Spinal shock explained

What is Spinal Shock?

Because of their nature, spinal cord injuries give rise to a wide range of symptoms. One of the most common of these symptoms is spinal shock, where patients suffer a temporary or permanent loss of their natural reflex response.

Our reflexes are important and controlled by the autonomic nervous system. If your hand touches something hot, for example, the reflex response would be to rapidly pull it out of the way. It’s a way our bodies have of protecting us from adverse conditions.

Spinal shock is a condition that inhibits our ability to do this and can put individuals at risk because they are unable to avoid dangerous situations. It normally accompanies any spinal injury and affects areas below the damage.

The spinal shock definition outlines two different modes or forms. The first is hyporeflexia where the individual has significant loss of reflexes. The other is areflexia where the subject has a temporary loss of reflex.

Spinal Shock Causes

The primary cause of spinal shock is damage to the spinal cord. The severity or otherwise of the shock, however, is no real determinate of how serious the overall damage is.

While spinal shock is often associated with a traumatic event such as a car accident where the spinal cord injury is immediate, it can also be found with other injuries where damage occurs over a period of hours or days.

Spinal shock may not become evident until a cord injury has been fully investigated, mainly because it only manifests if a reflex is needed. In fact, an individual might not even know that they are in spinal shock at all until they are in the hospital and being checked out.

Spinal shock caused by vehicle accident

How long does spinal shock last? That can depend on a number of factors, most importantly the severity of the spinal injury. It is, however, normally a relatively short-lived phenomena compared to the overall effect or impact of the spinal injury itself.

Spinal Shock Symptoms

There are thought to be four stages to spinal shock.

The first and most immediate is a condition known as hyporeflexia where your reflexes can appear reduced or missing below the area where the spinal cord damage has occurred. This can often get mixed up with the injury itself which makes full diagnosis difficult. The first stage usually lasts about 24 hours and is accompanied by feelings of numbness and lack of response to reflex producing stimuli.

The second stage is where the reflexes gradually begin to return and this normally takes place over couple of days after injury.

The third and fourth stages of spinal shock can be a little disturbing and may involve hyperreflexia which is where the reflex response is amplified. Sufferers can exhibit twitching and muscle spasms during this time which can last anything up to four weeks. This process is thought to be due to new synapses developing as well as changes in the neuronal cells.

A person with spinal shock may also exhibit other symptoms such as changes in heart rate and blood pressure and bladder overflow and incontinence. These vary from individual to individual, however, and each case is unique.

Spinal Shock Treatment

Spinal shock is generally seen as a symptom of a more serious spinal cord injury. In itself, it’s not particularly dangerous and follows a fairly straightforward pattern. It is something that is monitored in conjunction with the general treatment of the damage to the spinal cord.

Treatment will revolve first around securing the patient and ensuring there is no further damage. Surgery may be necessary to reduce the pressure on the nervous system and treat the spinal cord injury. Long term treatments may include physical therapy, medication and exercise therapy.

Spinal Shock vs Neurogenic shock

Spinal shock can occur anywhere on the spine where there is spinal cord damage. Neurogenic shock, however, is a related but slightly different condition. It occurs when the damage is higher up, above the thoracic nerves, which can have an impact on autonomic responses such as your heartbeat and respiration.

This is taken more seriously than spinal shock itself purely because it can be life-threatening. Treatment may include administering drugs such as dopamine and vasopressin which dampen the neurogenic shock.

In short, spinal shock will usually resolve itself naturally while neurogenic shock is seen as a medical emergency that requires immediate attention.


Spinal shock is a common part of a spinal cord injury. While it is something that generally rectifies itself over time, it can be a signal that spinal damage has occurred in the first place and you should seek medical advice immediately if you exhibit the symptoms. Recovery from spinal shock can take place fairly quickly or may last several weeks, if not months, depending on the severity of the injury.