What should you know about tetanus onset symptoms?

Tetanus affects the nervous system and causes muscles to tighten or spasm. Early changes may begin around the jaw, making it hard to open the mouth, and can extend to the neck, back, or abdomen. Swallowing may become difficult. The entry wound may be small, healed, or not obvious, so the absence of a dramatic skin problem does not rule out concern. These symptoms can have other causes, but suspected tetanus is an emergency.

Seek emergency medical help immediately if you develop jaw stiffness, new swallowing difficulty, repeated painful tightening, or unexplained muscle spasms, particularly after a wound or when vaccination history is uncertain. Do not drive yourself if spasms or weakness make travel unsafe. Tell the medical team about the injury, the timing of symptoms, and your vaccine record. Preventive information is available in [Tetanus Vaccination](/treatments/preventive-care-and-vaccination/tetanus-vaccination/).

Call emergency services for breathing difficulty, severe or repeated spasms, inability to swallow fluids, or rapidly worsening stiffness. A wound that is red, hot, swollen, draining pus, or accompanied by fever also needs prompt clinical review, even before muscle symptoms appear.

Ask what may be causing the stiffness, whether you need hospital assessment, how the wound should be treated, and how your immunization history affects prevention.