Myelopathy: Causes, Symptoms & Relief

What Is Myelopathy?

Myelopathy refers to any functional disturbance or disease of the spinal cord, typically resulting from compression, inflammation, or injury. It can affect movement, sensation, and the ability to control bodily functions. 

Most often, myelopathy arises from compression of the spinal cord due to degenerative changes in the spine, such as herniated discs, bone spurs, or spinal stenosis. Myelopathy can occur in the neck (cervical myelopathy), mid-back (thoracic myelopathy), or lower back (lumbar myelopathy), but the cervical form is the most common in adults.
Other terms you might hear include “cervical spondylotic myelopathy” or “spinal cord compression.”

Why It Happens

Myelopathy can develop from a variety of spinal and non-spinal causes. Common reasons include:

• Degenerative disc disease and spondylosis: Age-related wear and tear can cause discs to collapse and bone spurs to form, narrowing the spinal canal and pressing on the cord.
• Spinal stenosis: Progressive narrowing of the spinal canal from arthritis or thickened ligaments.
• Herniated disc: A bulging or ruptured disc can directly compress the spinal cord.
• Trauma: Fractures, dislocations, or severe injuries can damage the cord.
• Tumors: Growths inside or near the spinal canal, whether benign or malignant, can apply pressure.
• Inflammatory conditions: Diseases such as multiple sclerosis, rheumatoid arthritis, or infections can cause inflammation around the spinal cord.
• Congenital spinal canal narrowing: Some people are born with a smaller spinal canal, increasing risk.

Risk Factors

• Age over 50
• History of arthritis or disc degeneration
• Previous spinal injury or surgery
• Congenital spine conditions
• Smoking and sedentary lifestyle

Signs & Symptoms

Myelopathy often develops gradually, but symptoms may worsen over time or, less commonly, appear suddenly. Watch for:

• Loss of fine motor skills: Trouble with handwriting, buttoning shirts, or using utensils
• Clumsiness or weakness in the hands or arms
• Numbness or tingling in the arms, legs, hands, or feet
• Stiffness or weakness in the legs, often described as “heavy legs”
• Difficulty walking, frequent tripping, or balance problems
• Neck or back pain
• Loss of coordination
• Urinary urgency or incontinence, sometimes bowel changes
• Sexual dysfunction

Red-Flag Warnings (Seek Immediate Care)

• Rapid or severe progression of weakness
• Sudden loss of bladder or bowel control
• Numbness in the groin or inner thighs
• Difficulty breathing (very rare, but possible in severe cases)

Diagnosing Myelopathy

A timely and accurate diagnosis is crucial for preserving spinal cord function and preventing permanent disability. At Precision Pain & Spine Institute, you can expect:

• Detailed history & neurological examination: Assessing strength, sensation, reflexes, balance, and gait.
• Imaging:
  • MRI: Gold standard for visualizing spinal cord compression, disc herniation, tumors, or inflammation.
  • X-rays: Identify spinal alignment, bone spurs, or instability.
  • CT scans: May be used to evaluate bone detail, especially after trauma or surgery.
• Electrodiagnostic testing (EMG/NCS): If symptoms are complex or to distinguish myelopathy from peripheral nerve problems.
• Blood tests: Occasionally needed to rule out infection, inflammation, or metabolic conditions.

After your initial visit, you’ll receive a clear explanation of findings and a multidisciplinary treatment plan.

Treatment Options

Our focus is always on relieving spinal cord pressure, improving symptoms, and protecting long-term function. Treatment depends on the cause, severity, and your general health.

Conservative (Non-Surgical) Treatments

• Physical Therapy: Focused on maintaining strength, balance, flexibility, and coordination. Therapy also teaches safe movement and fall prevention strategies.
• Medications: Anti-inflammatory drugs, muscle relaxants, or nerve pain medications to manage pain and stiffness.
• Lifestyle adjustments: Ergonomic changes, mobility aids, and supportive footwear to improve safety and comfort.

Note: Conservative care may be sufficient for very mild or stable cases, but progressive myelopathy is a surgical condition - delaying surgery can result in permanent nerve damage.

Interventional and Image-Guided Procedures

• Steroid injections: May be used for short-term relief of inflammation, but do not address cord compression directly.
• Pain management procedures: For associated back or neck pain, such as trigger point or facet injections.

Surgical Treatments (If Needed)

Surgery is often the primary treatment for moderate to severe myelopathy, or when symptoms progress. Options may include:

• Decompression: Removal of bone spurs, disc herniation, or thickened ligaments (laminectomy, discectomy).
• Spinal Fusion: Stabilizes the spine if instability is present.
• Tumor removal or abscess drainage: For myelopathy from masses or infection.
• Minimally invasive techniques: Used whenever possible for faster recovery and less pain.

Your surgical plan will be customized based on your age, diagnosis, and overall health.

Living With Myelopathy

Living with myelopathy requires adjustments, but many people achieve a high quality of life with proper management:

• Engage in regular, safe exercise: Walking, swimming, or stationary biking to maintain strength and mobility.
• Fall prevention: Remove trip hazards at home, use mobility aids if needed, and practice balance exercises.
• Good posture and ergonomics: Sit with support, keep workspaces at comfortable heights, and avoid straining your neck or back.
• Supportive footwear: Prevent slips and support balance.
• Plan for daily activities: Allow extra time, use adaptive devices for dressing or grooming.
• Mental health support: Chronic neurological conditions can be emotionally taxing. Support groups, counseling, and mindfulness techniques can be beneficial.

Prevention Tips

While not all cases of myelopathy can be prevented, these strategies reduce risk and promote spine health:

• Protect your spine: Use seatbelts, avoid risky activities, and practice safe lifting techniques.
• Address back or neck pain early: Seek evaluation if pain persists or neurological symptoms develop.
• Stay active: Regular exercise maintains flexibility, strength, and balance.
• Quit smoking: Smoking accelerates disc degeneration and impairs healing.
• Manage chronic conditions: Control diabetes, arthritis, and other risk factors.
• Regular checkups: Especially if you have a family or personal history of spine problems.

How We Can Help

At Precision Pain & Spine Institute, our multidisciplinary team of board-certified spine specialists, neurosurgeons, pain management doctors, physical therapists, and rehabilitation experts collaborate to provide thorough, compassionate care for myelopathy.
We use advanced imaging, evidence-based treatment, and minimally invasive surgical techniques. Fast, same-week appointments and comprehensive support mean you don’t have to face this alone.

Frequently Asked Questions

1. Is myelopathy reversible?

Early treatment can stop progression and sometimes improve symptoms, but advanced cases may leave some lasting effects.

2. What is the difference between myelopathy and radiculopathy?

Myelopathy involves the spinal cord, causing symptoms in both arms and legs; radiculopathy affects single nerve roots, causing symptoms in a specific area.

3. Do all patients with myelopathy need surgery?

Surgery is often needed for progressive symptoms or significant compression, but some mild, stable cases may be monitored with therapy.

4. How long is recovery from myelopathy surgery?

Recovery varies by age, overall health, and surgical approach. Many patients see gradual improvement in the first weeks to months.

5. What happens if myelopathy is left untreated?

Progressive spinal cord compression can lead to permanent weakness, paralysis, and loss of bladder or bowel control. Early intervention is essential.