle and lower back vertebra break/fracture?

asroc · Jul 11, 2015

Punk28 said:
Honestly, I don't want him to be able to get up. Basically, he's thrown against the tree then he finds himself unable to move anything of his body (except for his eyes and mouth, that is). He feels pain, it courses through his body, but he can't feel or move his extremities.

That's going to be tough to achieve. You want an incomplete spinal cord lesion at the cervical level that bilaterally disrupts motor function but leaves sensory function intact. The descending and ascending pathways are intermingled and very close together, and it's hard to injure one without injuring the other.

Punk28 · Jul 11, 2015

asroc said:
That's going to be tough to achieve. You want an incomplete spinal cord lesion at the cervical level that bilaterally disrupts motor function but leaves sensory function intact. The descending and ascending pathways are intermingled and very close together, and it's hard to injure one without injuring the other.

Is it possible to injure one without injuring the other?

WeaselFire · Jul 12, 2015

Punk28 said:
Anyone know what it feels like when a back is broken? What type of pain is felt? Is pain felt or is it like *pow* back breaks, can't feel or move a thing?

What do you need for your story? This could range from a bruise and ache to total paralysis below a certain body location. Each feels different so there's no way we can give you specifics to a general question. And it doesn't make sense to tell you how something feels that doesn't fit your story.

Jeff

asroc · Jul 12, 2015

Punk28 said:
Is it possible to injure one without injuring the other?

In general yes, but if you want complete paralysis from the neck down without affecting sensory function, it's hard to come up with a realistic scenario. I don't think I've ever seen that. Unilateral wouldn't be too outlandish, but both sides, caused by injury... What might be possible though is losing part of his sensory function along with all of his motor function. If the injury somehow managed not to affect the spinothalamic tracts the character might still feel pain.

MDSchafer · Jul 13, 2015

Punk28 said:
Honestly, I don't want him to be able to get up. Basically, he's thrown against the tree then he finds himself unable to move anything of his body (except for his eyes and mouth, that is). He feels pain, it courses through his body, but he can't feel or move his extremities.

Since I want a sense of reality in what I've writing I'm wanting to make sure that pain (and what type of pain) is felt after such back trauma occurs.

It was a pretty brutal fight and the impact from his hitting the tree was a very bad one. One of the witnesses does claim that the guy's head "did a 360" - meaning; his head just flipped back - after he hit the tree.

Would temporary paralysis happen from a middle and lower back vertebra break/fracture?

What you're describing isn't really possible. You do get some spinal patients with sensation but not movement, but that's far from the norm. Also, there's no way your character survives that kind of damage and remains fully conscious. What you're describing is a near fatal, or fatal spinal, and probably a coup-contra coup brain injury as well from the "360 degree flip." Also, there would probably be some basal skull fractures and significant bruising to the neck.

You can get descending paralysis when you have a partial transection of the spinal cord. It's become someone of a lantern in fiction, especially after the whole Matthew's miracle recovery on Downton Abbey. But basically sometimes when the spinal cord tears it swells and cuts off movement, and dulls sensation, below the level of the injury. Typically it takes four months or so to recover and it's not really sure if it's shock or injury for several weeks to a month or two

Punk28 · Jul 20, 2015

asroc said:
In general yes, but if you want complete paralysis from the neck down without affecting sensory function, it's hard to come up with a realistic scenario. I don't think I've ever seen that. Unilateral wouldn't be too outlandish, but both sides, caused by injury... What might be possible though is losing part of his sensory function along with all of his motor function. If the injury somehow managed not to affect the spinothalamic tracts the character might still feel pain.

I changed it so he couldn't move his mouth. He's able to only more his eyes now (as in: look to the side or up and down). He can take things in but he can't move or say anything (or make any sounds, for that matter). Would this be the logical choice in changing the scenario or should I change it back?

MDSchafer said:
What you're describing isn't really possible. You do get some spinal patients with sensation but not movement, but that's far from the norm. Also, there's no way your character survives that kind of damage and remains fully conscious. What you're describing is a near fatal, or fatal spinal, and probably a coup-contra coup brain injury as well from the "360 degree flip." Also, there would probably be some basal skull fractures and significant bruising to the neck.

You can get descending paralysis when you have a partial transection of the spinal cord. It's become someone of a lantern in fiction, especially after the whole Matthew's miracle recovery on Downton Abbey. But basically sometimes when the spinal cord tears it swells and cuts off movement, and dulls sensation, below the level of the injury. Typically it takes four months or so to recover and it's not really sure if it's shock or injury for several weeks to a month or two

He does have some neck vertebra bruising after the fight (the flip was nearly 360 degrees not a full 360 degree flip).

Roxxsmom · Jul 20, 2015

Punk28 said:
Honestly, I don't want him to be able to get up. Basically, he's thrown against the tree then he finds himself unable to move anything of his body (except for his eyes and mouth, that is). He feels pain, it courses through his body, but he can't feel or move his extremities.

Not being able to move at all sounds more like a neck injury. If you sever or crush the spine above the eighth cervical nerve (protrudes from between the seventh cervical vertebrae and the first thoracic one), you'll have some degree of arm paralysis as well as leg paralysis. Injuries to the spine can be complete or partial. It's also possible to cause numbness, tingling, or compromised movement via pinching the nerve roots that protrude from between vertebrae. This happens with slipped discs. The sensory and motor nerve roots are separate when they first leave or enter the spinal cord, which is why it's possible to have pain, numbness or tingling and still be able to move the affected body part sometimes.

Would temporary paralysis happen from a middle and lower back vertebra break/fracture?

It depends on whether the spinal cord was severed or crushed, or whether it was temporarily compressed or pinched. In the latter case, physical therapy, antiinflammatories, and/or surgery can restore function.

With injuries to the spine that cause paralysis,recovery is most likely in cases when paralysis is partial and where sensation starts to return within the first week of the injury.

These links may give you some idea about the symptoms.

http://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/basics/symptoms/con-20023837

http://www.merckmanuals.com/home/in...ies/injuries-of-the-spinal-cord-and-vertebrae

http://www.nlm.nih.gov/medlineplus/ency/article/001066.htm

http://www.spinalinjury101.org/details/levels-of-injury

Also, a bit of spinal anatomy

http://neuroscience.uth.tmc.edu/s2/chapter03.html

asroc · Jul 20, 2015

Punk28 said:
I changed it so he couldn't move his mouth. He's able to only more his eyes now (as in: look to the side or up and down). He can take things in but he can't move or say anything (or make any sounds, for that matter). Would this be the logical choice in changing the scenario or should I change it back?

Now that's a completely different scenario. The mouth is innervated by cranial nerves, so that's a (very serious) head injury, not a back injury. Not being able to speak is particularly worrisome, as the laryngeal muscles are controlled by branches of the vagus nerve, which also controls the diaphragm = patient will most likely suffocate.

Honestly, with the extent of the injuries you want your character to have, it's very hard to come up with a scenario that's medically believable.

Punk28 · Jul 21, 2015

Roxxsmom said:
Not being able to move at all sounds more like a neck injury. If you sever or crush the spine above the eighth cervical nerve (protrudes from between the seventh cervical vertebrae and the first thoracic one), you'll have some degree of arm paralysis as well as leg paralysis. Injuries to the spine can be complete or partial. It's also possible to cause numbness, tingling, or compromised movement via pinching the nerve roots that protrude from between vertebrae. This happens with slipped discs. The sensory and motor nerve roots are separate when they first leave or enter the spinal cord, which is why it's possible to have pain, numbness or tingling and still be able to move the affected body part sometimes.

It depends on whether the spinal cord was severed or crushed, or whether it was temporarily compressed or pinched. In the latter case, physical therapy, antiinflammatories, and/or surgery can restore function.

With injuries to the spine that cause paralysis,recovery is most likely in cases when paralysis is partial and where sensation starts to return within the first week of the injury.

These links may give you some idea about the symptoms.

http://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/basics/symptoms/con-20023837

http://www.merckmanuals.com/home/in...ies/injuries-of-the-spinal-cord-and-vertebrae

http://www.nlm.nih.gov/medlineplus/ency/article/001066.htm

http://www.spinalinjury101.org/details/levels-of-injury

Also, a bit of spinal anatomy

http://neuroscience.uth.tmc.edu/s2/chapter03.html

Thank you! That's a great help!

Question on Back Injury

Punk28

MDSchafer

Punk28

cornflake

practical experience, FTW

MDSchafer

boron

Health writer

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asroc

Alex

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WeaselFire

Benefactor Member

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Alex

MDSchafer

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Roxxsmom

Beastly Fido

asroc

Alex

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