Beyond Normal Ageing: Spotting the Key Signs and Symptoms of Cervical Myelopathy.
Neck pain, numbness/ heaviness in the arms, hands and legs, progressive balance problems, or repeated falls are often dismissed as a “normal” part of ageing. However, these symptoms can be signs of a serious spinal condition called Cervical Myelopathy.
Unfortunately, Cervical Myelopathy is often misdiagnosed or ignored in its early stages. Some patients live with symptoms for years, thinking it’s a usual part of ageing or “weakness with age,” only to later discover it’s a progressive spinal cord problem resulting from compression of the spinal cord in the neck, leading to gradual and often irreversible neurological damage if left untreated.
What is Cervical Myelopathy?
The cervical spine refers to the neck or portion of the spine comprising the first seven vertebrae (C1 to C7). Inside this bony column lies the spinal cord, the delicate bundle of nerves that carries messages between your brain and body.
Cervical Myelopathy refers to a state of dysfunction of the spinal cord resulting from either compressive or non-compressive causes. The compression may develop gradually over years or more acutely with a rapid onset and progression of symptoms.
Common causes include:
- Degenerative changes such as cervical spondylosis (age-related wear and tear).
- Herniated discs/ PIVD compressing the cord.
- Ossification of the posterior longitudinal ligament (OPLL): Abnormal ossification of the tissues resulting in narrowing of the spinal canal.
- Spinal tumours originating from the bone or the neural tissue can cause compression of the cord.
- Infections such as spinal tuberculosis and pyogenic infections can cause cord compression.
- Congenital spinal stenosis results in a narrow spinal canal and early onset of compressive symptoms.
Why Cervical Myelopathy is Not Just Ageing
While age-related degeneration is the most common cause, not every neck pain in older adults is “normal.” In Cervical myelopathy, the key difference is spinal cord involvement, meaning the nerves controlling your arms, legs, bladder, and bowel may all be affected.Dismissing symptoms as “just ageing” can delay diagnosis and treatment. Unlike age-related joint and muscular degeneration, cervical myelopathy worsens over time, resulting in relatively irreversible changes in the structure and function of the nerves and in advanced stages, may not improve even with surgical intervention.
Key Signs and Symptoms of Cervical Myelopathy
Recognising the signs and treating the disease early can make the difference between halting disease progression and restoring mobility vs lifelong disability.
1. Neck Pain and Stiffness
Persistent neck discomfort that feels deep and aching. Symptoms may worsen with activity, poor posture, or trivial trauma.
2. Numbness and Tingling in Hands and Feet
Often starting in the fingertips, this “pins and needles” sensation/ numbness may spread to the arms or legs.
3. Weakness in Arms or Legs
You may notice your grip becoming weaker, objects slipping out of your hand, or your legs feeling heavy on walking/ climbing stairs.
4. Loss of Fine Motor Skills
Difficulty buttoning a shirt, changes in your handwriting/ signature, or picking up small objects.
5. Balance and Walking Problems
A feeling of unsteadiness or a tendency to trip on uneven ground or while climbing stairs. In advanced stages, it might be difficult to walk steadily even on flat ground.
6. Changes in Reflexes
Overactive reflexes in the knees or ankles may be detected by a doctor during examination.
7. Bowel or Bladder Disturbances
In advanced cases, loss of control over bladder or bowel function can occur.
Other Conditions That Can Mimic Cervical Myelopathy
Several other serious spine conditions can cause similar symptoms and must be ruled out:
- Neurological Disorders like Parkinsonism, Multiple Sclerosis, Syringomyelia, etc.
- Peripheral Neuropathy, which may be due to uncontrolled Diabetes Mellitus or Vitamin B12 deficiency.
- Non-compressive Myelopathy like Transverse Myelitis
When to Worry: Red Flags You Should Never Ignore
You should seek immediate expert advice if you experience:
- Progressive or rapidly worsening weakness in arms or legs.
- New onset numbness, heaviness or tingling in arms or legs.
- Difficulty walking, maintaining balance or frequent falls.
- Loss of fine motor function of the hand, like changes in signature/ handwriting, difficulty buttoning your shirt
- Loss of bladder or bowel control.
- Neck pain with fever, night sweats, loss of appetite or unexplained weight loss (possible spinal infection).
Understanding How Cervical Myelopathy Is Diagnosed
A spine specialist like Dr. Archit Goyal will typically recommend:
- A comprehensive history to understand patient complaints
- Clinical examination to assess neurological function.
- An MRI scan is the most accurate for assessing spinal cord compression.
- X-rays to check for bone changes or instability.
- Blood tests are performed if an infection (like tuberculosis) is suspected.
Early diagnosis is vital because nerve damage caused by prolonged spinal cord compression may be irreversible.
Treatment Options
Treatment depends on severity and underlying cause:
- Mild Cases: May be monitored with lifestyle changes, physiotherapy, and medications to reduce symptoms.
- Moderate to Severe Cases: Surgical decompression is often required to relieve pressure on the spinal cord.
- Treating the cause is pivotal to effective and quality care.
Why Early Specialist Care Matters
Many patients with cervical myelopathy are first seen by general practitioners or treated for “age-related neck pain” for months before being referred to a specialist. This delay can cause permanent disability.
A Spine Specialist & Orthopaedic Surgeon in Delhi, Dr. Archit Goyal, has extensive experience in diagnosing and treating complex cervical spine conditions, ensuring patients receive the correct care at the right time.
Cervical myelopathy is not just a part of getting older. If you or a loved one has persistent neck pain, numbness, weakness, or balance problems, don’t ignore it. The earlier you seek specialist care, the better your chances of avoiding irreversible spinal cord damage.
‘The right treatment at the right time can change the outcome’
Dr. Archit Goyal
Spine Specialist & Orthopaedic Spine Surgeon, Delhi
https://drarchitgoyal.com
