What Is Myelopathy?
Myelopathy is dysfunction of the spinal cord caused by compression, inflammation, injury, or another disease process. The old site emphasized that cervical myelopathy is common in adults; PPSI keeps that focus because neck-level compression can affect the arms, hands, legs, balance, and bladder.
Why It Happens
- Degenerative stenosis and spondylosis: Bone spurs, thickened ligaments, and disc collapse narrow the spinal canal.
- Herniated discs: Disc material can press directly on the cord.
- Trauma: Falls or accidents can worsen pre-existing narrowing.
- Inflammatory, infectious, or tumor-related causes: Less common, but considered when symptoms or imaging suggest them.
Symptoms to Take Seriously
Myelopathy may cause hand clumsiness, dropping objects, trouble buttoning clothes, balance problems, leg stiffness, numbness, weakness, electric-shock sensations with neck movement, falls, or bowel and bladder changes. Progressive weakness, new walking difficulty, or bladder changes should be evaluated urgently.
Diagnosis
PPSI evaluates reflexes, strength, sensation, gait, balance, and hand coordination. MRI is often the key test because it shows the spinal cord, discs, ligaments, and canal narrowing. X-rays may assess alignment and instability. EMG/NCS can help separate cord compression from peripheral nerve problems when symptoms overlap.
Treatment Options
Treatment depends on severity. Mild, stable symptoms may be monitored with activity precautions, physical therapy focused on safe mobility, medication guidance, and fall-prevention planning. Moderate or progressive myelopathy often requires spine surgery consultation because injections do not remove pressure from the spinal cord. Pain-focused treatments may still help related neck, shoulder, or nerve pain, but cord protection comes first.
PPSI Care Path
We separate pain control from neurologic risk. If signs point to cord compression, we prioritize imaging review and surgical referral while coordinating supportive care. Patients receive clear guidance on activities to avoid, symptoms that require urgent care, and realistic next steps.
Frequently Asked Questions
Is myelopathy the same as radiculopathy?
No. Radiculopathy affects a nerve root. Myelopathy affects the spinal cord and is usually more urgent.
Can physical therapy cure myelopathy?
PT can support balance and function in selected cases, but it cannot decompress the spinal cord when structural compression is significant.
When should I seek urgent care?
New weakness, repeated falls, rapidly worsening balance, numbness spreading into both arms or legs, or bowel or bladder changes need urgent evaluation.