Stages of tetanus

Tetanus develops when toxins from bacteria affect the nervous system, often after contamination of a wound. The first signs may be stiffness or difficulty opening the mouth, followed by tightness in the neck, abdomen, or back. Painful spasms can then spread or become triggered by sound, touch, or light. Swallowing may become difficult, and severe muscle tightening can interfere with breathing. Symptoms can worsen quickly once they begin; the appearance of a wound does not reliably show whether tetanus will develop. Tetanus is a medical emergency, not an illness to monitor at home.

Clean a wound promptly with clean running water and seek medical advice for deep, puncture, crushed, dirty, or burn wounds. Tell the clinician when the injury happened and when you last received a tetanus vaccine. Do not wait for stiffness or spasms before asking for advice. [Tetanus Vaccination](/treatments/preventive-care-and-vaccination/tetanus-vaccination/) can prevent disease, and a clinician may recommend a booster or additional protection according to the wound and your immunisation history. Do not close a contaminated wound yourself or put unclean substances into it.

Go to emergency care immediately for jaw locking, trouble swallowing, painful muscle spasms, rigid muscles, unusual arching of the back, or any breathing difficulty after a wound. Call emergency services if spasms are severe, repeated, or associated with a change in alertness. A wound can require urgent assessment even when it looks small, particularly if vaccination history is incomplete or unknown.

Ask whether your wound needs professional cleaning, whether your vaccine record is up to date, which preventive treatment is appropriate, and what symptoms should send you straight to emergency care.