Cervical myelopathy is a condition that compresses your spinal cord. This happens due to narrowing or pressure in your cervical spine, or the neck region of your backbone. This condition is the most common cause of spinal damage in adults.
The symptoms of cervical myelopathy can start as mild, then progress. People who are diagnosed with cervical myelopathy early are usually able to stop this progression from happening. This generally leads to a better outcome.
Sometimes those early, mild symptoms are simply dismissed as typical signs of aging. That’s why it’s important to understand and be able to recognize the symptoms of cervical myelopathy.
When cervical myelopathy symptoms first appear, you might not be able to tell that someone serious is at play. According to a
- neck pain and stiffness
- limited range of motion
- fine motor clumsiness, such as difficulty holding a pen or counting out change
- headache that stems from nerves in your neck (occipital neuralgia)
Can cervical myelopathy symptoms come and go?
At first, cervical myelopathy symptoms may not seem too severe. You might have good days and bad days, but you probably won’t have days where your symptoms are completely absent.
Those “good days” don’t mean your condition is getting better on its own. As compression on the spinal cord increases, your symptoms will likely worsen and become more and more noticeable.
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After the initial stage, which consists mostly of neck pain and stiffness, other, more severe symptoms may begin to appear. These symptoms may include:
- difficulty walking or keeping your balance
- confusion or cognitive difficulty
- loss of bladder control
- tingling or numbness in your extremities
A 2019 study of 484 people with cervical myelopathy found that their most common symptom complaint was not neck pain. It was actually a loss of sensation in their upper limbs. These participants also reported difficulty moving their arms, legs, or both more than they reported having neck pain.
How does cervical myelopathy affect the body?
Your spinal cord delivers signals from your brain to the rest of your body. When the spinal cord is compressed, it can interrupt those signals. Over time, this compression can destroy neural tissue, the special tissue that regulates your body’s movement. That’s why cervical myelopathy impacts your range of motion and your fine motor skills in your upper extremities.
When cervical myelopathy is left untreated, it can start to impact your lower extremities, too. This can feel like losing your balance or loss of bladder control. Some people may eventually experience paralysis in their lower limbs.
Does cervical myelopathy affect the brain?
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This can feel like numbness and tingling, cognition issues (“brain fog“), and a lack of spatial awareness.
When to talk with your doctor
You should speak with your doctor right away if you suspect that cervical myelopathy is a possibility. Symptoms that warrant scheduling a doctor’s visit include:
- frequent headaches that seem to radiate from your spine or neck
- frequent neck pain and stiffness
- muscle fatigue that seems unrelated to your activity levels
- decrease in your range of motion
You may also want to speak with your doctor if you have a family history of spinal stenosis or cervical myelopathy. Some people are genetically more likely to have a narrowed spinal column.
Experts recommend surgery to correct the compression on your spine in the majority of cervical myelopathy cases. Doctors used to take a more conservative approach to surgery since. This is because, as this
A 2016 review of the literature estimated that
Anterior cervical diskectomy and fusion (ACDF) is a surgery used to remove bone spurs or damaged disks in your neck. This surgery has a relatively high success rate. If you receive this surgery before there is significant damage to your neural tissue, it can help relieve your cervical myelopathy symptoms.
A 2020 retrospective review of 219 people who had ACDF for their cervical myelopathy found that people who had the most severe symptoms pre-surgery tended to experience the most relief from symptoms afterward. However, outcomes for people with mild and moderate symptoms still appeared to be very good.
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According to one 2013 study, the progression of cervical myelopathy is unpredictable. As of this 2016 review of 60 studies, this unpredictability is why doctors now recommend surgery for almost everyone with this condition.
Your condition will progress according to the underlying cause as well as other health factors. You may see your symptoms become more intense quite rapidly. Or, your condition may stay on a steady, gradual decline for several years before you notice a sharp decrease.
Your orthopedist or neurologist will be able to give you a better idea of how quickly your cervical myelopathy is progressing.
Living with cervical myelopathy
Cervical myelopathy can sometimes limit your mobility and affect almost every part of your life. But it doesn’t have to cut you off from support. There are thousands of people going through the same thing that you are. You may find it helpful to reach out them:
- Myelopathy.org runs a private Facebook group and support group. They also raise awareness by collaborating with researchers.
- Spine Nation offers several support groups as well as other resources for those with spine conditions.
- The United Spinal Association runs a peer support network for those with spinal injuries and disorders.
Cervical myelopathy symptoms are mild in the beginning, but they can progress at an unpredictable rate. Getting an early diagnosis is the best way to prevent permanent damage to your spinal cord and the surrounding tissue.
If you are concerned about cervical myelopathy because of your symptoms, other health conditions, or family history, you should speak with your doctor to let them know that you think it’s a possibility. A full physical exam, plus a CT scan or MRI, will help you determine the next steps.