Cervical myelopathy is a term used to describe the compression of your cervical spinal cord, the long band of tissue that carries signals from your brain to the rest of your body. Depending on the cause, the compression can cause sudden or gradually worsening pain, sensory problems, loss of balance, or paralysis.

This condition is one common cause of chronic neck pain. According to a 2015 review, it’s the most common condition that causes spinal impairment worldwide.

Cervical myelopathy progresses from mild to severe symptoms. If you are able to get a diagnosis and start treatment early, you may be able to avoid corrective surgery. Let’s go over the causes, signs, and treatment options for this condition.

A 2015 review suggests that cervical myelopathy may be caused by one or a few of the following.


Cervical myelopathy can happen as the result of changes in the spine and other supportive tissues that can occur with aging and as a result of repetitive movements. As you grow older, the spinal canal may grow narrow as the tissue in your spine grows less supportive.

Cervical myelopathy is found more often in people who are 40 years or older. In a 2017 review of thousands of MRI images, researchers saw that 9.1 percent of people over the age of 70 had developed some form of cervical myelopathy. If aging is the primary cause of your cervical myelopathy, doctors may refer to it as degenerative.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune condition that affects the soft tissue between your joints. When you have RA, the tissue around the bones and cartilage in your cervical spine may degenerate, and the tissues around it can become inflamed. This can result in spinal cord compression.


A spinal injury can cause or speed up cervical myelopathy. Whiplash-type injuries can create traumatic tears in the structures supporting the spine and may cause fractures. This may cause the spine to get out of place. Some injuries can cause tissue swelling that puts pressure on the spinal cord as well.

Bone spurs

Bone spurs, also known as osteophytes, in your vertebrates can narrow your spinal canal. These smooth projections in your bones are more common in people over 60 years old and in people with osteoarthritis.


Some people are more prone to cervical myelopathy simply because they were born with a narrowed spinal canal. According to a 2015 review, people with genetic conditions like, such as Down syndrome, may also be more prone to this condition.

The symptoms of cervical myelopathy will typically start in the area of your neck. Early signs of cervical myelopathy include neck pain or stiffness.

If cervical myelopathy is untreated, the compression of the spinal cord will start to have neurological effects as well. This can cause more severe symptoms as time goes on, including:

  • weakness or tingling in your arms, shoulders, and hands
  • limited range of motion
  • weakness in your extremities
  • loss of fine motor abilities, like grasping and picking things up
  • numbness or tingling in your arms and hands
  • losing your balance
  • walking difficulties
  • sustained muscle contractions, also known as spasticity

Getting diagnosed with cervical myelopathy will require imaging tests. These procedures will determine whether you have the condition and, if confirmed, what your treatment options are. Cervical myelopathy has a much better outcome if it is diagnosed early, so make sure to talk with your doctor if you’re experiencing any unusual neck pain.

Your doctor will start by asking questions and performing a physical exam. This exam may be performed by your general practitioner or by a specialist, like an orthopedist or rheumatologist. Your sensation, muscle strength, and reflexes will be tested during this part of the diagnostic process.

If your doctor suspects cervical myelopathy, you will be referred for an MRI, an X-ray, or a CT scan called a myelogram. These tests can determine your diagnosis and if any damage to your spinal cord has already occurred.

Guidelines suggest it’s important to get treatment for cervical myelopathy. Letting the condition progress without any treatment can result in complications, like lasting pain or weakness, bone spurs, or spine fusion. This can severely limit your mobility.

Your treatment options will vary depending on how much the disease has progressed by the time you get a diagnosis.

Physical therapy for cervical myelopathy

If your cervical myelopathy is diagnosed fairly early and not progressing quickly, your doctor may prescribe physical therapy. A physical therapist may be able to help you maintain your range of motion and address neck pain and stiffness.

Doctors also usually recommend physical therapy after surgery, as part of your recovery regimen.

Pain relief options

If your symptoms are mild, corticosteroids and anti-inflammatory medications may be prescribed to help you manage pain from cervical myelopathy.

Surgery risks and benefits for cervical myelopathy

If your symptoms are progressive, severe, and surgically correctable, your doctor will most likely recommend surgery for cervical myelopathy. This surgery will aim to create more space in your spinal column and release your spinal cord from pressure.

The doctor who performs this surgery is typically a neurosurgeon. The method of surgery varies case by case. It may be that a spinal fusion is recommended. Or, a laminectomy or laminoplasty may be recommended instead. Many people who receive either surgery experience a reduction or complete resolution of their symptoms.

Doctors used to take a “wait and see” approach to cervical myelopathy. But now, clinical guidelines recommend getting the surgery as soon as it becomes clear you’re going to need it. This can help you have the best long-term outcome. Older adults and people who have already lost some nerve function may not see the same surgery benefits as others.

Like any surgical procedure, surgery to correct cervical myelopathy does carry risks, including the risk of infection. For some people who have cervical myelopathy, doctors feel that these potential risks are minimal and far outweighed by the potential benefits of the surgery.

Experts say that people with cervical myelopathy can usually expect their symptoms to progress. How quickly these symptoms progress will depend on how long you have already had the condition, as well as the factors that are causing the condition. Sometimes if the cause is small, such as a bone spur, the condition may always remain mild and never require surgery.

Physical therapy and pain management may be able to slow the progression of cervical myelopathy. The evidence is limited on how long physical therapy can delay worsening symptoms. People who have surgery to correct cervical myelopathy have the best outcomes if they get it 6 months after symptoms start or sooner, according to StatPearls.

If cervical myelopathy is not treated, guidelines say that symptoms often get worse. Rare but serious long-term serious outcomes can include having trouble walking, paralysis, and death. However, these are not typical outcomes.

Living with cervical myelopathy

People who live with cervical myelopathy may feel isolated in their pain. But there are resources where you can find people to talk with who are also living with this condition.

By connecting with other people who have chronic neck pain, you may be able to learn your treatment options, find new pain relief strategies, or just vent about the unique difficulties of having this condition.

You might find these resources helpful:

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Cervical myelopathy is a progressive condition. It can be caused by osteoarthritis, rheumatoid arthritis, injury, bone spurs, or just your genetics. Symptoms typically start with neck pain and stiffness and can progress to pain, sensory changes, and muscle weakness. Cervical myelopathy may cause spasticity at late stages.

It’s essential that you get diagnosed with cervical myelopathy as soon as possible to ensure the best outcome. Doctors now recommend surgery early on in the progression of the condition for some people. Those who are treated with surgery for cervical myelopathy often see their symptoms decrease significantly.

If you are having symptoms that you think are linked to cervical myelopathy, speak with your doctor right away. Don’t be afraid to ask questions, and ask them if you could benefit from diagnostic imaging, like an MRI or CT scan.