If you experience weakness and a loss of fine motor function in your arms and hands after neck trauma, you may have a spinal cord injury called central cord syndrome.

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Central cord syndrome is the most common form of incomplete spinal cord injury. It happens when compression of your spinal cord damages the nerves at its center — for instance, after a car accident or fall where your neck jerks abruptly and your head is forcefully tilted back.

This type of injury can disrupt communication between your brain’s cerebral cortex and the central area of your spine. The nerves in the center of your spine are mainly linked to arm and hand function, which is why you’ll most likely notice more severe symptoms in your arms than in your legs or feet.

You won’t experience full body paralysis with an incomplete cord injury as you might with a complete cord injury. With central cord syndrome, your brain can still transmit messages throughout your body — just in a more limited capacity.

Often, noninvasive approaches like rest and physical therapy will help improve your symptoms, usually within several weeks. In some cases, however, a doctor may recommend surgery.

Below, get the details on central cord syndrome, including its symptoms, treatment options, and when your care team may suggest surgery.

Central cord syndrome most commonly involves hand and arm symptoms. That said, if your injury extends to other parts of your spinal cord, you might also experience weakness in your legs and feet.

The specific symptoms you experience will depend on the extent of the damage to your spinal cord, but they often include:

Your symptoms will likely start right when your injury happens. To put it simply, as soon as something happens to disrupt the communication between your brain and body, you’ll begin to experience changes in motor and sensory function.

In some cases, your symptoms may get worse over time, during what’s called the secondary injury phase. With a secondary injury, swelling, bleeding, and inflammation add to the strain on your spinal cord. This can lead to increased loss of sensation or motor function.

A secondary injury may begin within a few minutes or hours after your original injury and can last for several weeks after the trauma.

Severity of spinal cord injuries

The American Spinal Injury Association (ASIA) grades spinal cord injuries on an alphabetical scale of severity:

  • ASIA A: This is a complete spinal cord injury with no sensory or motor function.
  • ASIA B: There’s some sensory ability but complete loss of motor function.
  • ASIA C: There’s partial motor function with limited movement. Less than half the muscle groups have a full range of motion against the force of gravity (called “anti-gravity”).
  • ASIA D: This is partial motor function. The majority of muscle groups are anti-gravity.
  • ASIA E: This is typical motor function.
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Central cord syndrome most often develops after a fall or motor vehicle accident. Most cases happen after when you fall forward and hit your chin, which causes your neck to jerk backward.

Falls commonly cause central cord syndrome in older adults, in part because existing bone changes due to conditions like cervical spondylosis or age-related weakening already raise the risk of spinal cord compression.

A high-speed impact, such as the impact you might experience in a car accident, more commonly causes this condition in younger adults. Other injuries, like ruptured discs and vertebra fractures, can complicate the condition.

Non-traumatic causes

Not all cases of central cord syndrome relate to a direct spinal injury. Other less common causes include spinal tumors and cysts.

According to an older case study from 2014, one person developed central cord syndrome after receiving treatment for an aneurysm. The study authors suggested that nimodipine, a calcium channel blocker that healthcare professionals injected into her arteries during the procedure, was the cause.

But since this was a case study, experts would need more evidence from larger studies to support nimodipine as a possible cause of central cord syndrome.

Spinal cord injuries require immediate treatment. If you experience any symptoms after a neck injury, it’s best to seek treatment at an emergency room as soon as possible.

If you have only minor symptoms and no obvious visual signs of trauma, you might feel tempted to wait, just in case your symptoms improve on their own.

But your neck contains many important nerves, and even injuries that seem minor can lead to serious or life threatening conditions or complications.

It’s also difficult to know how severe your injury is on your own.

Your care team can recommend tests to check the extent of the damage to your spinal cord and surrounding areas. These tests might include:

They can also check your medical history for any factors that might increase your chances of developing central cord syndrome.

While central cord syndrome doesn’t have a cure, many people regain most of their sensory and motor function over time — often within the first 6 weeks after the injury.

Your care team may suggest trying noninvasive treatments first, such as wearing a cervical collar to keep your neck still, along with physical and occupational therapy to help you regain motor function.

If these approaches help your symptoms improve in the weeks after your injury, you likely won’t need surgery.


Many medical professionals, however, believe surgical decompression of the spinal cord may improve recovery outcomes in certain circumstances.

Your care team may recommend surgery if you have:

  • ongoing spinal cord compression
  • spinal instability
  • fractures
  • disc herniation or dislocation
  • a major decline in nerve function

Some evidence suggests that delayed surgery and immediate surgery have similar outcomes. So, if you’d like to give your symptoms time to improve before having surgery, it may be worth asking your doctor about trying a more conservative treatment approach first.

Central cord syndrome is a type of spinal cord injury that can cause weakness and loss of sensation in your arms and hands. This injury often happens after a fall or motor vehicle accident.

Mild or moderate symptoms often improve within a few weeks, and you may regain most of your motor and sensory function.

Your care team may recommend surgery for injuries that involve ongoing spinal compression or severe loss of function and sensation.