--- title: What You Should Know about C4 Spinal Cord Injuries description: Learn what you need to know about C4 spinal cord injury at this level and what you can expect concerning cervical spinal cord injury recovery. image: https://www.spinalcord.com/hubfs/Blog-Images/SCI-patient-in-wheelchair-being-pushed-by-nurse-min.jpg --- [![spinalcord logo desktop](https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png) ![spinalcord logo mobile](https://www.spinalcord.com/hubfs/Logos/spinal-cord-white_png.png) ](https://www.spinalcord.com/) MENU ** ![spinal cord logo slide out mobile](https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png) ** [![Dale Swope](https://www.spinalcord.com/hs-fs/hubfs/dale-img-min.jpg?width=100&name=dale-img-min.jpg) The Purpose Behind Spinalcord.com ** Play Dale Swope's Story ](https://www.youtube.com/watch?v=C1kPXDw_CQU) [For Advice Call: (877) 336-7192 ](tel:8773367192) ![Spinalcord Logo](https://www.spinalcord.com/hubfs/Logos/spinal-cord-logo-icon-svg.svg) - 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[Speak With An Injury Lawyer](https://www.spinalcord.com/spinal-cord-injury-legal-help-get-a-lawyer) - [Personal Injury Lawyer](https://www.swoperodante.com/tampa-personal-injury-lawyer/) - Digital Resources - [Frequently Asked Questions & Answers](https://www.spinalcord.com/frequently-asked-questions-and-answers) - [When To Get A Lawyer](https://www.spinalcord.com/your-guide-to-knowing-when-to-get-a-lawyer) - [Organizing Life From A Hospital](https://www.spinalcord.com/blog/traumatic-injury-digital-tools-organize-from-hospital) - [Free Brain and Spinal Cord eBooks](https://www.spinalcord.com/spinal-cord-resources) - [Spinal Cord Infographics](https://www.spinalcord.com/infographics) - [SCI Life Uncovered Podcast](https://www.spinalcord.com/sci-life-uncovered/episode-1) - Local Resources - [Florida Spinal Cord Injury Resources ](https://www.spinalcord.com/florida-sci-resources) - [Local Assistance](https://www.spinalcord.com/florida-personal-injury-claims) - [Map of State Resources](https://www.spinalcord.com/state-programs) - [Community](https://www.spinalcord.com/spinal-cord-injury-community) - [Trusted Organizations](https://www.spinalcord.com/trusted-by-the-spinal-cord-injury-community) - [Events Calendar](https://www.spinalcord.com/events) - [Podcast](https://www.spinalcord.com/sci-life-uncovered/episode-1) - Recognition - [Best of Awards](https://www.spinalcord.com/best-of-awards) - [Trusted By Designation](https://www.spinalcord.com/trusted-by-the-spinal-cord-injury-community) - [** ](tel:8773367192) - [** ](https://www.spinalcord.com/blog/what-to-know-about-c4-spinal-cord-injury#) - [** **(877) 336-7192** ](tel:8773367192) - [** **Contact Us** ](https://www.spinalcord.com/contact-us) # What You Should Know about C4 Spinal Cord Injuries Author: [Spinal Cord Team](https://www.spinalcord.com/meet-our-authors) Publish Date: December 01, 2020 There is a lot to learn and know about any type of spinal cord injury (SCI) — everything from the effects of a spinal cord injury to a survivor’s potential rate of recovery to how the injury impacts their daily life. Every level of the cervical spinal cord that remains uninjured means an increased likelihood of the individual achieving a higher level of recovery. ![SCI-patient-in-wheelchair-being-pushed-by-nurse](https://www.spinalcord.com/hs-fs/hubfs/Blog-Images/SCI-patient-in-wheelchair-being-pushed-by-nurse-min.jpg?width=300&name=SCI-patient-in-wheelchair-being-pushed-by-nurse-min.jpg) Have you or someone you love sustained a traumatic [C4 spinal cord injury](https://www.spinalcord.com/c3-c4-c5-vertebrae-spinal-cord-injury)? Our goal in this article is to provide you with the information you need to know about [cervical spinal cord injuries](https://www.spinalcord.com/cervical-spinal-cord-injury) affecting the C4 vertebral region, how they differ from other SCIs, and what recovery from C4 spinal cord injuries can entail. ## **What Is a C4 Spinal Cord Injury?** According to [Johns Hopkins Medicine](https://www.hopkinsmedicine.org/healthlibrary/conditions/physical_medicine_and_rehabilitation/spinal_cord_injury_85,p01180), cervical and thoracic spinal cord injuries are the most common types of spinal cord injury. A cervical spinal cord injury is considered the most severe and deadly type of SCI. This is because the higher up the damage occurs on the [spinal cord](https://www.spinalcord.com/what-is-the-spinal-cord), and the more complete the injury, the higher the risk of complete paralysis and death. A C4 spinal cord injury occurs when damage is dealt about mid-way down the cervical spinal cord — the topmost portion of the spinal cord that is located in the neck and upper shoulders. ## **Complete vs. Incomplete C4 Spinal Cord Injuries** Although the term “incomplete” generally has a negative connotation, in the case of a spinal cord injury, an incomplete spinal cord injury may preferable. [Incomplete spinal cord injuries](https://www.spinalcord.com/incomplete-spinal-cord-injury) run the gamut, however — [they can be mild](https://craighospital.org/resources/incomplete-spinal-cord-injuries-the-early-days) in the sense that they cause little to no muscle weakness, or they can be so severe that they are nearly indistinguishable from a [complete SCI](https://www.spinalcord.com/complete-spinal-cord-injury). ## **Symptoms and Complications from a C4 Spinal Cord Injury** Depending on the level and type of SCI sustained, some of the symptoms and secondary complications will vary. Survivors of a C4 spinal cord injury may experience any or all of the following: - A limited range of motion below the injury site; - Quadriplegia or tetraplegia — paralysis in the hands, arms, torso, and legs; - Bladder or bowel function issues; - Loss of control of the abdominal and intercostal muscles in the torso, eliminating the ability to cough or sneeze; and - Retention of some head and neck mobility, as well as limited shoulder movement. When someone suffers a cervical spinal cord injury at the C4 level or higher, they may need a personal care assistant to help with everyday tasks such as getting out of bed, getting dressed, bathing, and eating. They may also require a ventilator to provide breathing assistance because this section of the spinal cord plays a role in the control and function of the diaphragm. The diaphragm, a major muscle that enables breathing, is controlled by the phrenic nerve. According to Joseph Krainin, M.D., a board-certified sleep medicine physician, the [phrenic nerve](https://www.spinalcord.com/blog/sleep-disordered-breathing-in-the-cervical-spinal-cord-injury-patient) is comprised of inputs from the C3, C4, and C5 nerve roots (primarily C4). One of the conditions that can result from a C4 spinal cord injury is known as sleep-related hypoxemia. According to a [2019 study](https://pubmed.ncbi.nlm.nih.gov/30321507/) on sleep disordered breathing (SDB) in people with spinal cord injuries, "Individuals living with spinal cord injury or disease (SCI/D) are at increased risk for sleep-disordered breathing (SDB), with a prevalence that is three- to fourfold higher than the general population." ## **How a C4 Cervical Spinal Cord Injury Differs from Other SCIs** The further down the spinal cord injury occurs, the greater the chance of recovery for the patient. For example, someone with a C1 or C3 spinal cord injury will have more limitations than someone with C6 spinal cord injury. [Each level of the cervical spinal cord](https://www.spinalcord.com/blog/4-ways-to-cope-with-a-c4-spinal-cord-injury-vs.-a-c6-spinal-cord-injury) controls different functions throughout the body as part of the body’s central nervous system (CNS). This means that, even though the injuries occur within close nerve proximity, someone with a C4 spinal cord injury will have a different outcome than someone with a C6 spinal cord injury. ## **C4 Spinal Cord Injury Treatment and Recovery** Every spinal cord injury is different. Two people with the same level of spinal cord injury can have significantly different experiences, limitations, and levels of recovery. Much of the success of a patient’s C4 spinal cord injury recovery is dependent on the level of medical care they receive immediately following the incident. The neck and spinal cord must be stabilized as much as possible, and medications or surgery may be necessary to help reduce swelling and inflammation. Other C4 spinal cord injury treatment options include [epidural electrical stimulation](https://www.spinalcord.com/blog/electrical-stimulation-helps-paralyzed-man-move-legs), participation in experimental stem cell research, [cold therapy](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101829/) (therapeutic hypothermia), and engaging in [activity-based therapy sessions](https://www.spinalcord.com/blog/topic/activity-based-therapy) ### **Remember: You Are Not Alone and Have Access to SCI Information and Support** We are here for you. SpinalCord.com is an [online community](https://www.spinalcord.com/spinal-cord-injury-community) for spinal cord injury survivors and their families. We provide a wealth of useful information, news about SCI research, and information about a person’s legal rights after sustaining a spinal cord injury. Sponsored by [Swope, Rodante P.A.](https://www.swoperodante.com/), a catastrophic injury law firm based in Florida, this site aims to serve as an informational resource for people with catastrophic injuries. To learn more about coping with a spinal cord injury, including a cervical spinal cord injury, be sure to check out our complimentary guide by clicking on the link below. [![New Call-to-action](https://no-cache.hubspot.com/cta/default/575040/d59d2232-0b56-4b13-a195-eab292389dfa.png)](https://cta-redirect.hubspot.com/cta/redirect/575040/d59d2232-0b56-4b13-a195-eab292389dfa) **Topics:** Spinal Cord Injury, Research ### Stay Updated on Advancements On Traumatic Brain & Spinal Cord Injuries About the Author #### Spinal Cord Team The authors of Spinalcord.com are made up of attorneys, those in the medical field, and survivors of spinal cord injuries or traumatic brain injuries. Learn more about our team of authors including a brief biography that explains how they impact the SCI and TBI community. [Learn More About the Author](https://www.spinalcord.com/meet-our-authors) **Leave a Comment** [![New Call-to-action](https://no-cache.hubspot.com/cta/default/575040/dc8bc979-ba55-463a-9400-f92cbdebcb1a.png)](https://cta-redirect.hubspot.com/cta/redirect/575040/dc8bc979-ba55-463a-9400-f92cbdebcb1a) true ### Spinal Cord Injury - [Types of Spinal Cord Injuries](https://www.spinalcord.com/types-of-spinal-cord-injuries) - [Secondary Complications](https://www.spinalcord.com/secondary-complications-after-sci-spinal-cord-injury) - [Causes](https://www.spinalcord.com/signs-symptoms-of-spinal-cord-injuries) - [Symptoms](https://www.spinalcord.com/types-of-spinal-cord-injuries) - [Prognosis](https://www.spinalcord.com/prognosis-of-spinal-cord-injuries) - [Legal Help](https://www.spinalcord.com/spinal-cord-injury-legal-help-get-a-lawyer) ### Brain Injury - [Types of Brain Injuries](https://www.spinalcord.com/types-of-traumatic-brain-injury) - [Causes](https://www.spinalcord.com/causes-of-traumatic-and-acquired-brain-injuries) - [Symptoms](https://www.spinalcord.com/traumatic-brain-injury-tbi-symptoms) - [Prognosis](https://www.spinalcord.com/brain-injury-prognosis-for-tbi-abi) - [Legal Help](https://www.spinalcord.com/brain-injury-legal-help-get-a-lawyer) ### Finding Treatment - [Physician Directory](https://www.spinalcord.com/brain-and-spinal-cord-injury-physician-directory) - [Rehabilitation Directory](https://www.spinalcord.com/spinal-cord-injury-hospitals-rehabilitation-directory) - [Technology Advancements](https://www.spinalcord.com/sci-technology-advancements) - [Prevention](https://www.spinalcord.com/spinal-cord-injury-prevention) ### Legal Options - [Spinal Cord Injury Lawyer](https://www.spinalcord.com/spinal-cord-injury-lawyer) - [Brain Injury Lawyer](https://www.spinalcord.com/brain-injury-lawyer) - [Types of Personal Injury Claims](https://www.spinalcord.com/types-of-personal-injury-claims) - [Where To Start](https://www.spinalcord.com/brain-spinal-cord-injury-lawyer-where-to-start) - [Local Assistance](https://www.spinalcord.com/florida-personal-injury-claims) #### [About Us](https://www.spinalcord.com/about-us) Spinal cord injuries are traumatic for patients and their families. They cause disruptive changes to every aspect of your life and there is a lot of new information to navigate and understand. Our experts have collected everything in one place to help you learn more about your injury, locate doctors and treatment centers, find financial support, and get assistance navigating your next move. [Learn More About SpinalCord.com →](https://www.spinalcord.com/about-us) ## [Contact Us](https://www.spinalcord.com/contact-us) ![logo-footer-spinal-cord.png](https://www.spinalcord.com/hs-fs/hubfs/img/logo-footer-spinal-cord.png?width=249&name=logo-footer-spinal-cord.png "logo-footer-spinal-cord.png") **  [877-336-7192](tel:8773367192) ** [support@spinalcord.com](mailto:support@spinalcord.com) [**](https://www.facebook.com/spinalcordcom) [**](https://www.linkedin.com/company/spinalcord-com/) [**](https://twitter.com/SpinalCordCom) [**](https://www.youtube.com/channel/UCAbz2AC18acXQkpMNPeDIqg) Copyright 2026 | All Rights Reserved. [Spinal Cord, Inc.](https://www.spinalcord.com) Sponsored by [Tampa personal injury lawyers](https://www.swoperodante.com/tampa-personal-injury-lawyer/) at Swope, Rodante P.A. a Florida law firm located at 1234 E 5th Ave, Tampa, FL 33605. The information provided by SpinalCord.com is not a substitute for professional medical advice, diagnosis, or treatment, see [ Disclaimer Policy.](https://www.spinalcord.com/disclaimer) [**](https://www.spinalcord.com/blog/what-to-know-about-c4-spinal-cord-injury#) [**](https://www.spinalcord.com/blog/what-to-know-about-c4-spinal-cord-injury#) ```json { "@context" : "https://schema.org", "@type" : "WebSite", "name" : "Spinal Cord, Inc.", "potentialAction" : { "@type" : "SearchAction", "query-input" : "required name=search_query", "target" : "https://www.spinalcord.com/search?q={search_query}" }, "url" : "https://www.spinalcord.com/" } ``` ```json { "@context" : "https://schema.org", "@type" : "Organization", "contactPoint" : [ { "@type" : "ContactPoint", "contactType" : "customer service", "telephone" : "+1-877-336-7192" } ], "legalName" : "Spinal Cord, Inc.", "logo" : "https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png", "sameAs" : [ "https://www.facebook.com/spinalcordcom", "https://twitter.com/SpinalCordCom", "https://www.youtube.com/channel/UCAbz2AC18acXQkpMNPeDIqg", "http://www.linkedin.com/company/spinalcord-com" ], "url" : "https://www.spinalcord.com/" } ``` ```json { "@context" : "http://schema.org", "@type" : "Article", "articleBody" : "The spinal cord is a vital part of the human body. As the vehicle responsible for carrying messages from the brain to the rest of the body and back again, even the smallest interference can be detrimental. Following a traumatic spinal cord injury, this bundle of nerves can become bruised, also known as a contusion. Because of the nature of the nervous system, any interference can constitute a serious spinal contusion, but these facts will help you dissect all of the information from the medical professionals.

\n\n

What Is a Spinal Contusion?

\n\"Signs-of-a-spinal-contusion-title-image\"\n

Much like any other bruise, a contusion can cause bleeding from local blood vessels and inflammation which, rather unlike bruises on other parts of the body, can have serious negative impacts on the spinal cord itself. Because the “blood must clot to stop the bleeding”a bruise results from contusions also increase cardiovascular risks.

\n

For example, the swelling a contusion can cause will often disrupt nerve impulses that travel from the brain to the body through the spinal cord, and the severity of this will depend upon the level of injury. Unlike a concussion, a contusion would not cause unconsciousness or a ‘blackout’, but instead cause the patient to feel a numbness or tingling in the extremities.

\n

A contusion can cause spinal compression, which happens when there is pressure on the spinal cord. This can go on to cause an array of physical symptoms such as loss of sensation in the feet, inability to use the hands and loss of sexual ability. It must be noted that not all contusions cause spinal compression, and not all spinal compression is caused by a contusion, although they do often connect this way.

\n

Warning Signs of a Serious Spinal Contusion to Watch For

\n

Firstly, doctors will try and establish what area or limb the injury has affected. Spinal contusions most often “affect the upper extremities bilaterally and also sometimes involve the lower extremities,” according to Dr. Wong, an orthopedic physician.

\n

Symptoms include “numbness, tingling, [or] electric shock-like sensations and burning in the extremities,” (American Association of Neurological Surgeons, 2016). Generally falling into the category of “spinal trauma” there are many symptoms which are similar to other forms of spinal trauma and spinal cord injury. Below are some symptoms of spinal trauma:

\n\n

Unfortunately, it is sometimes challenging to identify which symptoms are due to a spinal contusion, and which ones are the result of a spinal cord injury directly. It can sometimes require a few days or weeks for the body to recover from spinal trauma and reveal if any permanent damage is left from the accident that caused the SCI.

\n

Understanding what a contusion is, and how it can come into play following a spinal cord injury is important in order to clearly appreciate your injury, understand your diagnoses, and work toward treatment and a prognosis. Doctors can sometimes use jargon that’s difficult to understand, so the more you can educate yourself about your condition, the more control you can have in your recovery and treatment.

\n

If you still have questions about the details of the spinal cord and how it may be affected from your injury, please contact us or download our guide to understanding a spinal cord injury.", "author" : { "@type" : "Person", "name" : "Spinalcord.com Team" }, "datePublished" : "2020-12-03", "image" : "https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion", "name" : "Warning Signs of a Serious Spinal Contusion", "url" : "https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion" } ``` ```json { "@context":"https://schema.org", "@graph":[{"@type":"WebSite", "@id":"https://spinalcord.com/#website", "url":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion", "name":"Spinal Cord Inc", "description":"The spinal cord is a vital part of the human body. As the vehicle responsible for carrying messages from the brain to the rest of the body and back again, even the smallest interference can be detrimental. 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Because of the nature of the nervous system, any interference can constitute a serious spinal contusion, but these facts will help you dissect all of the information from the medical professionals.", "inLanguage":"en-US"}, { "@type":"ImageObject", "@id":"Spinalcord Logo", "inLanguage":"en-US", "url":"https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png", "width":327,"height":300, "caption":"spinal contusion"}, { "@type":"WebPage","@id":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/#webpage", "url":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion", "name":"Warning Signs of a Serious Spinal Contusion", "isPartOf":{"@id":"https://spinalcord.com/#website"}, "primaryImageOfPage":{"@id":"www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/#primaryimage"}, "datePublished":"2020-12-03T18:30:35+00:00","dateModified":"2020-12-03T18:30:35+00:00", "author":{"@id":"https://www.spinalcord.com/meet-our-authors"}, "description":"The spinal cord is a vital part of the human body. As the vehicle responsible for carrying messages from the brain to the rest of the body and back again, even the smallest interference can be detrimental. Following a traumatic spinal cord injury, this bundle of nerves can become bruised, also known as a contusion. Because of the nature of the nervous system, any interference can constitute a serious spinal contusion, but these facts will help you dissect all of the information from the medical professionals. What Is a Spinal Contusion? Signs-of-a-spinal-contusion-title-image Much like any other bruise, a contusion can cause bleeding from local blood vessels and inflammation which, rather unlike bruises on other parts of the body, can have serious negative impacts on the spinal cord itself. Because the “blood must clot to stop the bleeding”a bruise results from contusions also increase cardiovascular risks. For example, the swelling a contusion can cause will often disrupt nerve impulses that travel from the brain to the body through the spinal cord, and the severity of this will depend upon the level of injury. Unlike a concussion, a contusion would not cause unconsciousness or a ‘blackout’, but instead cause the patient to feel a numbness or tingling in the extremities. A contusion can cause spinal compression, which happens when there is pressure on the spinal cord. This can go on to cause an array of physical symptoms such as loss of sensation in the feet, inability to use the hands and loss of sexual ability. It must be noted that not all contusions cause spinal compression, and not all spinal compression is caused by a contusion, although they do often connect this way. Warning Signs of a Serious Spinal Contusion to Watch For Firstly, doctors will try and establish what area or limb the injury has affected. Spinal contusions most often “affect the upper extremities bilaterally and also sometimes involve the lower extremities,” according to Dr. Wong, an orthopedic physician. Symptoms include “numbness, tingling, [or] electric shock-like sensations and burning in the extremities,” (American Association of Neurological Surgeons, 2016). Generally falling into the category of “spinal trauma” there are many symptoms which are similar to other forms of spinal trauma and spinal cord injury. Below are some symptoms of spinal trauma: Spinal shock — or the loss of feeling or movement below site of injury (Columbia University Medical Centre, 2016) that can last between hours and weeks Loss of bladder or bowel function Difficulty breathing Muscle spasticity Difficulty understanding speech Problems with attention Memory challenges Heart rate and blood pressure problems Unfortunately, it is sometimes challenging to identify which symptoms are due to a spinal contusion, and which ones are the result of a spinal cord injury directly. It can sometimes require a few days or weeks for the body to recover from spinal trauma and reveal if any permanent damage is left from the accident that caused the SCI. Understanding what a contusion is, and how it can come into play following a spinal cord injury is important in order to clearly appreciate your injury, understand your diagnoses, and work toward treatment and a prognosis. Doctors can sometimes use jargon that’s difficult to understand, so the more you can educate yourself about your condition, the more control you can have in your recovery and treatment. If you still have questions about the details of the spinal cord and how it may be affected from your injury, please contact us or download our guide to understanding a spinal cord injury.", "breadcrumb":{"@id":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/#breadcrumb"}, "inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion"]}]}, { "@type":"BreadcrumbList", "@id":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/#breadcrumb", "itemListElement":[{"@type":"ListItem", "position":1, "item": { "@type":"WebPage", "@id":"https://spinalcord.com/", "url":"https://spinalcord.com/", "name":"Home"}}, {"@type":"ListItem", "position":2, "item":{"@type":"WebPage", "@id":"https://spinalcord.com/blog/", "url":"https://spinalcord.com/blog/", "name":"Articles"}}, {"@type":"ListItem", "position":3, "item":{"@type":"WebPage", "@id":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/", "url":"https://www.spinalcord.com/blog/signs-of-a-serious-spinal-contusion/", "name":"Warning Signs of a Serious Spinal Contusion"}}]}, {"@type":"Person", "@id":"https://www.spinalcord.com/meet-our-authors", "name":"Spinalcord Team", "image":{"@type":"ImageObject", "@id":"https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png", "inLanguage":"en-US", "url":"https://www.spinalcord.com/hubfs/Logos/spinal-cord_png.png", "caption":"Spinalcord Team"}, "description":"The authors at SpinalCord.com come from diverse backgrounds including doctors, attorneys, medical journalist, and survivors of spinal cord injuries or traumatic brain injuries. Each author brings with them different experiences and expertise which when combined provide clinically accurate information which is useful to all individuals in the spinal cord and traumatic brain injury communities. Within the content you will find citations to medical journals, scientific research, as well as national and local resources to provide immediate support to families in need of assistance. Content is reviewed and updated regularly with changes in the clinical guidelines, new resources, and fresh ways to understand the content such as videos and infographics. ." } ]} ```