A fall may be serious if the person is unconscious, has concerning symptoms like nausea or severe headache, or experiences bleeding that won’t stop with pressure or a loss of feeling.

Falls are among the most common causes of injury in the United States and the most common causes of traumatic brain injuries. According to a 2016 research review, anywhere from 7 to 36 percent of falls occur on stairs.

Additionally, an average of slightly more than 1 million people were treated in emergency departments annually for falls on stairs between 1990 and 2012, according to a 2017 study.

The study above also noted that while the majority of stair falls occur among people ages 11 to 62, the most serious injuries stemming from these incidents affect young children and older adults.

While some stair falls result in obvious head injuries or hip fractures that necessitate an emergency room visit, it’s sometimes hard to know whether a fall down the stairs is serious enough to require medical attention.

After a fall, there are obvious signs that a trip to the emergency department is necessary. Here are some things to look out for:

Signs of a serious condition

  • If someone is unconscious, call 911 immediately. Even if the individual comes to and seems fine, get that person to an emergency department for a concussion evaluation and a complete medical evaluation.
  • Seek medical help immediately, if someone is experiencing a severe headache, nausea and vomiting, or confusion.
  • Some injuries may cause severe bleeding that won’t stop after at least 15 minutes of pressure or there may be an obvious fracture. These conditions are considered emergencies.
  • If a fall has caused a loss of feeling in any of the extremities, or someone finds it difficult to walk or speak, that person should be evaluated by a doctor immediately.

If you fall and you are alone in the home, there are a few things you can do:

  • If you are conscious, but alone and unable to reach or use your phone, call out loudly for help.
  • If possible, slap the stairs or floor with a shoe or otherwise make as much noise as you can.
  • You should also try to get to a safe, comfortable space to wait for help. This may mean moving off the stairs if you aren’t on a flat surface.
  • If you feel that moving will cause further injury, then stay put and wait for help.

Many stair-related injuries don’t necessitate a visit to a hospital emergency department. They may need medical attention at some point, however.

Stair-related injuries to your lower body are the most common injuries, followed by injuries to your head and neck.

Sprains and strains

According to a 2017 study, sprains and strains account for about one-third of stair-related fall injuries. An ankle sprain or knee sprain occurs when your ligaments that stabilize your joint stretch or tear.

A fall can also cause a muscle strain, an injury in which a muscle is overstretched, sometimes to the point of being torn. A fall can trigger strains in your:

  • legs
  • arms
  • neck
  • back

Leg pain

Leg pain from a fall-related injury may be caused by an injury to your knee or ankle or one of your larger muscles in your leg, including your:

  • quadriceps
  • hamstring
  • calves

Back pain and buttocks bruise

Back pain is a common complaint after a fall. It may be due to a muscle injury or a herniated disk.

A herniated disc happens when one or more of the cushions in between your vertebrae tears or otherwise allows the inner portion of your disk to slip out. That’s why this injury is sometimes called a slipped disk.

A fall down the stairs in which you land hard on your buttocks can result in a painful butt bruise.

In a 2013 study of fractures caused by falls down stairs, researchers found that the risk of a foot or ankle fracture was double that of a fall from a standing position.

The study above also found that in addition to foot and ankle fractures, stair falls also pose substantial risk of fractures to your shoulder or scapula.

Among the biggest risks associated with falling down the stairs are:

  • head injuries, including concussions
  • back and spinal cord injuries
  • hip fractures and other broken bones
  • neck injuries
  • cuts and bruises

Some injuries lead to permanent disabilities. A 2016 research review of 38 studies found that hip fractures have a significant impact on older adults’:

  • medium- and long-term abilities
  • quality of life
  • performance of daily activities

If your fall down the stairs didn’t result in any serious injuries that required a visit to the emergency room, there may still be reasons to follow up with a doctor the next day or in the days or weeks after the incident.

After a fall, if you experience any of the following symptoms, contact a doctor soon as they could indicate internal injuries, concussion or spine or nerve damage:

  • back pain that worsens or continues for more than a few weeks
  • pain anywhere that is severe and doesn’t respond to over-the-counter pain relievers, such acetaminophen or ibuprofen
  • headaches that come and go or linger for days
  • heightened sensitivity to light and other stimuli
  • blurry vision that you didn’t have before
  • swelling that doesn’t subside with ice and rest
  • muscle weakness that persists
  • pain so severe it interferes with sleep
  • numbness in the extremities or in your groin

Falls can often be prevented by fall-proofing your home and taking extra measures when climbing up and down stairs. Consider the following tips:

6 tips to prevent a fall

  • Use a handrail when possible, even on short staircases. If your stairs at home have no railing, have one installed. Make sure you can grip the rail easily instead of using a thick banister that you cannot grab securely.
  • Make sure your stairs have a nonslippery surface, such as carpet. Look into nonskid treads that can be placed on wooden or metal stairs.
  • Make sure your stairs are easily visible during the day and illuminated at night.
  • Always clear the stairs of shoes or other objects that could be fall hazards.
  • Take your time climbing up and down the stairs. Be especially mindful if you wear bifocals, as they can affect your depth perception.
  • Don’t use two hands to carry objects up or down the stairs.
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If you or a loved one lives alone, and you are concerned about falls, there are a few home alert devices that can help. These days, they are more convenient and accessible than ever. A few examples include:

  • Smart speakers, like Siri and Alexa, that respond to voice commands can be programmed to call 911 when instructed, or call neighbors or family members.
  • Certain smartwatches, such as the Apple Watch, have a built-in emergency call button.
  • You can also wear a medical alert button on your wrist or around your neck. These devices include a button that can be pressed to call a switchboard. Someone with the alert company will respond and contact someone for you or call 911 on your behalf.

There are dozens of medical alert systems, so choose a system that fits your needs and budget, and has a device that you will wear all the time.

Medical alert systems cost about $30 a month. Some systems have a fall-detection feature for an extra $10 or $15 per month.

A fall down the stairs can be frightening and painful. For older adults, most falls should be evaluated by a doctor to determine whether there is a greater risk of future falls.

If you have any doubt whether you, a child, or an older adult should call a doctor after a fall, go ahead and get an evaluation.

If new symptoms develop in the hours or days after a fall, it’s best to call a doctor to rule out an injury. Sometimes serious injuries aren’t obvious at the time.