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
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.
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
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, 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
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
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.
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
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,
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.
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
If cervical myelopathy is not treated,
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:
- cervical stenosis resources from the American Pain Association
- spinal fusion support group at Spine Nation
- national support groups for chronic pain by Pain Connection
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.